Chapter 3: Is This Topic a Priority?

INTRODUCTION

You have identified a topic and stated a purpose. Now, ensure that your topic is a priority, so it has the resources and support necessary for success. Organizational context and a climate for change are fundamental and strong determinants of evidence-based practice (EBP) adoption (Kelly et al., 2017; Pittman et al., 2019). To strengthen the project (Benzer et al., 2017):

• Link the EBP topic to shared strategic goals.

• Access resources (e.g., librarian, data, EBP facilitator) to build local capacity for change.

• Promote knowledge sharing and synergy of ideas through formal and informal communication.

When a culture of inquiry supports EBP, clinicians may identify many triggering issues and opportunities. In fact, there are often far more questions than resources available to address them. Generate ideas and then compare projects to select a topic that best matches priorities and context (see Tool 3.1). In this step, you will determine if you can align the EBP topic with priorities to secure leadership support and the resources needed for the project to succeed (Benzer et al., 2017; Iowa Model Collaborative, 2017; Rogers, 2003). Understand the topic scope, impact on patient quality of life or health disparity, economic burden, and anticipated return on investment. Then, consider departmental and organizational priorities, the existing infrastructure, and available resources (Braithwaite et al., 2014; Fleiszer et al., 2016b).

THE DECISION POINT

Examine department and organizational strategic plans including responsibilities, tactics for achieving them, and metrics for evaluating progress to identify priorities (Benzer et al., 2017). Executive announcements and annual reports provide insight into priorities of organizational leaders. Core metrics, national patient safety goals, and publicly reported quality and safety data are an ongoing priority with resources, expertise, and an infrastructure to support continuous improvement (Centers for Medicare & Medicaid Services, 2021a; The Joint Commission, 2021b). Organizational initiatives (e.g., facility or program expansion) have an associated investment that makes them priorities with implications for EBP (Sarff & O’Brien, 2020). Clinical issues that align with priority outcomes create relevance, urgency, and interprofessional engagement (Storey et al., 2019) and should build on past work (Benzer et al., 2017). However, competing priorities may develop as healthcare needs, standards, and funding evolves (Centers for Disease Control and Prevention, 2018). For example, consider the massive shift in priorities created by a pandemic (Zerwic et al., 2021) or the renewed focus on health equity (National Academies of Sciences, Engineering, and Medicine, 2017, 2021a).

Once you have selected your EBP topic, use identified criteria to determine whether the purpose matches health system priorities (see Tool 3.2). Then, decide to move forward or reconsider the topic (see Figure 3.1).