June 2009

Evidence-Based Practices: Key to Optimal Care

CHI is beginning to implement its Evidence-Based Practice-Process Improvement (EBP-PI) objective, designed to achieve one of CHI's destination metrics: to have 85% or more of care delivered across the system conform to CHI-approved evidence-based practices by 2020.

CHI's evidence-based practice is built on three components: the most current research evidence, clinical expertise and patient preference. Together, they create the foundation for CHI's EBP model, which has a goal to deliver the safest, most effective patient care. "The idea is that every patient, wherever they are in the CHI system, will consistently receive high quality care," said Marita Schifalacqua, RN, VP of evidence-based clinical practice and clinical technology. "That goal aligns with our strategic initiatives, with being One CHI, and with our dedication to doing what's best for patients."

In addition to CHI's commitment to deliver clinical care know-how that results in better patient outcomes and improves the patient experience, the EBP-PI initiative aims to improve financial returns to sustain the ministry. "This work is critical to ensuring we meet the quality measures defined by payers, now and in the future, to ensure maximum reimbursement for care provided," said Schifalacqua.

"There is tremendous leadership support for EBP-PI throughout CHI," said Kathy Sanford, RN, SVP and chief nursing officer. "That includes the Board of Stewardship Trustees and Quality Committee setting the path for EBP, the President's Council adding process improvements, the Clinical Leadership Council approving EBPs for the system, clinical leaders providing input to the scope of work and the Operations Leadership Group recommending a required set of EBPs for all MBOs."

In addition, MBO CEOs have accepted the role of EBP executive sponsor, MBO clinicians are acting as EBP leaders and subject matter experts from around the system are participating on design teams. Many MBOs also have the support of their Patient Care Advisory Councils.

All MBOs will implement six care bundles, which include 16 EBPs, during FY2010. Three more care bundles are optional.

Required EBPs

Ready for implementation in July:

  • Catheter-Associated Urinary Tract Infections (3 EBPs)
  • Healthcare-Acquired Infection Prevention (4 EBPs)
  • Surgical Never Events (2 EBPs)
  • Heart Failure (1 EBP)

Ready for implementation in October:

  • Pain Management (2 EBPs)
  • Fall Prevention (4 EBPs)

Optional EBPs

Ready for implementation in November:

  • Deep Vein Thrombosis/Pulmonary Emboli Prevention (3 EBPs)
  • Pressure Ulcer Prevention (6 EBPs)
  • Central Line-Associated Blood Stream Infection Prevention (3 EBPs)

Design teams are now working to develop toolkits and metrics to help MBOs implement and evaluate each EBP. To support CHI's philosophy of person-centered care, the design teams will involve patients in the development process by collecting their feedback on practices and materials. "We'll use the feedback to add to or redesign our EBP toolkit materials," said Schifalacqua. "Patients can lead us to insights we otherwise wouldn't have."

For more information, contact your local EBP-PI leader or Marita Schifalacqua, maritaschifalacqua@catholichealth.net