Once you have implemented your change, the work is not done. It is important to assess your new or revised practice. Auditing should be frequent at first, perhaps performed monthly for the first year after the change. Auditing ensures that your new practice meets defined benchmarks or has the desired effect on the specific problem. Below are some possible indicators you could monitor in a laboratory context:
- Is the change saving money as expected?
- Have patient or clinician complaints decreased?
- Are there fewer false positives or false negatives?
- Are volumes for a certain test increasing or decreasing as expected?
- Have turnaround times decreased?
- Have lab errors decreased?
- Are patient outcomes improving? (Patient outcome improvements can be measured in many ways, such as shorter lengths of stay, fewer drugs given, fewer follow-up tests ordered, or shorter time to diagnosis.)
Some practitioners of EBP focus all their attention on the "Evidence" aspect but neglect the follow-through. Effective practitioners close the circle by auditing the new process and periodically communicating how the change is working (or not working). They will then formulate new questions if the process needs further improvement or if additional process changes are needed to ensure quality practices and patient safety.
