Closing The Quality Gap A Critical Analysis Of Quality Improvement Strategies Volume 1 Series Overview And Methodology

In early 2003, the Institute of Medicine (IOM) released its report, Priority Areas for National Action: Transforming Health Care Quality. The report listed 20 clinical topics for which best practice treatment guidelines are strongly supported by clinical evidence. Unfortunately, the report and a substantial quantity of other scientific literature show best practice implementation rates in the United States have been disappointing low, and at an annual cost of many thousands of lives. To bring data to bear on the quality improvement opportunities laid out in the IOM's 2003 report, the Agency for Healthcare Research and Quality (AHRQ) asked the Stanford–UCSF Evidence-based Practice Center (EPC) to perform a critical analysis of the existing literature on quality improvement strategies for a number of the 20 disease and treatment priorities noted in the IOM Report. Rather than concentrating on the specific clinical practices that appear to improve health outcomes, these analyses focus on the effort of translating research into practice–identifying those activities that increase the rate at which effective practices are applied to patient care in real world settings. The goal is one of narrowing the quality gap that is largely responsible for suboptimal health care practices and outcomes. This is the first volume in a series of reports intended to support these goals. A carefully designed methodology will be applied to the scientific literature for a number of medical conditions characterized by the IOM as high-level threats to health and longevity. It is AHRQ's hope that the series will stimulate ideas for ongoing quality improvement activity nationally, as well as in individual health systems and among individual caregivers. Closing the Quality Gap is intended to assist a wide range of users: Policymakers can use the detailed evidence review to prioritize quality improvement strategies and choose how best to close the quality gaps in their organizations; Researchers can find detailed information about well-scrutinized areas of treatment, while learning of other areas in need of further exploration; Clinicians and trainees can see a broad spectrum of approaches to improving the quality of care. Some of these approaches fall within the control of individual practitioners, while others will require major systemic changes at the local level or beyond; Patients can learn quality improvement strategies that they can help to promote, while gaining a deeper understanding of the nature and extent of quality gaps, as well as the systemic changes necessary to close them; Groups and individuals charged with funding research will be able to identify high-yield areas of concern that warrant future research support. The purpose of this report is to help readers assess whether the evidence suggests that a quality improvement strategy would work in their specific practice setting or with their specific patient population. Three important questions should be considered: 1. Are the studies of the strategy valid? A study has validity (sometimes called “internal validity”) if its findings are likely to be true in the population in which the study was performed. The primary determinant of validity is the design and conduct of the study. 2. For each quality improvement strategy that has been evaluated in multiple studies with sufficient validity, does the weight of evidence indicate that the strategy is effective? 3. Can the conclusions of a body of evidence be applied to a specific practice setting or population of interest?

This review was organized to bring a systematic assessment of different quality improvement strategies & their effects to the process of identifying & managing hypertension. Findings suggest that quality improvement strategies appear, in general, to be associated with the improved identification & control of hypertension. It is not possible to discern with complete confidence which specific quality improvement strategies have the greatest effects, since most of the studies included more than one quality improvement strategy. Illustrations.

We are now entering the third decade of the 21st Century, and, especially in the last years, the achievements made by scientists have been exceptional, leading to major advancements in the fast-growing field of health services. “Advancements and Challenges in Implementation Science: 2022”, led by Professor Nick Sevdalis, Specialty Chief Editor of the Implementation Science section, is focused on new insights, novel developments, current challenges, latest discoveries, recent advances and future perspectives in the field of implementation science.

Praise for the First Edition: “This wonderful and informative resource provides a definitive base of information for those engaged in clinical inquiry. It not only presents the information in a systematic format, it also provides specific examples of projects that have been completed by advanced practice nurses.” Score 100, 5 Stars -Doody’s Medical Reviews This one-of-a-kind resource is specifically designed to guide DNP students in the essentials of conducting practice-based studies. It demystifies the process by helping students to identify the methodology that best fits their project idea, envision the key elements of the project, design, set up, and run the project, and write up and disseminate the project outcome. In addition to being substantially updated throughout, the second edition includes four new chapters and reflects current literature, with updated references and suggested readings. Additionally, each chapter concludes with a Discussion Guide to assist faculty in pinpointing key points within the chapter. The only book to address the complexities of clinical inquiry from a practice perspective rather than research perspective. The book builds on basic research concepts that, combined with the knowledge and experience gained by the APRN student, facilitate an in-depth understanding of how clinical research differs from traditional quantitative research. Packed with practical steps and tools, the book fosters the development of such skills as finding data, and reading, critiquing, and translating research to support evidenced-based practice within the health care system, either with a specific population, or for policy development. The text is based on the Scholarship of Integration and Application, one of the core DNP competencies, and is organized to build from simple to greater complexity. Each chapter features learning objectives, learning activities, and review questions. New to the Second Edition: Substantially updates all chapters Includes four new chapters: The DNP Project, Finding and Critiquing the Best Evidence, Descriptive Projects, and Disseminating Results New content reflects current literature Offers updated references and suggested readings Chapters conclude with a Discussion Guide to aid faculty and students to identify and explore key points Key Features: Delivers clear, essential guidance for clinical inquiry and research used to demonstrate practice outcomes Written by an esteemed educator highly experienced in teaching clinical inquiry Illustrates the application of “Scholarship of Integration and Application” , a core competency for the DNP Guides readers in DNP student program/project design and evaluation Presents content systematically from simple to complex