Evidence-Based Practice and the Quadruple Aim

Evidence-Based Practice and the Quadruple Aim

Assignment: Evidence-Based Practice and the Quadruple Aim Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs. More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions. To Prepare: Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources. Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare. Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery. To Complete: Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim. Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of: Patient experience Population health Costs Work life of healthcare providers Evidence-Based Practice and the Quadruple Aim


How evidence-Based Practice (EBP) Might Help in the Achievement of the Quadruple Aim

The fact that evidence-based practice or EBP is the current driving force behind all interventions and therapeutics in all areas of healthcare practice cannot be questioned. EBP means that only those interventions that have been scholarly and scientifically proven to be effective are employed when caring for patients. The rationale behind this is that an intervention with proven evidence of efficacy has the highest chance of bringing about the best patient outcomes (Melnyk & Fineout-Overholt, 2019; Crabtree et al., 2016). The United States healthcare system is one of the most expensive in the world. Paradoxically, however, it is also one of the most inefficient with healthcare outcomes such as patient experience, safety of care, readmissions, and effectiveness of care scoring very poorly. To try and improve the US healthcare system, therefore, the so-called Triple Aim comprising of three objectives (1. improvement of the care experience, 2. improvement of the health of patient populations, and 3. reduction of per capita cost of healthcare) was formulated (Berwick et al., 2008). Later, a fourth aim (providing an attractive and safe work environment for healthcare workers) was added when it was realized that the happiness of healthcare workers was a common denominator to all the initial three aims. This made it the Quadruple Aim (Feeley, 2017; Sikka et al., 2015). This paper is about how EBP can help in achieving the quadruple aim.

How EBP Can Help Achieve the Quadruple Aim

Because EBP relies on only healthcare interventions proven efficacy, it is best placed to help in improving the healthcare system and actualizing the Quadruple Aim. This is how it can be harnessed to achieve this goal for each of the four objectives in the Quadruple Aim:Evidence-Based Practice and the Quadruple Aim

  1. Patient Care Experience

The experience of care by patients is measured by patient satisfaction surveys. What s measured is the patient’s perception of the quality of care they received. It is a good measure of whether a country’s healthcare system provides care that is timely, safe, effective, efficient, patent-centered, and equitable. Adopting EBP will therefore ensure that the care given has proven efficacy and meets all the six domains of healthcare stated above.

  1. Population Health

This aim targets the improvement of the health of entire populations. To achieve this goal, the care given in a country such as the US must be timely, safe, and effective. A population in good health is a population that is productive. Improving the health of populations therefore means reducing morbidity and mortality in that population. But the reduction of morbidity and mortality requires the use of interventions that possess proven efficacy. This evidence for efficacy can only be provided through scholarly research that is peer-reviewed. This is exactly what EBP will provide (Melnyk & Fineout-Overholt, 2019).

  • Per Capita Healthcare Costs

High cost of care is the most important factor in determining the access to healthcare of different socioeconomic classes of Americans. In order to improve the healthcare system of the country and to take care of the poor as well, per capita cost of healthcare must be brought down. Measures that can achieve this goal must however be proven to be effective. The only kind of practice that can use these measures with proven efficacy is EBP.

  1. Work Life of Healthcare Providers

Better patient outcomes and patient safety are both direct functions of the psychological health and wellbeing of the healthcare worker. The provision of a conducive work environment with psychological safety for the healthcare workers is a necessity for the above three goals (the original Triple Aim) to be achieved. EBP will help with the employment of only those measures with proven effectiveness to advance safe and healthy work practices. Evidence-Based Practice and the Quadruple Aim


EBP is the best approach to employ in the quest to achieve the Quadruple Aim. This is because it relies on and uses peer-reviewed scholarly research evidence to back care.


Berwick, D.M., Nolan, T.W., & Whittington, J. (2008). The triple aim: Care, health, and cost. Health Affairs, 27(3), 759-769. https://doi.org/10.1377/hlthaff.27.3.759

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving patient care through nursing engagement in evidence-based practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. https://doi.org/10.1111/wvn.12126

Feeley, D. (2017). The triple aim or the quadruple aim? Four points to help set your strategy. Institute for Healthcare Improvement. http://www.ihi.org/communities/blogs/the-triple-aim-or-the-quadruple-aim-four-points-to-help-set-your-strategy

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.

Sikka, R., Morath, J.M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in work. BMJ Quality & Safety, 24(10), 608-610. http://dx.doi.org/10.1136/bmjqs-2015-004160

Evidence-Based Practice and the Quadruple Aim