Nursing & Health Sciences

EDUCATION

Nursing & Health Sciences Research Journal

Journal homepage: https://scholarlycommons.baptisthealth.net/nhsrj/

What’s in a Name: Performance Improvement, Evidence-Based Practice, and

Research?

Andrea Prentiss & Eve Butler

Keywords: performance improvement, evidence-based practice, research

Participants of the Institute of Medicine’s

Roundtable on Evidence-based Medicine have

identified that “by the year 2020, 90 percent of clinical

decisions will be supported by accurate, timely, and up-

to-date clinical information, and will reflect best

available evidence” as a goal (Institute of Medicine,

2009). The committee felt every American should have

as an expectation, at a minimum, this level of

performance with health care delivery. Using resources

already available to them, each organization should be

able to motivate and track their progress.

One of the challenges healthcare providers have in

meeting the IOM’s 2020 goal is a difficulty

differentiating between performance improvement

(PI), evidence-based practice (EBP), and research. The

terms performance improvement, evidence-based

practice, and research are frequently used inaccurately

and interchangeably with evidence-based practice

appearing to be the most misused of the three terms.

The common goal between PI, EBP, and Research

is to provide care to patients based on scientific

evidence and meet the patient’s needs. The final result

is the same; they all should lead to improving clinical

outcomes. Determining which process to use will be

defined by what one wants to know. Questions that

seek to answer a system issue, evaluate processes of

care, or improve care delivery are addressed using

quality improvement processes. Those that focus on

how well existing science is used in care are evidence-

based processes and those generating new knowledge

about under-explored areas are answered using

research methodologies. The purpose of this article is

to review the distinction between performance

improvement, evidence-based practice, and research.

PERFORMANCE IMPROVEMENT

The Centers for Disease Control and Prevention

(2015) indicated that hospitals use a variety of terms to

address similar principles (i.e., continuous quality

improvement, quality improvement, performance

improvement, six sigma, and total quality

management). Performance improvement (PI) is

comprised of systematic and continuous activities that

result in measurable improvement in health care

services and the outcomes of an identified group of

patients (Health Resources and Services