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Development and Implementation of a Model for Research, Evidence-Based Practice, Quality Improvement, and Innovation

Hagle, Mary PhD, RN-BC, FAAN; Dwyer, Darcy DNP, RN, ACNS-BC; Gettrust, Lynn DNP, RN, ACNS-BC; Lusk, Dana DNP, RN, CHPN, AHN-BC; Peterson, Kristen BSN, RN; Tennies, Sherry MSN-Ed, RN-BC, CWOCN

doi: 10.1097/NCQ.0000000000000422
Original Article: PDF Only

Background: Our medical center nursing council evaluated its current evidence-based practice (EBP) model and decided to consider alternatives.

Problem: No models were inclusive of major nursing activities, such as EBP and quality improvement (QI) projects and research studies.

Approach: A model was developed, meeting the criteria of accessibility, ease of use, and reflective of professional practice activities: EBP and QI projects, research studies, and innovation. In the new model, I3 Model for Advancing Quality Patient Centered Care, professional practice is represented by 3 “I's”: Inquiry, Improvement, and Innovation.

Outcomes: The model provides an algorithm with steps and decision points for nurses to follow based on a question from a clinical issue or problem. The model was approved by nursing-shared governance and is used for guiding relevant projects.

Conclusion: The I3 Model guides the nurse in inquiry or improvement while supporting a culture of innovation in professional practice.

Nursing Education and Research (Dr Hagle and Ms Tennies), Rehabilitation and Extended Community Care (Drs Dwyer and Lusk), Acute Care Outpatient (Dr Gettrust), and Acute Care Inpatient-4C (Ms Peterson), Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin.

Correspondence: Mary Hagle, PhD, RN-BC, FAAN, Nursing Education/Research, Clement J. Zablocki VA Medical Center, 5000 W. National Ave, Milwaukee, WI 53295 (

Grateful appreciation is extended to Robin Goff and Cortney Muns, MSN, RN, AGCNS-BC, for their contributions. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Veterans Affairs or the United States Government.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: May 13, 2019

Published ahead of print: July 8, 2019

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