Chapter 3: The Johns Hopkins Evidence-Based Practice (JHEBP) Model for Nurses and Healthcare Professionals (HCPs) Process Overview

Introduction

Evidence-based practice (EBP) is a core competency for all healthcare professionals (HCPs) in all practice settings (Saunders et al., 2019). Using an evidence-based approach to care and practice decision-making is not only an expectation in all practice settings, but also a requirement established by professional standards, regulatory agencies, health insurers, and purchasers of healthcare insurance. EBP is an important component of high reliability organizations and is a process that can enable organizations to meet the quadruple healthcare aim to enhance patient care, improve population health, reduce healthcare costs, and increase the well-being of healthcare staff (Migliore et al., 2020).

In 2009, the Institute of Medicine (IOM) set an ambitious goal that 90% of clinical decisions would be evidence-based by 2020. Although healthcare professionals are increasingly adopting EBP in practice, we have not met this grand challenge. However, licensed healthcare staff have the potential to make a major impact to improve patient outcomes through the appraisal and translation of evidence (American Association of Colleges of Nursing [AACN, 2020; IOM, 2011; Wilson et al., 2015). This requires leaders in both academia and service settings to align their learning and practice environments to promote evidence-based healthcare, to cultivate a spirit of continuous inquiry, and to translate the highest-quality evidence into practice. Using a model for EBP within an organization fosters end-user adoption of evidence, enables users to speak a common language, standardizes processes, improves care and care outcomes, and embeds this practice into the fabric of the organization. The objectives for this chapter are to:

• Describe the revised Johns Hopkins Evidence-Based Practice Model for Nurses and Healthcare Professionals (HCPs)

• Introduce frontline HCPs and leaders to the PET process (Practice Question, Evidence, and Translation)

The Johns Hopkins Evidence-Based Practice (JHEBP) Model for Nurses and HCPs—Essential Components: Inquiry, Practice, and Learning

The revised Johns Hopkins Evidence-Based Practice (JHEBP) Model for Nurses and HCPs (see Figure 3.1) is composed of three interrelated components—inquiry, practice, and learning—that take place in the context of interprofessional collaborative practice.

Inquiry

In the revised JHEBP Model, inquiry is the initial component that launches the EBP process. The concept of inquiry, a foundation for healthcare practice, encompasses a focused effort to question, examine, and collect information about a problem, an issue, or a concern generally identified through observation, assessment, and personal experience within the clinical setting. Curiosity and inquiry can foster meaningful learning experiences by prompting individuals to look for learning opportunities to know more. The National League for Nursing (NLN; 2014) describes a spirit of inquiry as