Applying an Implementation Science Approach to Genomic Medicine

Applying an Implementation Science Approach to Genomic Medicine PDF

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2016-07-06

Total Pages: 137

ISBN-13: 0309437792

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Although it is becoming increasingly more common for clinicians to use genomic data in their practices for disease prevention, diagnosis, and treatment, the process of integrating genomic data into the practice of medicine has been a slow and challenging one. Some of the major barriers impeding the incorporation of new genomic technology into clinical practice are: the difficulty of changing routine medical practices to account for the use of genetic testing, the limited knowledge of patients and providers about genomic medicine, assessing sufficient evidence to support the use of genetic tests, privacy and data security issues, and uncertainty about reimbursement. The field of implementation science may be able to provide insights concerning efficient ways to incorporate genomic applications into routine clinical practice. The focus of implementation science studies is to identify integration bottlenecks and optimal approaches for a given setting and ultimately to promote the up-take of research findings. To explore the potential of implementation science to improve the integration of genomics into medicine, the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, in November 2015. Participants explored the challenges and opportunities of integrating genomic advances into the clinic through the lens of implementation science. This report summarizes the presentations and discussions from the workshop.

Implementation Research in Health

Implementation Research in Health PDF

Author: David H. Peters

Publisher: World Health Organization

Published: 2013

Total Pages: 69

ISBN-13: 9241506210

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Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.

Patient Safety and Quality

Patient Safety and Quality PDF

Author: Ronda Hughes

Publisher: Department of Health and Human Services

Published: 2008

Total Pages: 592

ISBN-13:

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"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Knowledge Translation in Health Care

Knowledge Translation in Health Care PDF

Author: Sharon E. Straus

Publisher: John Wiley & Sons

Published: 2011-08-24

Total Pages: 213

ISBN-13: 1444357255

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Health care systems worldwide are faced with the challenge of improving the quality of care. Providing evidence from health research is necessary but not sufficient for the provision of optimal care and so knowledge translation (KT), the scientific study of methods for closing the knowledge-to-action gap and of the barriers and facilitators inherent in the process, is gaining significance. Knowledge Translation in Health Care explains how to use research findings to improve health care in real life, everyday situations. The authors define and describe knowledge translation, and outline strategies for successful knowledge translation in practice and policy making. The book is full of examples of how knowledge translation models work in closing the gap between evidence and action. Written by a team of authors closely involved in the development of knowledge translation this unique book aims to extend understanding and implementation worldwide. It is an introductory guide to an emerging hot topic in evidence-based care and essential for health policy makers, researchers, managers, clinicians and trainees.

Social Isolation and Loneliness in Older Adults

Social Isolation and Loneliness in Older Adults PDF

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2020-05-14

Total Pages: 317

ISBN-13: 0309671035

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Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

Evidence-Based Practice

Evidence-Based Practice PDF

Author: Janet Houser

Publisher: Jones & Bartlett Learning

Published: 2010-10-25

Total Pages: 295

ISBN-13: 0763776173

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Evidence-Based Practice: An Implementation Guide for Healthcare Organizations was created to assist the increasing number of hospitals that are attempting to implement evidence-based practice in their facilities with little or no guidance. This manual serves as a guide for the design and implementation of evidence-based practice systems and provides practice advice, worksheets, and resources for providers. It also shows institutions how to achieve Magnet status without the major investment in consultants and external resources.

Implementing Evidence-Based Practice in Healthcare

Implementing Evidence-Based Practice in Healthcare PDF

Author: Gill Harvey

Publisher: Routledge

Published: 2015-03-24

Total Pages: 240

ISBN-13: 1136768084

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The successful implementation of evidence into practice is dependent on aligning the available evidence to the particular context through the active ingredient of facilitation. Designed to support the widely recognised PARIHS framework, which works as a guide to plan, action and evaluate the implementation of evidence into practice, this book provides a very practical ‘how-to’ guide for facilitating the whole process. This text discusses: undertaking an initial diagnosis of the context and reaching a consensus on the evidence to be implemented; how to link the research evidence with clinical and patients’ experience and local information in the form of audit data or patient and staff feedback; the range of diagnostic, consensus building and stakeholder consultation methods that can be helpful; a description of facilitator roles and facilitation methods, tools and techniques; some of theories that underpin the PARIHS framework and how these have been integrated to inform a revised version of PARIHS Including internationally-sourced case study examples to illustrate how the facilitation role and facilitation skills have been applied in a range of different health care settings, this is the ideal text for those interested in leading or facilitating evidence based implementation projects, from the planning stage through to evaluation.

Bridging the Gap Between Practice and Research

Bridging the Gap Between Practice and Research PDF

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1998-08-11

Total Pages: 286

ISBN-13: 0309173922

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Today, most substance abuse treatment is administered by community-based organizations. If providers could readily incorporate the most recent advances in understanding the mechanisms of addiction and treatment, the treatment would be much more effective and efficient. The gap between research findings and everyday treatment practice represents an enormous missed opportunity at this exciting time in this field. Informed by real-life experiences in addiction treatment including workshops and site visits, Bridging the Gap Between Practice and Research examines why research remains remote from treatment and makes specific recommendations to community providers, federal and state agencies, and other decision-makers. The book outlines concrete strategies for building and disseminating knowledge about addiction; for linking research, policy development, and everyday treatment implementation; and for helping drug treatment consumers become more informed advocates. In candid language, the committee discusses the policy barriers and the human attitudesâ€"the stigma, suspicion, and skepticismâ€"that often hinder progress in addiction treatment. The book identifies the obstacles to effective collaboration among the research, treatment, and policy sectors; evaluates models to address these barriers; and looks in detail at the issue from the perspective of the community-based provider and the researcher.