From the bedside to the community: Comparative effectiveness, health services, and implementation research

This chapter highlights just a sample of the many rich areas for dissemination and implementation research that will assist us in shortening the gap between discovery and practice, thus beginning to realize the benefits of research for patients, families, and communities. Greater emphasis on implementation in challenging settings, including lower and middle-income countries and underresourced communities in higher income countries will add to the lessons we must learn to fully reap the benefit of our advances in dissemination and implementation research methods. Moreover, collaboration and multidisciplinary approaches to dissemination and implementation research will help to make efforts more consistent and more effective moving forward. Thus, we will be better able to identify knowledge gaps that need to be addressed in future dissemination and implementation research, ultimately informing the practice and policies of clinical care and public health services.

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Empowering students to innovate health services: Teaching transferability of health interventions

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.673 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

T Schloemer ◽

P Schröder-Bäck

Keyword(s):

Health Services ◽

Implementation Research ◽

Research Process ◽

Practice Change ◽

Practical Training ◽

Master Program ◽

Public Health Professionals ◽

High Workload ◽

Healthcare Professions ◽

Different Populations

Abstract Background To improve the health of different populations, health systems need healthcare professionals who are able to innovate health services. In order to empower students from various healthcare professions to change health service practice in a sustainable way, a training was developed based on the PIET-T models of transferability (Schloemer & Schröder-Bäck, 2018). It was evaluated at three universities in Germany and the Netherlands. Objective The aims of the training were to enable students to: 1. Critically analyze existing evidence about successful and unsuccessful transfers of evidence-based interventions to specific “real-world” contexts (1 day), 2. Conduct an assessment of transferability with case studies using problem-based learning (1 day), 3. Practice implementation research in a healthcare organization (4 months, 4 hours/week). The training was evaluated through discussions, a written reflection and a questionnaire in order to understand students' learning experiences. Results Two bachelor programs for occupational, physical and speech therapists, and one master program for public health professionals took part from 09/2019 to 03/2020, including 66 students. Students valued the training as important, 73 % found it helpful for professional practice. They reflected various ideas how to use the PIET-T models for practice change. Although the implementation research process was perceived as high workload, students valued the experience of getting to know barriers and solutions in a practical setting. Conclusions The students of all programs value the practical relevance of teaching with profession-related specifications. Practical application of the PIET-T models opens up new approaches in teaching in order to educate knowledge on improvement of health services in different contexts. Key messages Empowering students to improve healthcare requires practical training. Training on transferability helps students develop skills for improvement of health services.

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Implementation Research in Mental Health Services: an Emerging Science with Conceptual, Methodological, and Training challenges

Administration and Policy in Mental Health and Mental Health Services Research ◽

10.1007/s10488-008-0197-4 ◽

2008 ◽

Vol 36 (1) ◽

pp. 24-34 ◽

Cited By ~ 768

Author(s):

Enola K. Proctor ◽

John Landsverk ◽

Gregory Aarons ◽

David Chambers ◽

Charles Glisson ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Implementation Research ◽

And Training

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2286

Journal of Clinical and Translational Science ◽

10.1017/cts.2017.65 ◽

2017 ◽

Vol 1 (S1) ◽

pp. 14-14

Author(s):

William G. Adams ◽

Michael Mendis ◽

Shiby Thomas ◽

David Center ◽

Sara Curran

Keyword(s):

Health Services Research ◽

Health Services ◽

Community Health ◽

Comparative Effectiveness ◽

Large Scale ◽

Safety Net ◽

Services Research ◽

Patient Level Data ◽

Patient Level ◽

Level Data

OBJECTIVES/SPECIFIC AIMS: The primary objective of this effort is to develop and distribute an easy to use i2b2 component that is capable of evaluating diverse complex relationships for a wide variety of exposures and outcomes over time. In this manner we are able to leverage the unique design of the i2b2 database to support health services research, comparative effectiveness, and quality improvement using a single tool. Furthermore, our novel database redesign has the potential to provide user-friendly access to individual and group CHC data for CER. METHODS/STUDY POPULATION: For this project we used software experts, clinical informatics specialists, and the existing i2b2 open-source software to convert our legacy HOME Cell into a web-client version. The tool will be used to study health outcomes within a network of Boston based Community Health Centers and the largest safety-net hospital in New England, Boston Medical Center. RESULTS/ANTICIPATED RESULTS: The new web-client HOME Cell will allow i2b2 users to model virtually any exposure (including therapeutic interventions such as medications or tests) in i2b2 against any outcome accounting for complex temporal relationships and other factors. In addition we plan to use our new Community Health Center views to enhance our community engagement activities by allowing direct access to their data for our partners. DISCUSSION/SIGNIFICANCE OF IMPACT: Our project addresses multiple national priorities related to data sharing, clinical research informatics, and comparative effectiveness. The web-client version of the HOME Cell substantially improves our community’s access to HOME Cell functionality and is a novel, sharable resource for use within the CTSA/NCATS community. Our approach provides a new way to perform large-scale collaborative research without the need to actually move patient-level data and has demonstrated that CER, health services research, and quality measurement can share a common framework. In addition, and as demonstrated in our earlier pilot work, the HOME Cell also has the potential to support large-scale multivariate analyses in a distributed manner that does not require sharing of patient-level data. We believe our approach has great promise for supporting the reuse of clinical data for rapid, transparent, health outcome assessments on a national scale. Our efforts support multiple strategic goals including: (1) support for building national clinical and translational research capacity by enhancing a broadly adopted informatics tool (i2b2); (2) enhanced consortium-wide collaborations by offering a tool that can be easily shared within the CTSA network to support multi-institutional collaboration; and (3) improving the health of our communities by offering a tool that has the potential to provide new insights into health care processes and outcomes that could drive innovation and improvement activities.

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