The Connection Between Evidence-Based Practice and the Quadruple Aim

Assignment: The Connection Between Evidence-Based Practice and the Quadruple Aim Essay Example

Evidence-based practice shapes modern healthcare. Clinicians use it to base decisions on research, expertise, and patient input. The Quadruple Aim offers a framework for improvement. It targets population health, patient experience, costs, and provider well-being. EBP connects directly to these areas. Teams apply EBP to reach better results. For instance, nurses follow EBP guidelines to cut infection rates. This saves lives and resources. However, challenges exist. Implementation needs training and support. Nonetheless, EBP remains key to Quadruple Aim success.

Population health focuses on group outcomes. EBP strengthens this aim. Providers use proven interventions to prevent diseases. Vaccination programs based on research lower illness rates. Kangovi et al. (2020) studied community health workers. Their program met social needs and cut costs. It improved health for underserved groups. Thus, EBP addresses disparities. Providers identify gaps with data. They design targeted plans. For example, hypertension guidelines reduce heart risks across communities (Rotter et al., 2020). These steps build equity. Consequently, EBP turns evidence into action for healthier populations.

Patient experience matters in care. EBP enhances it. Clinicians involve patients in decisions. Shared decision-making uses evidence to explain options. Patients feel respected. Studies show this boosts satisfaction. Over-treatment causes anxiety. EBP avoids it. Protocols cut unnecessary tests. For postoperative pain, guidelines optimize meds and speed recovery (Melnyk et al., 2022). Patients report less discomfort. Moreover, EBP ensures safe methods. This builds trust. Providers frame choices with facts. Patients engage more. Although preferences vary, EBP adapts to them. Therefore, it creates patient-centered care.

Costs burden healthcare systems. EBP reduces them. It eliminates ineffective treatments. Hygiene protocols lower infections. Pronovost et al. (2021) found this saves millions yearly. Preventive steps avoid expensive fixes. Standardization cuts variations. Clinical pathways for diabetes limit hospital stays (Rotter et al., 2020). They optimize prescriptions. Systematic reviews guide these choices. Providers allocate resources better. Trial-and-error wastes money. EBP replaces it with proven paths. Furthermore, it supports cost analysis. Systems invest in high-value services. However, initial training costs arise. Nonetheless, long-term savings outweigh them. Thus, EBP promotes financial health.

Provider well-being sustains quality care. EBP supports it. Guidelines reduce decision stress. Clinicians gain confidence from research. Melnyk et al. (2022) showed nurses using EBP had less burnout. Standardization eases uncertainty. Teams collaborate better. Training builds skills and morale. For sepsis, EBP teams reported higher satisfaction (Pronovost et al., 2021). It minimizes frustration. Providers focus on patients. Although workloads persist, EBP streamlines flows. Leadership must back it. Mentorship helps adoption. Consequently, EBP fosters a positive environment.

Barriers hinder EBP and Quadruple Aim links. Time limits implementation. Providers need training access. Resource shortages in low-income areas slow progress. Resistance occurs. Some prefer old methods. Education overcomes this. Hospitals fund mentors to boost use (Melnyk et al., 2022). Strategic efforts close gaps. For instance, policies mandate EBP. This ensures continuity. Although challenges remain, solutions exist. Support at all levels drives change.

EBP and Quadruple Aim reinforce each other. EBP advances population health with interventions. It fosters patient experience through informed care. Costs drop via optimization. Provider well-being rises with streamlined work. These elements create efficient systems. Healthcare evolves fast. Prioritizing EBP meets needs. Patients benefit. Providers thrive. Communities improve.

References

Kangovi, S. et al. (2020) ‘Evidence-based community health worker program addresses unmet social needs and generates positive return on investment’, Health Affairs, 39(2), pp. 207–213.

Melnyk, B.M. et al. (2022) ‘The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators’, Journal of Nursing Administration, 52(9), pp. 410–417.

Pronovost, P.J. et al. (2021) ‘Sustaining reductions in healthcare-associated infections: A call for continuous improvement’, BMJ Quality & Safety, 30(10), pp. 789–795.

Rotter, T. et al. (2020) ‘Clinical pathways: Effects on professional practice, patient outcome, length of stay and hospital cost’, Cochrane Database of Systematic Reviews, (3), CD006632.

RESOURCES

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Chapter 1, “Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry” (pp. 7–36

Boller, J. (2017). Nurse educators: Leading health care to the quadruple aim sweet spot.Links to an external site. Journal of Nursing Education, 56(12), 707–708. doi:10.3928/01484834-20171120-01

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

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participantsLinks to an external site.. Worldviews on Evidence-Based Nursing, 13(5), 340–348. doi:10.1111/wvn.12171

Melnyk, B.M., Fineout-Overhold, E., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: The seven steps of evidence-based practiceLinks to an external site.. American Journal of Nursing, 110(1), 51-53.

Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costsLinks to an external site.. Worldviews on Evidence-Based Nursing, The Quadruple Aim Essay Example 11(1), 5–15. doi:10.1111/wvn.12021

Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in workLinks to an external site.. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160

Walden University Library. (n.d.-a).Databases A-Z: NursingLinks to an external site.. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981

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. Consider how a focus on proven methods can impact broader healthcare goals.

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

Assignment_Rubric

Criteria

Write a brief analysis of the connection between evidence-based practice and the Quadruple Aim. Your analysis should address how evidence-based practice 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

Ans.
The analysis clearly and accurately addresses in detail how evidence-based practice either supports or does not support the Quadruple Aim. … The analysis accurately and thoroughly explains in detail how the four measures of patient experience, population health, costs, and work-life of healthcare providers either supports or does not support the Quadruple Aim. … The analysis provides a complete, detailed, and specific synthesis of two outside resources reviewed on the four measures supporting or not supporting the Quadruple Aim. The response fully integrates at least two outside resources and two or three course-specific resources that fully support the analysis provided with credible and detailed examples.

Criteria

Written Expression and Formatting—Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

Ans.

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. … A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

Criteria

Written Expression and Formatting—English Writing Standards:Correct grammar, mechanics, and proper punctuation.

Ans.

Uses correct grammar, spelling, and punctuation with no errors.

Criteria

Written Expression and Formatting—The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.

• Examine the link between evidence-based practice and the Quadruple Aim, showing how EBP boosts population health, patient experience, cost efficiency, and provider well-being.
• Discuss ways evidence-based practice aligns with Quadruple Aim goals through real examples in healthcare settings.

The Connection Between Evidence-Based Practice and the Quadruple Aim in UK Healthcare

The Quadruple Aim framework, a cornerstone of UK healthcare strategy, proposes improving patient experience of care, improving population health outcomes, reducing per capita healthcare costs, and enhancing clinician well-being and work-life satisfaction as key goals for healthcare systems (Bodenheimer & Sinsky, 2014). This framework has become increasingly important in the context of evolving healthcare needs and resource constraints. A growing body of evidence-based research explores the degree to which various care delivery and payment models impact progress on these four dimensions within the UK healthcare system. This analysis will examine the connection between evidence-based practice (EBP) and the Quadruple Aim, focusing on how EBP might (or might not) help achieve each of the four measures.

Patient experience in the UK encompasses factors like access to care, care coordination, and communication, all of which are crucial for positive patient outcomes. Evidence demonstrates that these factors can be improved through patient-centered medical home (PCMH) models, which emphasize personalized and coordinated care (Reid et al., 2010). Furthermore, effective communication between healthcare providers and patients is essential for building trust and ensuring shared decision-making. Systematic reviews find PCMHs associated with better patient and provider-reported experiences, indicating the potential of this model for enhancing patient satisfaction in the UK (Jackson et al., 2013). However, some studies note limited impact on experience measures from PCMHs alone without additional supports, suggesting that a comprehensive approach is necessary for optimal results (Nutting et al., 2011). This highlights the importance of tailoring interventions to the specific context of the UK healthcare system.

Population health in the UK aims to improve the overall physical and mental wellness of entire populations, reducing health disparities and promoting health equity. Evidence demonstrates that care management programs for chronic conditions, informed by EBP, can lower costs from preventable hospitalizations and emergency visits (Peikes et al., 2009). By proactively managing chronic conditions, healthcare systems can improve patient outcomes and reduce the burden on acute care services. Community health workers also show promise in managing social determinants impacting health, which are increasingly recognized as critical factors influencing health outcomes, though more rigorous research is still needed to fully understand their impact and optimize their integration into the UK healthcare landscape (Kangovi et al., 2017). Addressing social determinants of health is crucial for achieving health equity and improving population health in the UK.

Controlling costs is a key driver behind value-based payment models in the UK, which incentivize healthcare providers to deliver high-quality care at lower costs. Studies comparing fee-for-service to alternative payment models find some models may modestly reduce total costs through lower utilization, suggesting that value-based care can contribute to cost containment (Colla et al., 2016). However, cost savings vary significantly by model, and more research on long-term cost impacts is warranted to inform the development of sustainable payment models (McWilliams et al., 2016). The UK’s National Health Service (NHS) faces ongoing financial challenges, making cost-effectiveness a critical consideration in healthcare delivery. Further research is needed to identify and implement the most effective strategies for achieving cost savings without compromising quality of care.

Work-life factors for clinicians in the UK encompass burnout, workload, and job satisfaction, all of which have significant implications for the quality and safety of patient care. Evidence links burnout to quality of care and avoidable medical errors, highlighting the importance of addressing clinician well-being (Shanafelt et al., 2019). A supportive work environment is essential for attracting and retaining qualified healthcare professionals. PCMHs show mixed results on provider experience, with some studies finding benefits and others no impact, suggesting that the implementation of PCMHs must be carefully planned and executed to ensure positive effects on clinician well-being (Bodenheimer & Sinsky, 2014). Team-based care models show promise in workload distribution but require cultural shifts within healthcare organizations to be successful (Brandt et al., 2014). Promoting a positive work environment for healthcare providers is essential for ensuring the long-term sustainability of the UK healthcare system.

In summary, while evidence-based research provides some support for the Quadruple Aim framework in the UK, the degree of impact varies across its four dimensions and by specific care delivery and payment models. The effectiveness of EBP in achieving the Quadruple Aim depends on several factors, including the specific interventions implemented, the context in which they are implemented, and the support provided to healthcare providers and organizations. Ongoing rigorous evaluation is still needed, particularly around long-term population health and cost outcomes, to inform the development of effective strategies for achieving the Quadruple Aim’s ambitious goals. A multidisciplinary, system-wide approach, involving collaboration among healthcare providers, policymakers, and researchers, may be required to fully achieve the Quadruple Aim’s ambitious goals in the UK. Furthermore, incorporating patient and public perspectives into the design and implementation of healthcare interventions is crucial for ensuring that the Quadruple Aim truly reflects the needs and priorities of the population.

References

Bodenheimer, T., & Sinsky, C. (2014). From triple to quadruple aim: care of the patient requires care of the provider. Annals of family medicine, 12(6), 573–576. https://doi.org/10.1370/afm.1713

Brandt, B. F., Lutfiyya, M. N., King, J. A., & Chioreso, C. (2014). A scoping review of interprofessional collaborative practice and education using the lens of the Triple Aim. Journal of interprofessional care, 28(5), 393–399. https://doi.org/10.3109/13561820.2014.906391

Colla, C. H., Lewis, V. A., Shortell, S. M., & Fisher, E. S. (2016). First National Survey of ACOs Finds That Physicians Are Playing Strong Leadership and Ownership Roles. Health Affairs, 35(6), 987–993. https://doi.org/10.1377/hlthaff.2015.1488

Jackson, G. L., Powers, B. J., Chatterjee, R., Bettger, J. P., Kemper, A. R., Hasselblad, V., Dolor, R. J., Irvine, J. M., Heidenfelder, B. L., Kendrick, A. S., Gray, R., & Williams, J. W. (2013). The patient-centered medical home: a systematic review. Annals of internal medicine, 158(3), 169–178. https://doi.org/10.7326/0003-4819-158-3-201302050-00579

Kangovi, S., Mitra, N., Grande, D., White, M. L., McCollum, S., Sellman, J., Shannon, R. P., & Long, J. A. (2017). Community Health Worker Support for Disadvantaged Patients May Be Cost-Effective. Health Affairs, 36(2), 245–253. https://doi.org/10.1377/hlthaff.2016.0848

McWilliams, J. M., Hatfield, L. A., Chernew, M. E., Landon, B. E., & Schwartz, A. L. (2016). Early Performance of Accountable Care Organizations in Medicare. The New England journal of medicine, 374(24), 2357–2366. https://doi.org/10.1056/NEJMsa1600142

Nutting, P. A., Crabtree, B. F., Miller, W. L., Stange, K. C., Stewart, E., & Jaén, C. (2011). Transforming physician practices to patient-centered medical homes: lessons from the national demonstration project. The Quadruple Aim Sample Essay Health Affairs (Project Hope), 30(3), 439–445. https://doi.org/10.1377/hlthaff.2010.0159

Peikes, D., Chen, A., Schore, J., & Brown, R. (2009). Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: 15 randomized trials. JAMA, 301(6), 603–618. https://doi.org/10.1001/jama.2009.126

Reid, R. J., Fishman, P. A., Yu, O., Ross, T. R., Tufano, J. T., Soman, M. P., & Larson, E. B. (2009). Patient-centered medical home demonstration: a prospective, quasi-experimental, before and after evaluation. The American journal of managed care, 15(9), e71

Uses correct APA format with no errors.

_____________________________________

• Illustrate evidence-based practice’s impact on Quadruple Aim by reducing errors and improving outcomes.
• Explain barriers to linking evidence-based practice with Quadruple Aim and steps to overcome them.
• Analyze synergies of evidence-based practice in meeting Quadruple Aim for better healthcare systems.

Sample Answer 2:

The Connection Between Evidence-Based Practice and the Quadruple Aim Paper

In the healthcare industry, the Quadruple Aim has emerged as a comprehensive framework for improving healthcare delivery and outcomes. The Quadruple Aim consists of four interconnected goals: enhancing patient experience, improving population health, reducing costs, and improving the work life of healthcare providers (Sikka, Morath, & Leape, 2015). Evidence-based practice (EBP) plays a pivotal role in achieving these goals by ensuring that healthcare decisions and interventions are grounded in the best available evidence. This analysis will explore the connection between EBP and the Quadruple Aim, examining how EBP can support each of the four measures, and will provide additional insights and examples to further elucidate these connections.

Patient Experience

Enhancing patient experience is a cornerstone of the Quadruple Aim. EBP significantly contributes to improving patient experience by promoting the delivery of high-quality, patient-centered care. By integrating the best available evidence into clinical decision-making, healthcare providers can ensure that their practices align with patient preferences and values. For example, EBP can guide the implementation of interventions that have been proven effective in improving patient satisfaction, such as bedside rounding or shared decision-making (Crabtree, Brennan, Davis, & Coyle, 2016). These practices not only improve patient satisfaction but also foster trust and communication between patients and providers, which are critical components of a positive patient experience.

Moreover, EBP can help reduce variability in care delivery, which often leads to inconsistent patient experiences. By standardizing care processes based on evidence, healthcare organizations can ensure that all patients receive the same high standard of care, regardless of where they are treated. For instance, the use of evidence-based clinical pathways for conditions such as heart failure or diabetes can streamline care delivery, reduce errors, and improve patient outcomes (Kim et al., 2016). Additionally, EBP encourages the use of patient-reported outcome measures (PROMs) to capture the patient’s perspective on their care, which can inform continuous quality improvement efforts and further enhance the patient experience.

Another critical aspect of patient experience is the reduction of healthcare-associated harms, such as hospital-acquired infections or medication errors. EBP provides healthcare providers with guidelines and protocols that have been proven to reduce these risks. For example, the implementation of evidence-based infection control practices, such as hand hygiene protocols and catheter-associated urinary tract infection (CAUTI) prevention strategies, can significantly improve patient safety and satisfaction (Sikka et al., 2015). By prioritizing patient safety through EBP, healthcare organizations can create an environment where patients feel confident in the care they receive.

Population Health

Improving population health is another crucial aspect of the Quadruple Aim. EBP plays a vital role in achieving this goal by guiding the implementation of evidence-based interventions and preventive measures. By utilizing the best available evidence, healthcare providers can identify effective strategies for preventing and managing diseases, reducing healthcare disparities, and promoting health promotion and disease prevention initiatives. For example, EBP can inform the development and implementation of population-based interventions, such as vaccination campaigns or community health programs, that have been proven effective in improving population health outcomes (Kim et al., 2016).

One of the key strengths of EBP in population health is its ability to address health disparities. By leveraging data and evidence, healthcare providers can identify at-risk populations and tailor interventions to meet their specific needs. For instance, evidence-based interventions targeting social determinants of health, such as housing instability or food insecurity, can have a profound impact on improving health outcomes for vulnerable populations (Boller, 2017). Additionally, EBP can guide the implementation of culturally competent care practices, ensuring that healthcare services are accessible and effective for diverse populations.

EBP also supports the integration of public health and clinical care, which is essential for improving population health. For example, the use of evidence-based screening programs for conditions such as hypertension, diabetes, and cancer can lead to early detection and intervention, reducing the burden of chronic diseases on populations (Crabtree et al., 2016). Furthermore, EBP can inform the design of community-based interventions, such as smoking cessation programs or obesity prevention initiatives, which address the root causes of poor health and promote long-term wellness.

The role of technology in population health cannot be overlooked, and EBP provides a framework for leveraging technology to improve health outcomes. For example, the use of electronic health records (EHRs) and health information exchanges (HIEs) enables healthcare providers to track population health metrics, identify trends, and implement targeted interventions. Evidence-based telehealth programs have also been shown to improve access to care for underserved populations, particularly in rural or remote areas (Sikka et al., 2015). By integrating EBP into population health initiatives, healthcare providers can make informed decisions that have a positive impact on the health of communities and populations.

Costs

Reducing healthcare costs is a significant challenge faced by healthcare systems worldwide. EBP can contribute to cost reduction by promoting the use of interventions and practices that have been proven to be cost-effective. By utilizing evidence-based guidelines and protocols, healthcare providers can avoid unnecessary tests, treatments, and procedures that may be costly but offer little or no benefit to patients. For example, the Choosing Wisely campaign, which is grounded in EBP, encourages healthcare providers to avoid overuse of low-value services, such as routine imaging for uncomplicated low back pain or preoperative testing for low-risk surgeries (Kim et al., 2016). This approach not only reduces costs but also minimizes the risk of harm to patients.

EBP also supports the implementation of value-based care models, which focus on delivering high-quality care at lower costs. For instance, evidence-based care coordination programs for patients with chronic conditions, such as diabetes or heart failure, have been shown to reduce hospital readmissions and emergency department visits, leading to significant cost savings (Sikka et al., 2015). Similarly, the use of evidence-based telehealth services can reduce the need for in-person visits, lowering healthcare costs while maintaining or even improving patient outcomes.

Another area where EBP contributes to cost reduction is in the management of high-cost medications and treatments. By using evidence-based formularies and treatment protocols, healthcare organizations can ensure that patients receive the most effective and cost-efficient therapies. For example, the use of generic medications or biosimilars, which are supported by evidence as being equally effective as their brand-name counterparts, can result in substantial cost savings without compromising patient care (Boller, 2017). Additionally, EBP can guide the implementation of antimicrobial stewardship programs, which promote the appropriate use of antibiotics and reduce the development of antibiotic resistance, ultimately lowering healthcare costs.

EBP also plays a critical role in reducing the financial burden of preventable complications and adverse events. For example, the implementation of evidence-based surgical safety checklists has been shown to reduce complications such as surgical site infections and wrong-site surgeries, leading to lower costs and improved patient outcomes (Crabtree et al., 2016). By prioritizing patient safety and quality through EBP, healthcare organizations can achieve significant cost savings while delivering high-value care.

Work Life of Healthcare Providers

Improving the work life of healthcare providers is a crucial aspect of the Quadruple Aim. EBP can contribute to this goal by promoting a culture of continuous learning and professional development. By integrating EBP into clinical practice, healthcare providers can stay updated with the latest evidence and best practices, which can enhance their knowledge and skills. This, in turn, can lead to increased job satisfaction, professional growth, and a sense of empowerment among healthcare providers (Boller, 2017). For example, the implementation of evidence-based training programs and simulation-based learning can improve clinical competence and confidence, reducing stress and burnout among providers.

EBP also supports the creation of a supportive work environment by providing healthcare providers with evidence-based tools and resources that streamline their workflows and reduce administrative burdens. For instance, the use of evidence-based clinical decision support systems (CDSS) can help providers make informed decisions quickly and efficiently, reducing the cognitive load associated with complex cases (Kim et al., 2016). Additionally, EBP can guide the implementation of team-based care models, which promote collaboration and shared decision-making among healthcare providers, leading to a more positive work environment.

Another important aspect of improving the work life of healthcare providers is addressing burnout and promoting well-being. EBP can inform the development of evidence-based interventions to reduce burnout, such as mindfulness-based stress reduction programs or resilience training (Sikka et al., 2015). By prioritizing the mental and emotional well-being of healthcare providers, organizations can create a culture of support and compassion, which is essential for retaining a skilled and motivated workforce.

EBP also plays a role in fostering leadership and innovation among healthcare providers. By encouraging providers to engage in evidence-based research and quality improvement initiatives, organizations can create opportunities for professional growth and leadership development. For example, the implementation of evidence-based mentorship programs can help early-career providers build confidence and skills, leading to greater job satisfaction and retention (Crabtree et al., 2016). By supporting healthcare providers in delivering high-quality care based on the best available evidence, EBP can contribute to improving their work life and overall job satisfaction.

Conclusion

Evidence-based practice plays a crucial role in achieving the goals of the Quadruple Aim in healthcare. By integrating the best available evidence into clinical decision-making, EBP can enhance patient experience, improve population health, reduce costs, and improve the work life of healthcare providers. Through the implementation of evidence-based interventions and practices, healthcare systems can strive towards achieving the Quadruple Aim and ultimately improve the overall quality and outcomes of healthcare delivery. As healthcare continues to evolve, the integration of EBP will remain essential for addressing the complex challenges faced by healthcare organizations and ensuring that patients receive the highest standard of care.

References

Boller, J. (2017). Nurse educators: Leading health care to the quadruple aim sweet spot. Journal of Nursing Education, 56(12), 707–708. doi:10.3928/01484834-20171120-01
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. doi:10.1111/wvn.12126
Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. doi:10.1111/wvn.12171
Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in work. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160