Evidence-Based Practice Model and Change Model

Introduction

• Providing a theoretical background for relevant models.
• ARCC model as an evidence-based practice framework.
• Kotter and Cohen’s model as a change methodology.
• Introducing the models into a clinical practice environment.
• Both models are useful change methodologies.
• Stimulating evidence-based activities is critical in clinical practice.

Evidence-Based Practice Model

• ARCC model is a recognized evidence-based practice framework.
• The role of a mentor is seen as strategically critical (Melnyk & Fineout-Overholt, 2015).
• Quality care outcomes are achieved due to an evidence base.
• Inquiry, innovation, and solutions are the model’s components (Melnyk & Fineout-Overholt, 2015).
• Advanced practice nurses are the target audience.
• System and patient outcomes are addressed effectively.
• AARC model implies covering different aspects of the change process.
• Organizational behavior is one of the target areas (Melnyk et al., 2017).
• Evidence-based practice culture is the core of amendments.
• Mentorship contributes to enhancing nurses’ professional competencies (Melnyk et al., 2017).
• Improving organizational outcomes is a natural result.
• Change initiatives help address workplace culture.

Implementing a Practice Change: ARCC Model

• AARC model is a convenient framework for a personal clinical practice environment.
• The model contributes to rallying the team (Kim et al., 2017).
• Participating in a mentoring program is a valuable perspective.
• Several steps need to completed when using the model.
• Task setting, mentors’ involvement, and educational sessions are the stages.
• A practice change implies improving professional competencies and organizational behavior.
• Task setting is a stage that consists in defining change goals.
• The necessary objectives are determined and disseminated.
• Mentors’ involvement implies organizing a specialist team.
• Relevant EBP knowledge is the main resource to utilize (Kim et al., 2017).
• Educational sessions are the final component of the program.
• Advanced nurses are the target audience of the change program.
• Utilizing the model is a convenient method of achieving numerous objectives.
• Organizational outcomes are improved through the complex initiatives.
• Communicating the necessary changes to target participants is critical.
• The organizational environment directly influences patient outcomes (Kim et al., 2017).
• Target nurses can enhance their professional qualifications.
• Achieving personal self-development is among the most important objectives.

Change Model

• Kotter and Cohen’s model is a common change framework.
• The methodology provides an advanced intervention algorithm.
• Eight change stages are the background of the model (Melnyk & Fineout-Overholt, 2015).
• Addressing different change aspects is a strength.
• Interaction with the staff is a crucial condition (Melnyk & Fineout-Overholt, 2015).
• Multi-stage allows for engaging numerous stakeholders.
• The environment for implementing transformations is critical.
• The “climate for change” should be conducive (Mahmood, 2018, p. 175).
• Employees should be motivated to participate in change projects.
• Short-term wins are essential for achieving success (Mahmood, 2018).
• Relevant performance metrics help control the effectiveness of changes.
• The team should work jointly to accomplish the goals set.

Implementing a Practice Change: Kotter and Cohen’s Model

• The stages of the model are the change background.
• Creating urgency implies communicating the need for changes.
• Forming a coalition is associated with defining the main stakeholders.
• All the participants should have a clear working vision (Baloh et al., 2017).
• Communicating the vision needs to be person-oriented.
• All the members of a practice change project should realize their roles.
• Removing obstacles should be achieved through both organizational and personnel changes.
• Short-term wins may be identified due to proper planning (Baloh et al., 2017).
• Guiding change efforts should go hand in hand with short-term wins.
• Changes can be institutionalized through formal administrative decisions.
• The model is useful for different care settings (Baloh et al., 2017).
• All the changes are accompanied by utilizing evidence-based practice.

References

Baloh, J., Zhu, X., & Ward, M. M. (2017). Implementing team huddles in small rural hospitals: How does the Kotter model of change apply? Journal of Nursing Management, 26(5), 571-578.

Kim, S. C., Ecoff, L., Brown, C. E., Gallo, A. M., Stichler, J. F., & Davidson, J. E. (2017). Benefits of a regional evidence‐based practice fellowship program: A test of the ARCC model. Worldviews on Evidence‐Based Nursing, 14(2), 90-98.

Mahmood, T. (2018). What models of change can be used to implement change in postgraduate medical education? Advances in Medical Education and Practice, 9, 175-178.

Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3^rd ed.). Wolters Kluwer.

Melnyk, B. M., Gallagher‐Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., & Tan, A. (2017). The first US study on nurses’ evidence‐based practice competencies indicates major deficits that threaten healthcare quality, safety, and patient outcomes. Worldviews on Evidence‐Based Nursing, 15(1), 16-25.