Phase 3: Planning for Evaluation Table of Contents Evaluation of the Planned Change Project A clear understanding of the problem and opportunity for improvement is essential to effectively lead planne

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Phase 3: Planning for Evaluation

Table of Contents


Evaluation of the Planned Change Project

A clear understanding of the problem and opportunity for improvement is essential to effectively lead planned change. This leads to the development of a clear and measurable outcome statement to describe the intended end result of the planned change initiative. Both of these elements are pivotal for effective planning change.


Critical Role of the Evaluation Plan

Additionally, it is essential that a valid plan for evaluation of the outcome is established early on in the planning process. A plan for evaluation is necessary to define how successful achievement of the outcome will be measured. An accurate and effective evaluation plan will specifically correspond to the aligning outcome statement and will describe how successful achievement of the outcome statement will be measured.

If a clear outcome statement has been determined, the evaluation plan will naturally flow from that statement. Here are a few examples which convey the alignment between the outcome statement and the evaluation plan:


Outcome Statement


Corresponding Evaluation Plan

20% increase in the number of patients receiving the flu vaccine at Mercy Clinic by 12/31/2020 (baseline = 160 patients accepting the vaccine)

Track the number of patients receiving the flu vaccine at Mercy Clinic and compare with baseline in order to validate an increase of 20% by 12/31/2020.

25% decrease in the number of patients readmitted with CHF within 30 days at Fairfield Hospital by the end of the second quarter, 6/30/2020 (baseline = 16 patients readmitted during the first quarter)

Monitor the number of patients readmitted with CHF within 30 days at Fairfield Hospital and compare with baseline in order to validate a decrease of 25% by the end of the second quarter (6/30/2020).

20% decrease in the number of teen pregnancies at Judson High School by 6/1/2020 (baseline = 15 pregnancies)

Calculate the number of pregnancies at Judson High School and compare with baseline to verify a 20% decrease by 6/1/2020.


Elements of an Evaluation Plan

Evaluation plans describe how the project outcome will be assessed and measured, and will include each of the following components:


Component of the Evaluation Plan


Example

Outcome measure and current baseline for that measure

Outcome measure: Flu vaccine uptake among clinic patients

Current baseline

Baseline: 160 patients

Source of data

Electronic health records

Method of evaluating the outcome measure

Tracking and counting the number of people that receive the flu vaccine in the clinic

Indicator of success

192 patients (Increase of 20% by 12/31/2020 as noted above).


Helpful Reminders

As you develop an evaluation plan to correspond with the outcome for your planned change project, be sure to ask yourself the following:

  • What is the outcome measure, and do I know the current baseline?
  • What is the source of data and do I have access to that information?
  • Is there a method in place for gathering the specific data related to the indicators of success?
  • Will I have access to this data regarding the indicators for success?
  • Do I need to develop any tools to conduct the evaluation, or permission to access the necessary data to determine successful achievement of the outcome?
  • What will be the indicator of success?
  • Is the scope of the outcome and evaluation plan feasible for the time that I have in practicum?


Practicum Application and Activities

Once you have established a project outcome, or outcomes, it is essential that you develop a plan for evaluation of the outcomes. Review the

Johns Hopkins Appendix B, number 10

, located in the MSN Toolbox area of the course. Proceed with the following activities. Document your practicum-related activities on the Practicum Log:

  • Prepare a plan with specific talking points to meet your faculty (and practicum mentor if available) regarding your plan for evaluation of the project outcome.
  • Meet with your faculty (and practicum mentor if available) to discuss your plan for evaluation of the project outcome.
  • Complete the

    Johns Hopkins Appendix B, number 10

    .
  • Validate your work on Phase 3 with your faculty (and practicum mentor if available) as needed.
  • Revise your work as necessary.
  • Submit the

    Johns Hopkins Appendix B

    completed with your time log, once Phase 3 completed.

Phase 3: Planning for Evaluation Table of Contents Evaluation of the Planned Change Project A clear understanding of the problem and opportunity for improvement is essential to effectively lead planne
Johns Hopkins Nursing Evidence-Based Practice Appendix BQuestion Development Tool 1. What is the problem? Enter text 2. Why is the problem important and relevant? What would happen if it were not addressed? Enter text 3. What is the current practice? Enter text 4. How was the problem identified? (Check all that apply) ☐Safety and risk-management concerns ☐Quality concerns (efficiency, effectiveness, timeliness, equity, patient-centeredness) ☐Unsatisfactory patient, staff, or organizational outcomes ☐Variations in practice within the setting ☐Variations in practice compared to community standard ☐Current practice that has not been validated ☐Financial concerns 5. What are the PICO components? P – (Patient, population, or problem) I – (Intervention) C – (Comparison with other interventions, if foreground question) O – (Outcome measures to determine success) 6. Initial EBP question ☐Background ☐Foreground Enter text 7. List possible search terms, databases to search, and search strategies. Enter text 8. What evidence must be gathered? (Check all that apply) ☐Publications (e.g., EBSCOHost, PubMed, CINAHL, Embase) ☐Standards (regulatory, professional, community) ☐Guidelines ☐Organizational data (e.g., QI, financial data, local clinical expertise, patient/family preferences) ☐Position statements 9. Revised EBP question (Revisions in the EBP question may not be evident until after the initial evidence review; the revision can be in the background question or a change from the background to a foreground question) Enter text 10. Outcome measurement plan What will we measure? (structure, process, outcome measure) How will we measure it? (metrics are expressed as rate or percent) How often will we measure it? (frequency) Where will we obtain the data? Who will collect the data? To whom will we report the data? Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Enter text here. Directions for Use of the Question Development Tool Purpose This form is used to develop an answerable EBP question and to guide the team in the evidence search process. The question, search terms, search strategy, and sources of evidence can be revised as the EBP team refines the EBP question. What is the problem, and why is it important? Indicate why the project was undertaken. What led the team to seek evidence? Ensure that the problem statement defines the actual problem and does not include a solution. Whenever possible, quantify the extent of the problem. Validate the final problem description with practicing staff. It is important for the inter-professional team to take the time together to reflect, gather information, observe current practice, listen to clinicians, visualize how the process can be different or improved, and probe the problem description in order to develop a shared understanding of the problem. What is the current practice? Define the current practice as it relates to the problem. Think about current policies and procedures. Observe practices. What do you see? How was the problem identified? Check all the statements that apply. What are the PICO components? P (patient, population, problem) e.g., age, sex, setting, ethnicity, condition, disease, type of patient, or population I (intervention) e.g., treatment, medication, education, diagnostic test, or best practice(s) C (comparison with other interventions or current practice for foreground questions; is not applicable for background questions, which identify best practice) O (outcomes) stated in measurable terms; may be a structure, a process, or an outcome measure based on the desired change (e.g., decrease in falls, decrease in length of stay, increase in patient satisfaction) Initial EBP question A starting question (usually a background question) that is often refined and adjusted as the team searches through the literature: Background questions are broad and are used when the team has little knowledge, experience, or expertise in the area of interest. Background questions are often used to identify best practices. Foreground questions are focused, with specific comparisons of two or more ideas or interventions. Foreground questions provide specific bodies of evidence related to the EBP question. Foreground questions often flow from an initial background question and literature review. List possible search terms, databases to search, and search strategies. Using PICO components and the initial EBP question, list search terms. Terms can be added or adjusted throughout the evidence search. Document the search terms, search strategy, and databases queried in sufficient detail for replication. What evidence must be gathered? Check the types of evidence the team will gather based on the PICO and initial EBP question. Revised EBP question Often, the question that you start with may not be the final EBP question. Back- ground questions can be refined or changed to a foreground question based on the evidence review. Foreground questions are focused questions that include specific comparisons and produce a narrower range of evidence. Measurement plan Measures can be added or changed as the review of the literature is completed and the translation planning begins: A measure is an amount or a degree of something, such as number of falls with injury. Each measure must be converted to a metric, which is calculated before and after implementing the change. Metrics let you know whether the change was successful. They have a numerator and a denominator and are typically expressed as rates or percent. For example, a metric for the measure falls-with-injury would be the number of falls with injury (numerator) divided by 1,000 patient days (denominator). Other examples of metrics include the number of direct care RNs (numerator) on a unit divided by the total number of direct care staff (denominator); the number of medication errors divided by 1,000 orders. © 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing

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