7 Evidence Appraisal: Nonresearch 153
Organizational Experience
Organizational experience often takes the form of quality improvement (QI) and
financial or program evaluations. These sources of evidence can occur at any
level in the organization and can be internal to an EBP team’s organization or
published reports from external organizations. Although they may be conducted
within a framework of scientific inquiry and designed as research studies, most
internal program evaluations are less rigorous (Level V). Frequently, they com-
prise pre- and/or post-implementation data at the organizational level accompa-
nied by qualitative reports of personal satisfaction with the program. An example
of a program evaluation is “Promoting Optimal Parenting and Children’s Mental
Health: A Preliminary Evaluation of the How-to Parenting Program” (Joussemet,
Mageau, & Koestner, 2014), which evaluated the effectiveness of a parenting
program in fostering optimal parenting and child mental health. This pre- and
post-test method concluded that the How-to Parenting Program effectively im-
proved parenting style and promoted children’s mental health.
Quality Improvement Reports (Level V Evidence)
Quality improvement (QI) is a term that can be used interchangeably with qual-
ity management, performance improvement, total quality management, and con-
tinuous quality improvement (Yoder-Wise, 2014). These terms refer to ongoing
efforts to improve the quality of care delivery and outcomes within an organiza-
tion. QI is a cyclical method to examine workflows, processes, or systems within
a specific organization. This information usually cannot be generalized beyond
the organization. The organizational experience described here is distinctly differ-
ent from quality-focused research or health services research intended to general-
ize results. Health services research uses experimental, quasi-experimental, non-
experimental, and mixed-methods research designs (described in Chapter 6) and
should be reviewed and appraised accordingly.
QI is a method of self-examination to inform improvement efforts at the local
level. During their review of nonresearch evidence, EBP team members should
examine internal QI data relating to the practice question as well as QI initia-
tives based on similar questions published by peer institutions. As organizations
