Collaboration to Improve Regional Clinical Outcomes: Accelerating the Implementation of Evidence-Based Practice

The implementation of Evidence Based Practice is widely recognized as crucial to improving healthcare practice and outcomes; however, the challenges to achieving care truly based on solid evidence can be daunting. A regional collaboration was formed to accelerate the implementation of evidence based practice across the Dallas-Fort Worth, Texas metropolitan area. The initial focus was on the linking of nursing faculty with evidence based practice expertise to hospitals seeking to improve their staff members’ use of the principles and processes of evidence based practice.  From this initial focus grew an informal group of regional nursing leaders meeting periodically to discuss challenges and solutions to the implementation of evidence based practice. The collaborative group of nursing leaders next turned their focus to the development of a regional evidence based practice fellowship. This year-long fellowship, now in its eighth year, enrolls 50 – 70 nurses on an annual basis who engage in six day-long educational sessions focused on evidence based practice. The year-long fellowship culminates with a graduation day during which each participant presents their evidence based practice project in a poster format. The fellows also have the option to provide an oral presentation.

In addition to the example of the evidence based practice fellowship, this regional collaboration has also developed a focus on evidence synthesis as a strategic area of emphasis. Through affiliation with the Joanna Briggs Institute, the regional collaboration has developed expertise in evidence synthesis as a critical component in changing practice to be evidence based. The ability to not only engage in evidence synthesis, but to also provide training on evidence synthesis methodologies, has elevated the credibility of the processes used for evidence based practice in this region.

The recognition that practice changes must be evaluated has led to an initiative to evaluate the impact of the collaborative initiatives on the clinical outcomes of the region. A comprehensive evaluation process is in progress to evaluate the impact of the collaborative regional efforts.

While each of these initiatives involve individuals from various competing entities (hospitals, healthcare systems, universities, etc.), they are all housed in a Center for Evidence Based Practice and Research that is housed in a local university. The university serves as a neutral point of connection that allows competitors to interact and cooperate in ways they would not otherwise be able to accomplish. Points of difference are resolved by asking two simple questions: 1) What is best for nursing practice? 2) What is best for patient outcomes? These two simple centering questions have allowed the collaborative to move beyond points of conflict and focus on measurable clinical improvement.