Practice-based research networks add value to evidence-based quality improvement
Karen M Goldstein, Dawne Vogt, Alison Hamilton, Susan M Frayne, Jennifer Gierisch, Jill Blakeney, Anne Sadler, Bevanne M Bean-Mayberry, Diane Carney, Brooke DiLeone, Annie B Fox, Ruth Klap, Ellen Yee, Yasmin Romodan, Holly Strehlow, Julia Yosef, Elizabeth M Yano, Karen M Goldstein, Dawne Vogt, Alison Hamilton, Susan M Frayne, Jennifer Gierisch, Jill Blakeney, Anne Sadler, Bevanne M Bean-Mayberry, Diane Carney, Brooke DiLeone, Annie B Fox, Ruth Klap, Ellen Yee, Yasmin Romodan, Holly Strehlow, Julia Yosef, Elizabeth M Yano
Abstract
Background: Evidence-Based Quality Improvement (EBQI) is a systematic, multilevel approach to implementing research evidence into clinical settings. Little is known about EBQI effectiveness in the context of Practice-Based Research Networks (PBRNs), which are themselves designed to foster practice-based change. We evaluated EBQI implementation in a PBRN setting to determine the extent to which the PBRN infrastructure added value.
Methods: We conducted a four-site cluster randomized trial of an EBQI approach to tailoring an evidence-based gender awareness curriculum in the VA Women’s Health PBRN (WH-PBRN). After curriculum implementation, site teams identified impacts of the WH-PBRN context on EBQI processes using qualitative methods, including a formal review of project call minutes, post-project debriefing calls, and structured site team input. WH-PBRN site feedback was mapped to the Replicating Effective Programs implementation phases: pre-condition, pre-implementation, implementation, and maintenance/evolution.
Results: The pre-condition phase benefited from the existing WH-PBRN research-clinician relationships to facilitate stakeholder engagement and build project buy-in at local sites. During pre-implementation, differences across WH-PBRN sites offered variations in local tailoring of EBQI elements. The WH-PBRN Coordinating Center helped resolve process complexities stemming from local resource differences and the sharing of mid-project adaptations during implementation. Local efforts were amplified in the maintenance phase by WH-PBRN dissemination of findings.
Conclusions: The PBRN strengthened multi-site EBQI activities across all implementation phases.
Implications: PBRNs contribute to the uptake of evidence into everyday practice, and may serve as an important component of the future implementation of evidence-based initiatives. Level of evidence: V.
Keywords: Essential Health Care Program; Program Administrators; Program Beneficiaries and Program Implementers.
Conflict of interest statement
Conflict of interest disclosure statement
This statement accompanies the article “Practice-Based Research Networks Add Value to Evidence-Based Quality Improvement”. None of the authors have relevant commercial associations that might post a conflict of interest.
Published by Elsevier Inc.
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Source: PubMed