Navigating the Future: Evolving Leadership Models for Fostering an Evidence-Based Practice Culture in Ambulatory Care (Spotlight Poster)

The Institute for Medicine set a goal that 90% of healthcare decisions were evidence-based by 2024. As an industry, we need to meet this goal. Nurses account for the largest group of healthcare providers with direct patient access and managerial support of care initiatives. The gap between what nurses know and what they do can have life-altering consequences. The degree to which nurses base their practice behaviors on research, EBP competence, and use of EBP skills is sub-optimal and is directly influenced by organization and institutional barriers. Common barriers to implementing EPB behavior change include organizational culture, leadership, networks and communication, resources, evaluation, monitoring and feedback, and EBP mentors/champions. Some sub-features included resources that support collaboration, teamwork, communication, financial support, timing/staffing workload, EBP education, and training. Supporting organizational initiatives and leadership development can strengthen the cultural advancement of EBP5.

Supporting the development of EBP skills in an ambulatory care setting can be challenging. Our facility has 300 nurses in more than five facilities spanning five counties. In ambulatory care settings, fewer nurses are in one area than in inpatient settings. Nurses in ambulatory care settings become siloed in their specialty, resulting in variable practice delivery, even within the same setting. Ambulatory care nurses find additional challenges in participating in projects and meetings. Shortened/frequent workdays (compared to inpatient settings), limited free time during the day, tight clinic schedules, and lack of role coverage can prevent participation in hospital-wide meetings that often happen when the clinic is busiest. The EBP specialist role, in the form of leadership support, has enhanced the development of EBP competence in ambulatory care nursing.

Intervention: Leadership development and resource availability to ambulatory care nursing was a priority for the evidence-based practice specialist role. The EBP specialist role supported the development of the ambulatory care EBP council, stimulated individual nursing participation, provided a direct point of contact for support/services, integrated membership in various ambulatory care committees and leadership groups, and developed interaction with various councils (outpatient clinical council, ambulatory care RN leadership committee, professional governance nursing, and transition councils). Increased visibility of the EBP specialist role has allowed ambulatory care RNs increased opportunities to receive EBP-specific education, resources, podium/poster development support, project discussions, and opportunities to network and collaborate outside their clinic setting.

Outcomes: In the first six months of the EBP specialist role, ambulatory care nursing submitted at least six podium presentations and three poster submissions for at least four 2024 conference calls for abstracts. Ambulatory care nurses are more aware of local opportunities and are interested in participating in events. In addition, two ambulatory care registered nurses have published in peer-reviewed journals and a poster at a national conference and are participating in an EBP fellowship through a local university cohort. The outpatient clinic council participation has grown by 28% in the past year. The ambulatory care EBP council has consistently had meetings in 2023 (previously, in 2022, we did not have consistent interest) with 13 members (140% growth), a chair and co-chair with an active agenda, and multiple projects in development.