Lecture Notes: Evidence-Based Practice and the Stevens Star Model
Introduction
- Speakers:
- Kathleen Stevens: Professor, University of Texas Health San Antonio, pioneer in evidence-based practice
- Ethan Schuler: Acute Care Nurse Practitioner, Boston Children’s Hospital
- Purpose: Transforming healthcare with evidence-based practice for better patient outcomes
Kathleen Stevens' Contributions
- Founding director of the Academic Center for Evidence-Based Practice
- Generated $12 million for evidence-based quality improvements
- Initiated annual Summer Institute on Evidence-Based Practice
- Member of several prestigious boards and associations
Development of the Stevens Star Model
- Inspiration: Desire to move research directly into patient care
- Historical Context:
- 1999 Institute of Medicine report "To Err is Human"
- Followed by "Crossing the Quality Chasm" introducing STEEEP principles
The Stevens Star Model
- Discovery Research: Origin of research on interventions
- Evidence Summary: Synthesizing multiple research studies
- Translation into Guidelines: Creating clinical practice guidelines
- Practice Integration: Hardwiring new practices into standard care
- Evaluation: Assessing the impact on clinicians, patients, and outcomes
Effective Strategies for Evidence-Based Practice
- Interdisciplinary Collaboration: Engaging different stakeholders
- Practice Facilitation: Employing champions, setting standards, audit feedback
- Patient Involvement: Essential in making health decisions and preferences
Implementation Science
- Future Outlook: Expected growth in principles and methodologies
- Challenges: Establishing effective change management
- Theories: Over 60 theories on implementation; consolidation expected
Change Management and Organizational Culture
- Key Stakeholders: Clinicians, care teams, organizations, policy makers
- Team-Based Approach: Essential for comprehensive care delivery
- Creating a Culture of Trust: Crucial for adapting evidence-based practices
Sustaining Change
- Evaluation and Reinforcement: Ensuring continued adherence to new practices
- Return on Investment: Both financial and qualitative benefits
Advice for New Nurses
- Leadership and Followership: Balance between leading change and supporting it
- Steps to Change Management:
- Create urgency
- Build guiding teams
- Develop change vision
- Empower others
- Short-term wins
- Sustainability: Reinforcement through evaluation and feedback
Conclusion
- Emphasis on interdisciplinary collaboration
- Importance of adapting to change with evidence-based practices
- The role of nurses and healthcare teams in improving patient care
Questions for Reflection
- What facilitates evidence-based practice in your facility?
- How do you handle the review of clinical practice guidelines in your institution?
This lecture highlights the importance of implementing evidence-based practices in healthcare settings, as well as the significant role that nurses and interdisciplinary teams play in transforming patient outcomes through research and systematic methodologies. The Stevens Star Model provides a structured approach to integrating research into practice, ultimately aiming for improved healthcare quality and safety.