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The team should also assess the system’s readiness for change and determine
strategies to overcome possible barriers to implementation. Readiness for change
includes the availability of human and material resources, current processes, sup-
port from decision-makers (individuals and groups), and budget implications.
Implementation strategies include communication and education plans and in-
volvement of stakeholders and other individuals affected by the change.
Evidence-Based Practice, Research, and QI
Although a discussion of how to conduct research to test a new procedure or
product is beyond the scope of this chapter, it is important to clearly differentiate
the activities of research, QI, and EBP (Newhouse, 2007b; Newhouse, Pettit, Poe,
& Rocco, 2006; Shirey et al., 2011). Box 8.1 provides the common definitions
and an example of each. Note that research requires additional organizational
infrastructure, including affiliation with an institutional review board (IRB), ex-
perienced mentors who can serve as principal investigators, education in human
subject research, and a number of additional research competencies.
Box 8.1 Differentiating EBP, Quality Improvement, and Research
EBP
The EBP process identifies, appraises, and uses existing high-quality research and
nonresearch evidence to identify best practice to drive practice improvements.
EBP Example: For adult patients admitted with heart failure who smoke, what is
the best strategy to improve the success of quit attempts? An evidence review is
conducted using the PET process, and recommendations are generated. These
are implemented and then evaluated using the QI process.
Quality Improvement
QI focus is a local unit or organization improvement effort that uses small tests of
change and monitors effectiveness of change. Models such as PDSA and DEMAC
are often used as guides for implementing a QI process.
In QI, teams use systematic and continuous actions toward healthcare service
improvements to systems and processes with the intent to improve the health of
patients (Health Resources Services Administration, 2016). QI results are often
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