NEWS & EVENTS

NHLBI and American Thoracic Society Workshop On Implementation Research

NIH

Description

To advance implementation research (IR) in respiratory, sleep, and critical care medicine, the American Thoracic Society and the Division of Lung Diseases from the NHLBI cosponsored an Implementation Research Workshop on May 17, 2014. The goals of IR are to understand the barriers and facilitators of integrating new evidence into healthcare practices and to develop and test strategies that systematically target these factors to accelerate the adoption of evidence-based care. Throughout the workshop, presenters provided examples of IR that focused on the rate of adoption of evidence-based practices, the feasibility and acceptability of interventions to patients and other stakeholders who make healthcare decisions, the fidelity with which practitioners use specific interventions, the effects of specific barriers on the sustainability of an intervention, and the implications of their research to inform policies to improve patients’ access to high-quality care. During the discussions that ensued, investigators’ experience led to recommendations underscoring the importance of identifying and involving key stakeholders throughout the research process, ensuring that those who serve as reviewers understand the tenets of IR, managing staff motivation and turnover, and tackling the challenges of scaling up interventions across multiple settings.

Recap

Recommendations

  1. Integrate IR with respiratory, sleep, and critical care medicine research
  • Identify priority research areas
  • Work to adopt the nomenclature that is recognized by the field of IR
  • Determine how existing research infrastructure or changes to such infrastructure will facilitate IR
  1. Design and conduct IR
  • Identify relevant study designs beyond randomized clinical trials
  • Define appropriate control groups for IR and establish whether “usual care” is acceptable
  • Establish how to identify and engage stakeholders, including those who are not part of the health care “system”
  • Define elements within IR that can be adapted to leverage technology to increase dissemination
  • Establish how to measure adaptability
  • Determine how to prepare funding organizations or monitoring boards to provide an informative review
  • Consider methods to enhance staff participation and motivation to minimize turnover
  1. Measure outcomes in IR
  • Identify appropriate outcomes for IR
  • Define the metrics of success for IR
  • Establish the appropriate time interval and methodology to measure sustainability
  1. Train investigators
  • Build a collaboration to address training guidelines (establish a curriculum) for students or junior investigators who wish to become engaged in IR
  • Create programs and opportunities for established lung researchers to learn about IR
  1. Scale up interventions across multiple settings
  • Identify study champions at each setting
  • Emphasize simplicity when proposing integration across multiple care settings
  • Distinguish between evidence-based care and IR
  1. Implement and leverage supports for respiratory, critical care, and sleep IR
  • Develop an ATS “home” for investigators and members to coordinate and maintain communication between various groups conducting IR
  • Learn about the Center for Translation Research and Implementation Science (CTRIS) at NIH/NHLBI

Workshop Co-Chairs

  • Bruce G. Bender, Ph.D., National Jewish Health
  • Jerry A. Krishnan, M.D., Ph.D., University of Illinois Hospital and Health Sciences System

Workshop Participants

  • Andrea Apter, M.D., M.Sc., M.A., University of Pennsylvania
  • Shannon Carson, M.D., University of North Carolina
  • Michelle M. Cloutier, M.D., University of Connecticut Health Center
  • Maureen George, Ph.D., R.N., A.E.-C., F.A.A.N., University of Pennsylvania
  • Joe K. Gerald, M.D., Ph.D., University of Arizona
  • Lynn B. Gerald, M.S.P.H., Ph.D., University of Arizona
  • Chris Goss, M.D., M.Sc., University of Washington
  • Sande Okelo, M.D., Ph.D., University of California Los Angeles
  • Richard Mularski, M.D., M.C.R., M.S.H.S., Kaiser Permanente
  • Huong Nguyen, Ph.D., R.N., Kaiser Permanente
  • Minal Patel, Ph.D., University of Michigan
  • Cynthia S. Rand, Ph.D., Johns Hopkins School of Medicine
  • Kristin A. Riekert, Ph.D., Johns Hopkins School of Medicine
  • Michael Schatz, M.D., M.S., Kaiser Permanente Southern California
  • Stanley Szefler, M.D., Children’s Hospital of Colorado
  • Carey C. Thomson, M.D., M.P.H., Mount Auburn Hospital
  • Curtis Weiss, M.D., M.S., Northwestern University
  • Kevin C. Wilson, M.D., Boston University School of Medicine
  • Sandra R. Wilson, Ph.D., Palo Alto Medical Foundation Research Institute

NIH Staff

  • David Chambers, Ph.D., NIMH
  • Michelle Freemer, M.D., NHLBI
  • James Kiley, Ph.D., NHLBI