{"id":469,"date":"2013-08-05T16:52:01","date_gmt":"2013-08-05T16:52:01","guid":{"rendered":"https:\/\/iims.uthscsa.edu\/isrn\/?p=469"},"modified":"2024-11-07T16:56:08","modified_gmt":"2024-11-07T16:56:08","slug":"improvement-science-summit-a-participants-point-of-view","status":"publish","type":"post","link":"https:\/\/iims.uthscsa.edu\/isrn\/2013\/08\/05\/improvement-science-summit-a-participants-point-of-view\/","title":{"rendered":"Improvement Science Summit &#8211; A Participants Point of View"},"content":{"rendered":"<p>Article Contributed by Eileen Engh, MSN, RN-BC, CPN<\/p>\n<p>ISRN Research Associate, STAR-2 study PI and participant ISRN 2013 Improvement Science Summit<\/p>\n<p>It\u2019s not often that one conference can achieve so many goals and introduce so many new ideas relevant and critical to our understanding of healthcare systems today.\u00a0 In this case the 2013 Improvement Science Summit, in San Antonio, Texas achieved and exceeds expectations.\u00a0 We were encouraged to give rapid consideration to the setting and the care needs under examination.<\/p>\n<p>I would like to capture in reflection a few highlights and concepts introduced and underscored in the course of the summit.<\/p>\n<p>Dr. Kathleen Stevens opened the summit and offered us a summary of the notable achievements made by the ISRN a just a few short years;<\/p>\n<ul>\n<li>A cyber infrastructure was developed and implemented,<\/li>\n<li>Landmark studies have been conducted,<\/li>\n<li>Evidence for healthcare systems has been generated,<\/li>\n<li>And a network or\u00a0<strong>\u201ccollaboratory\u201d,<\/strong>\u00a0has been created to conduct research.<\/li>\n<\/ul>\n<p>I had the opportunity as a site Principal Investigator to experience the entire spectrum of the achievements made by the ISRN.\u00a0 As Dr. Steven\u2019s shared each achievement, I had such appreciation for the pioneering work led by the ISRN.\u00a0 I had an eye witness account of just how responsive and relevant the network is as they introduced the tools to conduct the STAR 2 protocol, one of the landmark studies designed to address the gaps in our healthcare organizations today.<\/p>\n<p>Dr. Jack Needleman moderated the summit meeting.\u00a0 His comments truly resonated.\u00a0 \u201cThe key question to keep in mind is how do we make and sustain change in our healthcare systems.\u00a0 Systematic Research is essential to making and sustaining change.\u00a0 We need a conceptual understanding of what works.\u201d\u00a0\u00a0 I couldn\u2019t agree more.\u00a0 When something works, we need to understand\u2013 why it worked!<\/p>\n<p>I\u2019ve practiced clinical nursing, and supported the transition training and professional development of nurses in a pediatric academic medical center for many years.\u00a0 I\u2019ve carefully observed as changes have been made in our health care system.\u00a0 It\u2019s been more than a curiosity to appreciate why some changes are sustained, while others are not.\u00a0\u00a0 Laura Damschroder, MS, MPH Co implementation Research Coordinator, Diabetes QUERI Research investigator, VA HSR&amp; D Center for Practice Management &amp; Outcomes research presentation really impressed me. Her work and model introduced new ways to look at change and increase our understanding of healthcare environments.\u00a0\u00a0 She shared frameworks for the study of Improvement and Implementation, from her \u201cWorldview\u201d.<\/p>\n<p>She spoke\u00a0<em>truth\u00a0<\/em>about the Traditional Research Framework that ends with a publication compared to a \u201cNatural\u201d dissemination and implementation framework.\u00a0 Models and tools that can support how interventions can be sustained in our complex organizations are critical to our understanding and application. I took 15 pages notes during her presentation!\u00a0 \u00a0She compared the PRECIS tool, Explanatory Trial and Pragmatic Trial.\u00a0 These are important because the Pragmatic Explanatory Continuum looks at 10 dimensions.\u00a0 (Thrope, K. E.) The Explanatory Trial \u2013 aka efficacy trial looks a high internal validity and the Pragmatic Trial aka Effectiveness Trial \u2013 has high external validity (I think there was a typo on the slide).\u00a0 The\u00a0<strong>big deal<\/strong>\u00a0with all this underscores the need to understand the objectives of Implementation Research \u2013 which wants to answer,\u00a0<strong>What Works Where and Why?\u00a0 Can we generalize knowledge about how to implement and sustain interventions?\u00a0\u00a0<\/strong>Can we replicate successful implementation, navigate complex implementations and improve prospects for sustainability.\u00a0\u00a0 Ms. Damschroder, shared the Consolidated Framework for implementation Research (CFIR).\u00a0 CFIR is a comprehensive framework to promote consistent use of constructs, terminology and definitions.\u00a0 The CFIR has 5 major domains. \u00a0The reference to learn more about this is\u00a0<a href=\"http:\/\/www.implementationscience.com\/content\/4\/1\/50\">http:\/\/www.implementationscience.com\/content\/4\/1\/50.<\/a>\u00a0 There is also a wiki\u00a0<a href=\"http:\/\/cfirwiki.net\/wiki\/index.php?title=Main_Page\">www.cfir.wiki.net<\/a>.<\/p>\n<p>Dr. John Ovretveit, , BSC(Hons), Mphil, PhD, CPsychol, Csci, MIHM the director of research and professor of Health Innovation Implementation and Evaluation from the Karolinska Institute, Stockholm, Sweden\u00a0 is amazing.\u00a0 You have to see him in action to appreciate how very spot on he is!\u00a0 He carefully prepared us by setting the stage to understand a big problem with a solution that worked.\u00a0 The problem addressed the environment in public restrooms, specifically the floor around men\u2019s urinals.\u00a0 The story of success blended the application of male psychology, urinal design, and the image of a painted fly in the urinal bowl.\u00a0 It works, and it works most of the time to reduce spillage.\u00a0 It has now been widely adopted across Europe to keep public restrooms clean.\u00a0 \u00a0However, he noted that this approach doesn\u2019t work with Buddhist Monks\u2026. The point with this was to illustrate, \u201cCopy the principle \u2013 not the prescription\u201d.\u00a0 He asked, can you explain this variation?<\/p>\n<p>He also shocked us with a story about an RCT protocol that was a huge financial investment.\u00a0 The study was conducted over many years beginning in 2005.\u00a0 The results were published in 2012. To provide context, it was a HIT evaluation in the Swedish Health Informatics Center.\u00a0 The investigators religiously adhered to the RCT protocol to protect the integrity of the RCT study.\u00a0 During the same period, and parallel to the protocol timeline, the following technological changes were introduced globally: \u00a0IPhone, Amazon E-books, Facebook, web 2.0, web design, Twitter, and consumer driver interactions with the internet.\u00a0 When the study was published the results were STONEAGE.\u00a0 The key message is that we need alternative designs that are rapid, responsive, and relevant!! \u00a0(Riley, W.T.)\u00a0<em>Rapid, responsive, relevant (R3) research: a call for a rapid learning health research enterprise. See\u00a0<\/em><a href=\"http:\/\/www.clintransmed.com\/content\/2\/1\/10\">http:\/\/www.clintransmed.com\/content\/2\/1\/10<\/a>)<\/p>\n<p>More importantly he pointed out, the funders really get it!!\u00a0 In the next 5 years we can expect massive shifts toward applied research.\u00a0\u00a0 The more levels that are involved in an intervention, the more complicated it is to predict the outcomes.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Article Contributed by Eileen Engh, MSN, RN-BC, CPN ISRN Research Associate, STAR-2 study PI and participant ISRN 2013 Improvement Science Summit It\u2019s not often that one conference can achieve so many goals and introduce so many new ideas relevant and critical to our understanding of healthcare systems today.\u00a0 In this case the 2013 Improvement Science [&hellip;]<\/p>\n","protected":false},"author":13,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12],"tags":[],"class_list":["post-469","post","type-post","status-publish","format-standard","hentry","category-blog"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Improvement Science Summit - A Participants Point of View - Improvement Science Research Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/iims.uthscsa.edu\/isrn\/2013\/08\/05\/improvement-science-summit-a-participants-point-of-view\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Improvement Science Summit - A Participants Point of View - Improvement Science Research Network\" \/>\n<meta property=\"og:description\" content=\"Article Contributed by Eileen Engh, MSN, RN-BC, CPN ISRN Research Associate, STAR-2 study PI and participant ISRN 2013 Improvement Science Summit It\u2019s not often that one conference can achieve so many goals and introduce so many new ideas relevant and critical to our understanding of healthcare systems today.\u00a0 In this case the 2013 Improvement Science [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/iims.uthscsa.edu\/isrn\/2013\/08\/05\/improvement-science-summit-a-participants-point-of-view\/\" \/>\n<meta property=\"og:site_name\" content=\"Improvement Science Research Network\" \/>\n<meta property=\"article:published_time\" content=\"2013-08-05T16:52:01+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-11-07T16:56:08+00:00\" \/>\n<meta name=\"author\" content=\"wardk1\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"wardk1\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/iims.uthscsa.edu\\\/isrn\\\/2013\\\/08\\\/05\\\/improvement-science-summit-a-participants-point-of-view\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/iims.uthscsa.edu\\\/isrn\\\/2013\\\/08\\\/05\\\/improvement-science-summit-a-participants-point-of-view\\\/\"},\"author\":{\"name\":\"wardk1\",\"@id\":\"https:\\\/\\\/iims.uthscsa.edu\\\/isrn\\\/#\\\/schema\\\/person\\\/a25f85eb0ed96014af89ac31bc3a1b4c\"},\"headline\":\"Improvement Science Summit &#8211; 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