evidence based practice
Instructions
- Describe and evaluate the differences between evidence based practice and research.
- Describe the importance and application of health care information, data mining, and importance to application in patient care outcomes
- Discuss how data mining and interpretation influences case management and utilization
- Describe participation in managed care and the importance of quality care initiatives and performance indicators (remember to use AHRQ as a resource)
Parameters:
- 1000-1500 words not including the cover page and references (total, not for each topic)
- Follow the APA 7th edition for references and citations
- Include a minimum of 6 scholarly references (does not include text or websites)
- Demonstrate analysis, evaluation and synthesis of information
Sample Student Answer
Healthcare Information, Data Mining, and Healthcare Quality
The provision of quality care is highly dependent on evidence-based data. Healthcare organizations are one of the largest consumers of data, which they use to influence various administrative and clinical decisions and activities. The purpose of this paper is to elaborate on how data mining can influence the nature and quality of care in different contexts, such as case and utilization management.
Differences Between Evidence-Based Practice and Research.
Nursing is a field that is highly reliant on scientific evidence. The evidence that informs practice depends on the scientific research conducted in different fields, including some that are not health-related, including management, social sciences, and communication, to list a few. In this regard, two terms are usually confused and often mistakenly used interchangeably: evidence-based practice and research.
According to Saunders et al. (2019), evidence-based practice is a problem-solving approach that integrates the best evidence from research, patient data, clinical expertise, and patient preferences to deliver quality care. Evidence-based practice is a continuous step-by-step process that begins with asking relevant clinical questions, searching for evidence, appraising the evidence, implementing, and evaluating after implementation (Stucky et al., 2020). The purpose of evidence-based practice is to improve patient outcomes by providing the most effective care using the best available evidence.
On the other hand, research is a scholarly undertaking aimed at developing knowledge that promotes the delivery of care, improvement of health outcomes, and quality of nursing actions. Nursing research allows stakeholders to respond effectively to presenting healthcare needs (Chien, 2019). Like evidence-based practice, nursing research is also a process. While evidence-based practice is dependent on nursing research, research is not always dependent on evidence-based practice.
Application of Health Care Information, Data Mining, and Influence In Patient Care Outcomes
Nursing practice and care provision, in general, is a data-intensive venture. Nurses use data in almost all aspects of their practice. One of the most impactful information technologies in the clinical setting is electronic health records (EHR), which has helped in the collection and storage of data. The healthcare information collected through EHR has significantly helped in enhancing the quality and safety of care. Health care information collected through EHR can help improve the accuracy of interventions given to patients, including medication administration, thus reducing errors that are common in clinical settings.
Data mining and the exchange of healthcare information have also enhanced the speed at which interventions are delivered to patients. One example is during the pandemic when tracking healthcare information was used to deploy resources to most affected areas reducing the number of fatalities that could have occurred (Alsunaidi et al., 2019). Data mining also helps in providing satisfactory care that aligns with patient preferences. Organizations such as the Agency for Healthcare Quality and Research and the Centers for Medicare and Medicaid Services collect data that helps healthcare facilities to improve the quality of care they give to patients.
An example is the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Survey which gives patients the opportunity to assess healthcare providers and systems. The information collected acts as a benchmark for continuous improvement initiatives aimed at improving the delivery of care (Putri & Aini, 2021). These are some of the few examples of how healthcare information and data mining are used to enhance patient outcomes.
How Data Mining and Interpretation Influences Case Management and Utilization
Data mining allows care teams to use large amounts of raw data, turning them into useful information. Data mining in healthcare uses information and technology tools to collect patient data and use the data for decision-making, quality improvement, and ultimately enhancing patient outcomes (Kolling et al., 2021). Data mining is a great resource when it comes to case management and utilization. Case management and utilization is an evidence-based venture and highly reliant on data. This means that for case management and utilization services to be impactful, effective collection and interpretation of data is a must.
Case managers usually interact and use data to inform their decisions. Case management leadership use data collected from patients to evaluate patient needs, formulate quality improvement initiatives, allocate resources based on patient needs, including human resources, and evaluate what works and what does not both for the patient and the organization (Fallah & Niakan Kalhori, 2017). Case management leadership can use data collected through data mining to justify the continuation and discontinuation of interventions. With big data, case managers can establish patient preferences by assessing common trends and formulating plans that match those preferences.
Participation In Managed Care and The Importance of Quality Care Initiatives
Managed care is a healthcare delivery model that aims to provide effective and quality care while managing utilization and cost at acceptable levels. Managed care is usually conducted under contracted arrangements, for example, between the state governments and managed care organizations (Wallace et al., 2020). To be part of a managed care organization under the Medicaid program, states have to sign a contract with MCOs that offer healthcare services through their network of physicians, hospitals, and other care providers.
The MCO then becomes the sole provider of healthcare services for a specified duration, after which they are reimbursed by the state annually (Wallace et al., 2020). One of the ways in which healthcare costs are minimized under managed care is through negotiations between health insurance companies and healthcare organizations for lower rates in clinical procedures and tests.
The purpose of managed care organizations is to provide effective and quality care at a reduced cost. Therefore, quality care initiatives and performance indicators are crucial in achieving this goal. Continuous quality improvement initiatives allow healthcare facilities to reduce the utilization of healthcare services by promoting wellness and reducing the number of unnecessary readmissions (Aggarwal et al., 2019). However, these improvement initiatives depend on the key performance indicators to assess where the facility currently is in terms of providing effective and safe care.
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The AHRQ lists four key performance indicators that managed care organizations can use to improve the quality of care. These indicators include prevention, inpatient, patient safety, and pediatric quality indicators (AHRQ, n.d.). These evidence-based quality indicators are standardized and can be used by managed care organizations to improve their healthcare quality using readily available hospital data to measure and track performance and outcomes.
Conclusion
Evidence-based practice and nursing research are crucial in defining the quality of care given to patients. While the two terms seem similar, there are some differences in their purpose, application, and the process in which they are both undertaken. Other topics that have been a focus of this paper include data mining and how it influences patient outcomes, managed care, case management, and utilization. Data is a crucial element in decision-making, quality improvement, and understanding of patient preferences, allowing providers to deliver quality, effective and safe care to patients.
References
Agency for Healthcare Research and Quality. (n.d.). Quality Improvement and monitoring at your fingertips. https://qualityindicators.ahrq.gov/
Aggarwal, A., Aeran, H., & Rathee, M. (2019). Quality management in healthcare: The pivotal desideratum. Journal of Oral Biology and Craniofacial Research, 9(2), 180–182. https://doi.org/10.1016/j.jobcr.2018.06.006
Alsunaidi, S. J., Almuhaideb, A. M., Ibrahim, N. M., Shaikh, F. S., Alqudaihi, K. S., Alhaidari, F. A., & Alshahrani, M. S. (2021). Applications of big data analytics to control COVID-19 pandemic. Sensors, 21(7), 2282. https://doi.org/10.3390/s21072282
Chien L. Y. (2019). Evidence-Based Practice and Nursing Research. The Journal of Nursing Research 27(4), e29. https://doi.org/10.1097/jnr.0000000000000346
Fallah, M., & Niakan Kalhori, S. R. (2017). Systematic Review of Data Mining Applications in Patient-Centered Mobile-Based Information Systems. Healthcare Informatics Research, 23(4), 262–270. https://doi.org/10.4258/hir.2017.23.4.262
Kolling, M. L., Furstenau, L. B., Sott, M. K., Rabaioli, B., Ulmi, P. H., Bragazzi, N. L., & Tedesco, L. (2021). Data Mining in Healthcare: Applying Strategic Intelligence Techniques to Depict 25 Years of Research Development. International Journal of Environmental Research and Public Health, 18(6), 3099. https://doi.org/10.3390/ijerph18063099
Putri, Y. S. C., & Aini, Q. (2021). A Literature Review Inpatient Satisfaction Rate based on Composite Measured in Hospital Consumer Assessment Healthcare Providers and Systems (HCAHPS): Hospital Consumer Assessment Healthcare Providers and Systems (HCAHPS). Proceedings of International on Healthcare Facilities, 1(1), 128-145.
Saunders, H., Gallagher‐Ford, L., Kvist, T., & Vehviläinen‐Julkunen, K. (2019). Practicing healthcare professionals’ evidence‐based practice competencies: An overview of systematic reviews. Worldviews on Evidence‐Based Nursing, 16(3), 176-185. https://doi.org/10.1111/wvn.12363
Stucky, C. H., De Jong, M. J., & Rodriguez, J. A. (2020). A Five‐Step Evidence‐Based Practice Primer for Perioperative RNs. AORN Journal, 112(5), 506–515. https://doi.org/10.1002/aorn.13220
Wallace, J., Lollo, A., & Ndumele, C. D. (2020). Comparison of Office-Based Physician Participation in Medicaid Managed Care and Health Insurance Exchange Plans in the Same US Geographic Markets. JAMA Network Open, 3(4), e202727. https://doi.org/10.1001/jamanetworkopen.2020.2727
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