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THERE IS A GAP BETWEEN best evidence and current health care delivery practice re- sulting in subpar patient safety and quality outcomes. The Institute of Medicine (2001) iden- tifies this gap as a quality chasm in the provision of health care in the United States and presents several challenges and opportuni- ties to improve patient safety and quality outcomes. Moreover, re- cent patient safety and quality out- comes trends remain suboptimal (Landrigan et al., 2010). The scope and gravity of the challenges in current patient safety and quality outcomes demands the formula- tion of new, efficient, and effective modes of health care delivery. Organization-wide approaches are needed to improve safety and quality outcomes to move health care organizations closer to the triple aim of improving the indi- vidual care experience, improving population health, and reducing the cost of care (Berwick, Nolan, & Whittington, 2008; Pronovost et al., 2006; Pronovost et al., 2008).
Nursing, as the largest health care workforce involved in direct patient care, is central to the for- mulation and implementation of effective organizational approach- es to address many patient safety and quality care challenges. Nurse leaders need tools to help identify and close the existing gap between real-world practice and desired service, quality, and patient out- comes. Gap analysis (GA) provides an applicable organizational man- agement tool to identify differences between desired and actual practice conditions, including service deliv- ery and quality patient outcomes as measured against evidence-based benchmarks while incorporating key stakeholder concerns and expectations. An overview of the GA framework and the necessary steps for conducting GA are described.
An Overview
The overarching purpose for using GA is to identify discrepan- cies between known benchmarks for efficient and effective health care delivery and practice with the real-world conditions. Gap analysis uses evidence-based pract ice stan- dards to measure organizational outcomes. The evidence for best practice is distilled from the strong- est available research findings into systematic reviews and practice guidelines. In the absence of strong research-based evidence, the evi- dence can come from expert clini- cian guidance. In addition to meas- uring actual conditions against desired evidence-based best prac- tice, GA includes internal and external stakeholder input, with a key stakeholder being the patient perspective.
Often, the goal for conducting GA...