Research, evidence and
quality improvement
Jennifer Tieman, CareSearch Director
Deb Rawlings, CareSearch Research Fellow
PCNA, April 2014
Overview
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•
•
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Why does this matter
Differences and synergies
CareSearch approaches and strategies
CareSearch evaluation studies
Implications
Why this matters
“Between the healthcare we have
and the care we could have lies not a
gap but a chasm”.
Institute of Medicine, Crossing the Quality Chasm, 2001
Comparison of EBP, QI and Research
QI
EBP
Research
Definition
Evaluate effectiveness of
current process and
improve care processes
locally
Integration of research
evidence into clinical
decision
Formal, systematic
inquiry to generate
knowledge
Purposes
Bring about improvement
in this setting
Compare to standards or
benchmarks
Translate research into
practice
Increase effectiveness of
treatment
Answer a research
question
Generate new knowledge
Methods
PDSA
PICO/PICOT
Scientific methods
Adapted from North Dakota Centre for Nursing Comparison of Evidence based Practice, Quality
Improvement and Nursing Research, December 2013
Independent or complementary?
Clinical
decisions
Do right things
(EBP)
Process and
system
change
Do things right
(QI)
Good patient
care
Do right things
right (EBP &
QI)
Adapted from Glasziou, Ogrinc & Goodman 2011 Can evidence based medicine and clinical quality improvement
learn from each other? BMJ Qual Saf 20:113-117
Nurses’ roles
• Nursing practice
– Expectations as to knowledge and
competency in QI, EBP and research
• Specific roles
– QI activities (eg NSAP, PCOC)
– Research studies (eg PaCCSC)
– EBP (eg journal clubs)
CareSearch Strategies
• Making evidence accessible
– PubMed Searches
– Clinical Evidence
• Encouraging evidence use
– Nurses Hub (and Nurses Hub News)
– My Learning
• Partnerships in QI
– WTCF
– Information on QI
• Supporting research
– RDMS
– Research Resources
Evaluation Studies
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•
•
•
RDMS
Nurses Hub
Search Filters
WTCF
Nurses Hub
• Nurses Hub
– Evidence and resources contextualised
for, and specific to, nurses
– All settings of care
• Study Methodology
– Online survey (n=233)
– Stakeholder interviews (n=10)
• Key Findings
– ¾ of respondents had used information found on Hub
– 30% said information had assisted them in making changes
in their practice
– Issues reported relating to access to technology and time for
EBP and literature
RDMS
• RDMS
– Online data collection system
– Facilitates multisite research
• Study Methodology
– User survey (n=44)
– Stakeholder interviews (n=10)
• Key Findings
– Cost savings provided by a common resource
– Research value of ability to have multiple site data
entry
– Helps to focus and professionalise research
Search Filters
• PubMed Topic Searches
– Brokered access to literature
– Facilitate evidence use
• Study Methodology
– Online survey (n=82)
• Key Findings
– 1/3 look for information daily
– 95% indicated that PubMed searches found
information they hadn’t seen
– Less than 1/3 felt their own personal search would
have found the same information
WTCF
• Partnership
– NSAP, PCOC, CareSearch
– WTCF (Structured approach to
quality improvement activity
that incorporates evidence)
• Study Methodology
– Workshop evaluation (n=81)
• Key Findings
– 86% felt the content was relevant to needs in QI
– 70% of workshop participants felt more confident
in implementing change
So What?
• Nurses face increasing demands in practice and
expectations around knowledge and skills in EBP,
research and QI
• CareSearch has developed evidence based
resources and supports for those providing direct
clinical care
• CareSearch is working to support the processes
and activities that underpin research, QI and EBP
• CareSearch runs an evaluation program to assess
whether these strategies and approaches are
effective
CareSearch would like to thank the many people
who contribute their time and expertise to the project, including
members of the National Advisory Group and the Knowledge
Network Management Group.
CareSearch is funded by the Australian Government
Department of Health.
www.caresearch.com.au