Scaling Up Promising Quality Improvement Initiatives Noah Ivers MD PhD Family Physician, Family Practice Health Centre and Scientist , Women’s College Research Institute, Women’s College Hospital Assistant Professor, Department of Family and Community Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto noah.ivers@wchospital.ca @noahivers
The evidence-practice gap Institute of Medicine of the National Academies, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America , The National Academies Press, Washington, DC, 2012. Ivers. Academy Health June 2016
The learning health care system Ann Intern Med. 2012 Aug 7;157(3):207-10 Ivers. Academy Health June 2016
Learning across systems/projects? Ivers. Academy Health June 2016
Growing Literature, Stagnant Science? Evidence of “pilot - itis”: Patient oriented initiatives: 182 RCTs of med-adherence strategies by 2013 Provider oriented initiatives: 140 RCTs of audit and feedback by 2010 Health services initiatives: 142 RCTs of diabetes QI strategies by 2011 Ivers et al. Cochrane 2012; Ivers et al. JGIM 2014; Tricco, Ivers, et al. Lancet 2012; Ivers et al. Systematic Reviews Ivers. Academy Health June 2016 2014; Nieuwlaat et al. Cochrane 2014
Wanted: better implementation science Causal inference & Causal explanation JAMA. 2016;315(4):339-340. Ivers. Academy Health June 2016
Scaling-up: developing the science Scientific Research contributes to generalizable knowledge by testing or developing theories or hypotheses, to draw conclusions applicable beyond the specific populations or situations being studied Implementation Science Laboratories partnering researchers with health systems seeking to both improve local initiatives and identify generalizable lessons about how to close the evidence-practice gap Ivers. Academy Health June 2016
Questions? noah.ivers@wchospital.ca @noahivers Ivers. Academy Health June 2016
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