Date and Time
October 8, 2008
1:30 PM - 3:00 PM

Availability
Open to the public
No RSVP required

Speaker
Mary K. Goldstein - Stanford University

As public attention focuses on quality of health care, many health care systems are grappling with how best to implement improvements.  The Department of Veterans Affairs has established a program that links health services research with clinical operations: the Quality Enhancement Research Initiative (QUERI), whose mission is "to enhance the quality and outcomes of VA health care by systematically implementing clinical research findings and evidence-based recommendations into routine clinical practice." QUERI applies a six-step process to facilitate the implementation of research findings and evidence-based clinical practices with the aim of achieving better health care outcomes.  There are major challenges in moving from Step 3 (defining existing practice patterns and outcomes) to Step 4 (implementing best practices) and Step 5 (demonstrating that best practices actually do improve outcomes.)  This seminar will illustrate some organizational issues, in a framework of roles/routines/rules, using examples from implementation experiments of quality improvement programs for hypertension at different stages of dissemination (a program of group medical visits and a system for automated clinical decision support).

This session will be trainee-focused.

1. Merton, R. K. 1936.  "The unanticipated consequences of purposive social action". American Sociological Review 1:894-904.     
2. Fihn, S.D., "Moving implementation science forward". Journal of general internal medicine, 2006. 21 Suppl 2: p. S65-S66.
3. Rubenstein, L.V. and J. Pugh, "Strategies for promoting organizational and practice change by advancing implementation research". Journal of general internal medicine, 2006. 21 Suppl 2: p. S58-S64.
4. Madon, T., et al., "Public health. Implementation science". Science, 2007. 318(5857): p. 1728-1729.