Advancing Quality Improvement Research Challenges and Opportunities: Workshop Summary (2007) / Chapter Skim
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Thus the purpose of this workshop was to bring people together from various arenas to discuss what quality improvement is, and what barriers exist in the health care industry to quality improvement and also to research about quality improvement. The summary that ensues is thus limited to the presentations and discussions during the workshop itself.
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Non-Health Care Service Sector Although improving quality requires the use of specific tools, developing those tools and putting them to use is only part of the challenge. As Scot Webster of Medtronic, a manufacturer of medical devices, explained, the larger part of improvement is actually changing culture and driving change.
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Collectively, he said, these issues are viewed as the "iceberg of safety," with increased morbidity and mortality and potential increased medical liability at the tip of the iceberg. Quality improvement programs can help prevent patient safety issues in health care.
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APPROACHES TO QUALITY IMPROVEMENT RESEARCH There is a lack of understanding of how to connect the different strategies available for improving quality, said Paul Batalden of Dartmouth. He offered the following formula as a way of thinking about how the various factors of quality improvement fit together: 1 Baldrige criteria are: leadership; strategic planning; focus on patients, other customers, and markets; measurement, analysis, and knowledge management; workforce focus; process management; and results (Baldrige National Quality Program, 2007)
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The aim is to develop a generalizable evidence base that can be used to improve the implementation of research findings and enhance decision making at the local level. This research is inherently interdisciplinary, involving health care professionals, organization scientists, engineers, and others.
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While many agree with the concept of interdisciplinary research in theory, it is extremely difficult to put into practice. The fourth barrier is the "mismatch" between training and practice: Most people doing medical quality improvement projects have little or no research training, while most people with research training are not doing quality improvement projects.
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The sixth barrier identified during the workshop is the existence of methodological differences between the biological sciences and the social sciences. Quality improvement research faces the same challenges -- such as biases, confounders, and difficulties with measurement -- that clinical research does.
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