Gap Analysis

Synergies and Opportunities for Effective Nursing Leadership

Mary Lynn Davis-Ajami, PhD, MBA, MS, NP-C, RN; Linda Costa, PhD, RN, NEA-BC; Susan Kulik, DNP, MBA, RN


Nurs Econ. 2014;32(1):17-25. 

In This Article

Abstract and Introduction


There is a gap between best evidence and current health care delivery practice resulting in subpar patient safety and quality outcomes. The Institute of Medicine (2001) identifies this gap as a quality chasm in the provision of health care in the United States and presents several challenges and opportunities to improve patient safety and quality outcomes. Moreover, recent patient safety and quality outcomes trends remain suboptimal (Landrigan et al., 2010). The scope and gravity of the challenges in current patient safety and quality outcomes demands the formulation 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 individual 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 formulation and implementation of effective organizational approaches 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 outcomes. Gap analysis (GA) provides an applicable organizational management tool to identify differences between desired and actual practice conditions, including service delivery 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.