Chapter 5 : Tips for Success

In research, practice, and project management

"In recent years we have developed a number of web-based resources to support your dissemination and implementation work. Some guide you through the designing of your intervention to increase its adoption and implementation potential

(Make Research Matter)

others support your selection, adaptation, integration of theories and frameworks into your D&I work

(D&I Models)

."

— Boriska Rabin, PhD, MPH, PharmD

Assistant Clinical Professor
Department of Family Medicine
University of Colorado Denver, School of Medicine

"Remember your study subjects at the study end. They usually are always interested in receiving a summary or some type of report from the research project that gives them valuable information about what was learned, how they helped answer questions, and what remains to be answered."

— Juliana Barnard, MA

Project Manager
Children's Outcomes Research (COR), Children’s Hospital Colorado
University of Colorado School of Medicine

Learning Objective:

To apply D&I strategies and concepts for success in writing a research proposal, implementing a D&I program, or managing a project in D&I.

Six-Step Process of Implementing Research into Practice

Step 1: Select conditions per patient populations associated with high risk of disease and/or disability and/or burden of illness for Veterans

1a: Identify and prioritize

1b: Identify high-priority clinical practices and outcomes within a selected condition

Step 2: Identify evidence-based guidelines, recommendations, and best practices

2a: Identify evidence-based clinical practice guidelines

2b: Identify evidence-based clinical recommendations

2c: Identify evidence-based clinical practices

Step 3: Measure and diagnose quality and performance gaps

3a: Measure existing practice patterns and outcomes across VHA and identify variations from evidence-based practices

3b: Identify determinants of current practices

3c: Diagnose quality/performance gaps

3d: Identify barriers and facilitators to improvement

Step 4: Implement improvement programs

4a: Identify improvement/implementation strategies, programs, and program
components or tools

4b: Develop or adapt improvement/implementation strategies, programs, and program
components or tools

4c: Implement improvement/implementation strategies/programs to address quality gaps

Step 5: Evaluate Improvement Programs

Assess improvement program feasibility, implementation, and impacts on patient, family, and healthcare system processes and outcomes

Step 6: Evaluate Improvement Programs

Assess improvement program impacts on health-related quality of life (HRQOL)

Source: Stetler CB, Mittman BS, Francis J. (2008). Overview of the VA Quality Enhancement Research Initiative (QUERI) and QUERI theme articles: QUERI Series. Implment Sci;3:8. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2289837/

Ten Key Ingredients for Implementation Research Proposals

Proposal ingredient

Key question

Review criteria

Yes/No

1. The care gap or quality gap

The proposal has clear evidence that a gap in quality exists?

Significance Impact

2. The evidence-based treatment to be implemented

Is the evidence for the program, treatment, or set of services to be implemented demonstrated?

Significance Innovation

3. Conceptual model and theoretical justification

The proposal delineates a clear conceptual framework/theory/model that informs the design and variables being tested?

Approach Innovation

4. Stakeholder priorities, engagement in change

Is there a clear engagement process of the stakeholders in place?

Significance Impact Approach Environment

5. Setting’s readiness to adopt new services/treatments/programs

Is there clear information that reflects the setting's readiness, capacity, or appetite for change, specifically around adoption of the proposed evidence-based treatment?

Impact Approach Environment

6. Implementation strategy/process

Are the strategies to implement the intervention clearly defined, and justified conceptually?

Significance Impact Innovation

7. Team experience with the setting, treatment, implementation process

Does the proposal detail the team's experience with the study setting, the treatment whose implementation is being studied, and implementation processes?

Approach Investigator team

8. Feasibility of proposed research design and methods

Does the methods section contain as much detail as possible, as well as lay out possible choice junctures and contingencies, should methods not work as planned?

Approach Investigator Team

9. Measurement and analysis section

Does the proposal clarify the key constructs to be measured, corresponding to the overarching conceptual model or theory?

Is a measurement plan clear for each construct?

Does the analysis section demonstrate how relationships between constructs will be tested?

Approach Investigator team

10. Policy/funding environment; leverage or support for sustaining change

Does the proposal address how the implementation initiative aligns with policy trends?

Impact Significance

View the PCORI Merit Review Criteria Download This Checklist As A PDF

Tips From The Trenches with Alison Saville

Project Manager
Children’s Outcomes Research (COR), Children’s Hospital Colorado, University of Colorado School of Medicine

On Collaboration

Buy-in is important – from the top and also from the front-line project people. It takes time to build trust. Meet in-person, build relationships.

Meet regularly - over communicate particularly in the beginning.

Get feedback from key players on all sides, incorporate suggestions into the research plan.

Provide results of the study back to your key stakeholders – they want to know the results and how they can incorporate it into real world practices.

Share concerns and information as you go along, work together to resolve.

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On Project Management

Plan ahead - keep a timeline and change it as priorities change, often there are multiple pieces of the project in the air and you have to keep your eye on each piece.

Track progress – develop good database systems to manage all the process measures. These are often very valuable and complement the outcomes data quite well.

Meet regularly with your core research team – prioritize questions/concerns so meetings can be focused and solutions can be discussed.

Delegate – hire good graduate students and/or project coordinators who can help you carry out fine details so as a manager you can keep a bird’s eye view on all pieces.

Above all else – be flexible and adaptable. Just because something was written into the grant does not mean it will actually work out when you get it. Be willing to think through alternative protocols or techniques if something is not working.

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Key Takeaways

Click To Reveal Flipcard Answer

What is the best way to maximize collaboration?

Implementers should build relationships and take the time to get “buy-in.” Get feedback, provide results, share concerns and meet regularly!

Our experts suggest the following actions for project management:

Plan ahead, track progress, delegate and stay flexible/adaptable.

The Six-Step Process may aid in implementing research into practice. It includes:

Selecting conditions (identify and prioritize patient populations)
Identify evidence-based guidelines, recommendations and best practices
Measure and diagnose quality/performance gaps
Implement improvement programs
Assess feasibility, implementation and impacts on processes and outcomes
Assess impacts on health-related quality of life

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