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Improvement Research Priorities: USA Survey and Expert Consensus

DOI: 10.1155/2013/695729

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Abstract:

The purpose of this study was to identify stakeholder views about national priorities for improvement science and build agreement for action in a national improvement and implementation research network in the USA. This was accomplished using three stages of identification and consensus. (1) Topics were identified through a multipronged environmental scan of the literature and initiatives. (2) Based on this scan, a survey was developed, and stakeholders ( ) were invited to rate the resulting 33-topic, 9-category list, via an online survey. Data from 560 respondents (20% response) were analyzed. (3) An expert panel used survey results to further refine the research priorities through a Rand Delphi process. Priorities identified were within four categories: care coordination and transitions, high-performing clinical systems and microsystems improvement approaches, implementation of evidence-based improvements and best practices, and culture of quality and safety. The priorities identified were adopted by the improvement science research network as the research agenda to guide strategy. The process and conclusions may be of value to quality improvement research funding agencies, governments, and research units seeking to concentrate their resources on improvement topics where research is capable of yielding timely and actionable answers as well as contributing to the knowledge base for improvement. 1. Introduction Improvement science is an emerging multidiscipline which overlaps with other fields such as implementation science and conventional medical research as noted by Wensing and others [1]. Experts point out that the evidence base for the science spans controlled trials of interventions with patients, providers, and organizations, to small scale rapid cycle testing of improvement changes by local project teams [2]. A healthy debate in the literature focuses on the type and strength of evidence which might form the scientific basis and whether the aim should be to build a knowledge domain with characteristics distinct from other sciences [3–5]. Largely separate to these debates, healthcare organizations and governments globally are implementing different ideas and interventions which hold promise for improving quality, safety, and performance [6]. Research of different types can contribute to more effective choice and implementation of improvements, but resources are limited, and expertise in this field is scarce. There is a case for concentrating research resources on investigating targeted problems and potential solutions. If researchers and funders

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