The State Of Quality Improvement And Implementation Research

The Institute of Medicine (IOM) workshop "The Conduct of Health Care Quality Improvement and Implementation Research" was held on May 24-25, 2007, in Irvine, CA. The purpose of this workshop was to gain a better understanding of what is known and not known about quality improvement and implementation research. Experts were asked to identify current methods and best practices as well as areas where future efforts should be concentrated to propel the field. As with its previous workshop, the Forum on the Science of Health Care Quality Improvement and Implementation invited speakers from other disciplines to share their experiences in their respective fields. Although many disciplines are relevant to this topic, not all views could be incorporated because of workshop time constraints, but will be incorporated in the forum's future activities. The State of Quality Improvement and Implementation Research: Expert Views, Workshop Summary describes and summarizes workshop presentations and discussions.

The Institute of Medicine (IOM) workshop "The Conduct of Health Care Quality Improvement and Implementation Research" was held on May 24-25, 2007, in Irvine, CA. The purpose of this workshop was to gain a better understanding of what is known and not known about quality improvement and implementation research. Experts were asked to identify current methods and best practices as well as areas where future efforts should be concentrated to propel the field. As with its previous workshop, the Forum on the Science of Health Care Quality Improvement and Implementation invited speakers from other disciplines to share their experiences in their respective fields. Although many disciplines are relevant to this topic, not all views could be incorporated because of workshop time constraints, but will be incorporated in the forum's future activities. The State of Quality Improvement and Implementation Research: Expert Views, Workshop Summary describes and summarizes workshop presentations and discussions.

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

The Institute of Medicine's Forum on the Science of Health Care Quality Improvement and Implementation held a workshop on January 16, 2007, in Washington, DC. The workshop had its roots in an earlier forum meeting when forum members discussed what is meant by the terms "quality improvement" and "implementation science" and became convinced that they mean different things to different people. At the time, the members also discussed the need to identify barriers to quality improvement research and to implementation science. Thus the purpose of this workshop was to bring people together from various arenas to discuss what quality improvement is, and what barriers exist in the health care industry to quality improvement and also to research about quality improvement. The summary that ensues is thus limited to the presentations and discussions during the workshop itself. We realize that there is a broader scope of issues pertaining to this subject area but are unable to address them in this summary document. The workshop's first session was devoted to experiences that various institutions have had with quality improvement. Recognizing the wealth of experiences available outside of health care services, the workshop included presenters from outside the health care service industry as well as from inside. This includes discussions from a variety of perspectives: non-health care services, health plans, hospitals, and nursing. Advancing Quality Improvement Research: Challenges and opportunities - Workshop Summary describes the events of the workshop.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

Surgical education is a rapidly expanding area of surgical research and career interest, and as the Association for Academic Surgery (AAS) Fall Courses (www.aasurg.org) and International courses offer more and more specialty tracking there is a greater need for an accompanying textbook to supplement the material presented in the courses. Success in Academic Surgery: Health Services Research is a unique and portable handbook that focuses on clinical trials. It includes new educational materials which are necessary to address: (1) the rapid evolution and rise of novel research methodologies in basic science and clinical/educational research and (2) the changing environment for academic surgeons. Success in Academic Surgery: Health Services Research is a valuable text for medical students, surgical residents and others considering a career within surgery.

Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.

The definitive work in D&I research -- now completely updated and expanded The application of scientific research to the creation of evidence-based policies is a science unto itself -- and one that is never easy. Dissemination and implementation research (D&I) is the study of how scientific advances can be implemented into everyday life, and understanding how it works has never been more important for students and professionals across the scientific, academic, and governmental communities. Dissemination and Implementation Research in Health is a practical guide to making research more consequential, a collection assembled and written by today's leading D&I researchers. Readers of this book are taught to: � Evaluate the evidence base in an effective intervention � Choose a strategy that produces the greatest impact � Design an appropriate and effectual study � Track essential outcomes � Account for the barriers to uptake in communities, social service agencies, and health care facilities The challenges to moving research into practice are universal, and they're complicated by the current landscape's reliance on partnerships and multi-center research. In this light, Dissemination and Implementation Research in Health is nothing less than a roadmap to effecting change in the sciences. It will have broad utility to researchers and practitioners in epidemiology, biostatistics, behavioral science, economics, medicine, social work, psychology, and anthropology -- both today and in our slightly better future.

This review was organized to bring a systematic assessment of different quality improvement strategies & their effects to the process of identifying & managing hypertension. Findings suggest that quality improvement strategies appear, in general, to be associated with the improved identification & control of hypertension. It is not possible to discern with complete confidence which specific quality improvement strategies have the greatest effects, since most of the studies included more than one quality improvement strategy. Illustrations.