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Using a Pico(T) Framework and Evidence to Develop Care Practices


A PICOT design is an excellent technique to outline research questions that look at therapy outcomes. The (P)-population is a sample of participants for a study that a researcher is looking for, including patients. It may be required to strike a delicate balance between defining a sample that is most likely to react to a specific intervention and one that can be generalized to patients who will receive treatment in the health practice. (I)- An intervention is the treatment that your study’s participants will get. A person’s plan to use a reference group to compare their therapeutic intervention is referred to as a (C)-comparison.

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This comparison is referred to as the control group in many study designs. If a present-day treatment is regarded as the “gold standard,” it should be used as the comparison group. The (O)-outcome represents the outcome that a person intends to measure in order to assess the effectiveness of their goal. The Poland-Morris Questionnaire is a well-, (known and well-validated outcome evaluation instrument for typical chiropractic patient demographics. For diverse clinical groups, there are usually a variety of outcome tools available, each with its own set of strengths and shortcomings. Finally (T)-Time denotes the length of time the researcher spent collecting data.

Use of PICOT Approach in Urban Hospitals with Patient Discharging Problems

Identification of the Sources of Evidence

PICOT is based on the elements of a clinical research question, and it starts with a case scenario and an elicitation question. The research questions must include the patient included in the research, the interventions or therapies that will be used, the comparison of one intervention to another, and the expected outcome of the research. Researchers will be better positioned to examine the literature for evidence to support their original PICO query once they have created a well-structured question. Learning how to design a detailed PICOT question is critical to nursing manager abilities for RNs enrolled in a doctor of nursing practice (DNP) program. Exam with PICOT questions.

Congested Corridors and Wards

Hospitals are mainly congested because these institutions lack extra accommodation for the additional patients who need close monitoring, making admission the only option. As a result, a vast number of hospitals put two patients in single wards and four patients in double communities to create more space. Furthermore, corridors are customarily flooded with other patients waiting to be attended to or even receiving treatment from the waiting area. Other extra services like free medications are consequently denied, and the privilege is given to those patients without any source of income or families. In order to curb the problem of congestion, some patients should be transferred to other health institutions, and the financially able advised to seek private doctors and get treatment from homes.

Lack of Medical Equipment

Urban hospitals are known to offer the best medical care because they have the right resources and equipment. On many occasions, when patients visit these facilities, they are given another appointment, mainly because the required machines and equipment are fully occupied for the rest of the day. This situation reveals that most medical institutions have more patients than they are supposed to have. As a result, patients suffer from delayed medication, whose ultimate effect on the patient is health deterioration.

Movement of These Patients

When these patients fully heal, they are usually taken to their homes, where their relatives or neighbors take care of them. The hospital management also talks with homes where they take the older people and the street kids. The movement shows that these hospitals have a problem with discharging their patients, which leads them to retain extra patients (Bain, 2019). Employees also complain about being given extra duties of cleaning and cooking different food for these patients. They complain that they offer additional service while getting small wages or sometimes nothing at all.

Findings from Articles

Clinical Document Architecture (CDA) is a stock for encrypting medical documents for convenient data exchange. They include reports on images, procedural notes, continuity of care documents, and medical recommendations. CDA allows medical facilities to have patients’ information that they might want to send to other medical facilities or regulatory authorities. Any relevant information about the patient to the government entity or the health officer is contained in the CDA documents (Kreps, 2018). The document is also convenient as it is used in multiple health applications. CDA can also be read to people and be processed by a machine, showing all of the patient’s medical history in one document. Without this document, moving patients from one medical facility to another becomes a challenge.

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CDA document helps inform the other medical officers about the well-being of the patient that needs a transfer. The law also requires all the necessary documents to be attached to the patient’s profile before a patient is transferred to a care facility or another medical facility. That will ensure that all patients get discharged from the hospital once they are ready. With the CDA files, the people who will continue giving care will hint at the patient’s condition and were to continue. The CDA document takes less than two months to process, which means they are ready to start offering services in two months.

Relevance of the Findings from Articles

Knowing the content of the CDA document helps show the correct information about a patient that needs to be said. They also make work easier for any hospital that needs to transfer patients, as the alternative medical facility will readily accept the patient. Tracing the patient’s origin will be easy with the information so that when the patient is ready for discharge, there will be someone to take them home. The CDA takes less than two months to be processed, making it effective after about three months (Kmietowicz, 2017). Retaining the patients who need to be discharged due to lack of information is less effective compared to acquiring the CDA documents. CDA documents support the transfer of patients to other medical facilities or homes where they can continue receiving care.


Retaining abandoned patients due to lack of information is one of the reasons why urban hospitals get congested. Keeping more than enough patients in hospital wards is not the best solution; instead, hospitals should use a CDA document containing all the patients’ legal information despite their vast number. Also, the patient can find an alternative healthcare institution for the provision of care. CDA files take less than two months to be processed, meaning they start being effective after about three months. Finally, hospitals should get CDA documents to avoid overworking nurses and other employees with extra chores.


Bain, A. (2019). Do Hospitals Participating in Accountable Care Organizations Discharge Patients to Higher Quality Nursing Homes? Journal of Hospital Medicine.

Garzon Maaks, D. (2019). It’s Time to Lead Before Someone Else Does. Journal of Pediatric Health Care, 33(2), 129-130.

Kmietowicz, Z. (2017). Less than half of new mothers in England breastfeed after two months. BMJ, j1508.

Kreps, G. (2018). Promoting patient comprehension of relevant health information. Israel Journal of Health Policy Research, 7(1).

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