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Aligning Organizational Culture and Infrastructure to Support Evidence-Based Practice
Kristina Ost1, Casey Blalock1, Mary Fagan1
1Kristina Ost is a clinical educator, Casey Blalock is a clinical nurse specialist, Mary Fagan is Vice President for Patient Care Services and Chief Nursing Officer, and Kathleen M. Sweeney is Manager, Clinical Education and Development, Rady Children's Hospital-San Diego, San Diego, California.
Abstract:
Standardized nursing practice based on the foundations of evidence-based practice leads to high-quality patient care and optimal outcomes. Despite knowing the benefits of evidence-based practice, health care organizations do not consistently make it the standard of care; thus, implementation of evidence-based practice at the system level continues to be challenging. This article describes the process adopted by a facility in the Southwest that took on the challenge of changing the organizational culture to incorporate evidence-based practice. The organization met the challenges by identifying perceived and actual barriers to successful implementation of evidence-based practice. The lack of standardized practice was addressed by developing a group of stakeholders including organizational leaders, clinical experts, and bedside providers. Changing the culture required a comprehensive process of document selection and development, education, and outcome evaluation. The ultimate aim was to implement an integrated system to develop practices and documents based on the best evidence to support patient outcomes.
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