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Collaborating Effectively to Achieve QI/Research Outcomes

Collaborating Effectively to Achieve QI/Research Outcomes. Robin E. Remsburg, PhD, GCNS,BC, FAAN AMDA Foundation Fall Conference November 17, 2008. Objectives. Science of team science Examples of quality improvement (QI) research Strategies for effective collaboration

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Collaborating Effectively to Achieve QI/Research Outcomes

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  1. Collaborating Effectively to Achieve QI/Research Outcomes Robin E. Remsburg, PhD, GCNS,BC, FAAN AMDA Foundation Fall Conference November 17, 2008

  2. Objectives • Science of team science • Examples of quality improvement (QI) research • Strategies for effective collaboration • Pitfalls---where things can go wrong

  3. Collaboration • is a recursive process where two or more people or organizations work together toward an intersection of common goals — for example, an intellectual endeavor that is creative in nature by sharing knowledge, learning and building consensus. Wikopedia 08

  4. Team • Is a distinguishable set of two or more individuals who interact dynamically, interdependently and adaptively to achieve specified, shared and valued objectives.

  5. Science of Team Science • Transdisciplinary collaboration • For example: cancer, heart disease, diabetes, AIDS, global warming, inter-group conflict, terrorism • Transdisciplinarity • Integrative process in which researchers work jointly to develop and use a shared conceptual framework that synthesizes and extends discipline-specific theories, concepts, methods, or all three to create new models and language to address a common research problem

  6. Goals of Transdisciplinarity • Framing future research & scientific discovery • Design, develop, & implement evidence-based interventions • Translation of research to health care and public health practice

  7. Question • How can collaboration across disciplines lead to new ways of framing, understanding, and addressing human health issues?

  8. Transdisciplinarity • Rigor, openness, and tolerance are the fundamental characteristics of the transdisciplinary attitude and vision. Rigor is the argument, taking into account all existing data. Openess involves acceptance of the unknown, the unexpected and the unforeseeable. Tolerance implies acknowledging the right to ideas and truths opposed to our own.

  9. Importance of the Team • Willingness to commit sufficient time • Openness to learn each other’s disciplinary languages and jargon • Capacity to build mutual confidence and trust • Overcome challenges of working as equals, with no knowledge or discipline or practice assuming priority

  10. Challenges and Opportunities • Difficulties of defining roles for team members • Need to avoid defining the problem either in a narrow, reductive way or so broadly • Need to overcome discipline rigidity and hyperspecialization as barriers

  11. Facilitating Factors • Social psychology and organizational behavior • Infrastructures for collaboration • Experience

  12. Facilitating Contextual Factors • Intrapersonal • Interpersonal • Organizational/institutional • Physical/environment • Technologic • Sociopolitical

  13. Social Determinants of Cancer

  14. ICU Bloodstream Infections • Improvement model • -Interdisciplinary team • -Conceptual model for adhering to practice guidelines • -Human factors literature on safety

  15. ICU Bloodstream Infections • Interventions • Educational program • Central catheter insertion cart • Daily query about catheter removal • Implementing a procedure checklist • Empowering nurses to stop the procedure

  16. WHO Safe Surgery Initiative

  17. TIME OUT • Transdisciplinarity • Teams • Facilitating factors • Examples

  18. Collaborative QI Research • Assessing readiness • Defining the problem(s)/question(s)—root cause • Crafting the solution • Finding the evidence for the solution or testing a new idea • Implementing the solution • -setting up the treatment • -intervening variables • - fidelity to treatment • -monitoring the outcomes

  19. Collaborative QI Research • Measurement and documentation • Analyzing the data • Using the results • Disseminating the results

  20. Summary • Transdisciplinary approach to QI research • Understand the importance of the team • Described several examples of transdiscplinary QI research • Identified the important steps in the process of QI research that are vulnerable

  21. References and Resources • AHRQ. Nursing Home Survey on Patient Safety Culture Development. databasesonsafetyculture@ahrq.hhs.gov • http://safetyculturesurveys@ahrq.hhs.gov/. • AHRQ. Health Care Innovations Exchange. www.innovations.ahrq.gov, last accessed 11/15/08. • Am J Prev Med 2008:35. Transdciplinary Supplement • Berenholtz SM, et al. Eliminating catheter-related bloodstream infections in the ICU. Crti Care Med 2004;32(10):2014-2020. • Lynn J, et al. The ethics of using quality improvement methods in health care. Ann of Intern Med 2007;146:666-673. • .

  22. References and Resources • Pronovost P, et al. Improving patient safety in intensive care units in Michigan. J Crit Care 2008;23:207-221 • Rodrigguez-Paz J , Pronovost P. Prevention of catheter-related blood stream infections. Adv in Surg 2008; 42:229-248. • TeamSTEPPS.http://dodpatientsafety.usuhs.mil/index.php?name=News&file=article&sid=31, last accessed 11/15/08. • WHO. Safe Surgery. http://www.who.int/patientsafety/safesurgery/ss_checklist/en/index.html, last accessed 11/15/08.

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