One of the most important but often challenging steps in the evidence-based practice (EBP) process is ensuring that the change we wanted to happen actually occurred. After a practice change has been implemented, it’s important to ask if the expected outcome was achieved. Patient-related outcomes can be psychosocial (change in symptoms such as depression or anxiety), physiologic (reduction in catheter-associated urinary tract infections), or functional (increased exercise or mobility). Outcomes can also be process related, such as reduced readmissions or more efficient discharge planning.
Conduct a Premortem
Identifying which outcomes to measure and how to measure them is part of the planning process for practice change. A unique way to identify outcomes and to plan for successful implementation is to conduct a premortem on your project. We’re all familiar with postmortems—asking questions about what happened after a sentinel event or a poor patient outcome—but when planning a practice change, it is important to ask questions before starting the project. Conducting a premortem (also called prospective hindsight) can help to identify outcomes, barriers, and risks to successful implementation.
With a premortem, team members are told that the project has failed and are tasked with thinking about every reason they can think of for why the failure occurred. Each reason is noted, and the team leaders use them to look for ways to strengthen the practice change process. The process helps to identify outcome measurement strategies, barriers to implementation, and ideas to aid in successful implementation.
Share the Results
When the outcomes have been measured and evaluated, it may appear as if the project is complete, but work still needs to be done. Dissemination can occur in many forms within your organization and beyond, and it should be part of the planning process for the full project. Consider using intra- and interdepartmental in-services, journal clubs, online media, lectures, conferences (such as an abstract submission for the ONS Annual Congress), posters, and manuscripts. Share the outcomes but also the process of your project: what worked, what didn’t, what you learned, and what you would do (or not do!) again.
In addition to disseminating your project outcomes locally, it’s also a good opportunity to share your work with healthcare professionals on a regional or national level. Consider writing a manuscript for submission to a journal such as the Clinical Journal of Oncology Nursing. If you don’t think you have enough content for a full manuscript, consider a column or shorter piece to share what you’ve learned.
The upcoming ONS 43rd Annual Congress, May 17–20, 2018, in Washington, DC, will have many opportunities to learn from and share best practices. If you are new to disseminating your work, this is a great time to learn from others and see how a wide variety of EBP, research, leadership, and educational projects are presented. At the ONS Career Fair Pavilion on Thursday, May 17, from 1:45–2:45 pm, you can learn “Best Practices for Abstract Writing and Developing Your Presentation,” and on Friday, May 18, from 11:15 am–12:15 pm, you can learn how to “Impact your Profession by Publishing.” If you’re at Congress, stop by these presentations in the Learning Hall to learn key tips and strategies for disseminating your work.