EBP case study
You are consulting with the education and practice development team in a large tertiary care
hospital serving a region comprising mostly rural communities. The team is responsible for
strengthening the implementation of EBP based on outcomes. Over the next 2 years, it must set
performance objectives to (1) strengthen screening for pain, depression, and adverse health
behaviors (smoking, excess alcohol intake, and body mass index [BMI] greater than 30) at intake for
all adult admissions; (2) implement comprehensive geriatric assessment for all those over age 65
hospitalized for more than 7 days or readmitted within less than 3 days following discharge; and (3)
promote care-team performance.
The hospital has 200 adult admissions each week and has implemented an electronic health
record. Guideline dissemination generally occurs through educational venues or via the electronic
policy and procedure manual. The method of documentation for narrative notes is documentation
by exception using subjective, objective, assessment, and plan (SOAP) and the hospital has made
extensive use of checklists to complement the documentation system.
1. (200 words) Using clinical guidelines and standards of care, identify what data elements should be
included in the EHR assessment and evaluation screens if these goals are to be achieved.
2. (200 words) Identify how information system defaults and alerts could be used to achieve these goals.
3. (200 words) Once screening has been improved, what are the next steps in improving patient
4. (200 words) How could the electronic health record be designed to support these outcome-related
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