Learning Objective #1: Identify the core components of creating an environment for evidence-based practice in case management

Learning Objective #2: Identify improved patient outcomes related to the creation of evidence-based practice in case management

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Involving a College of Nursing in an enterprise to offer case management services provides an excellent setting for moving knowledge into practice. At the University of Oklahoma College of Nursing, the case management effort sought out "best practice" for its case management team of 65 members to foster independence and improve the quality of care in home dwelling elders. However, initial attempts to assure this process were an organizational struggle and lacked a uniform direction. Executive leaders arrived at a possible solution by appointing an Evidence Based Practice Task Force, composed of site managers, registered nurse and social work case managers, and quality improvement staff from each practice site. Two members attended a national Evidence-Based Practice (EBP) Conference with training in the ACE Star Model of EBP. On return, team members held a 2-day retreat off-campus with presentations on where/how to find evidence, methods of judging the merit of evidence and sources for established EBP guidelines. The name "The Sooner Star Program" was adopted by the group. Review of case management data identified several patient care situations or diagnoses that were high risk, problem prone and high volume. An infrastructure was created to support EBP changes. Key elements in implementing change drew from Kurt Lewin's basic change model of unfreezing, changing, and refreezing. Each team member received opportunity for education and development and all were encouraged to participate. After two years, positive changes show reduced risk of caregiver burnout, decreased patient falls, and decreased admission of patients to nursing homes. Changes and benefits of EBP are "marketed" to students and other faculty.