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Linking improvement science and biomedical research

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In this NEJM Catalyst article, Peter J. Pronovost, M.D., and Christine  G. Holzmueller, BLA, discuss linking biomedical research with improvement science.

Among their remarks:

“Biomedical research generally ‘feeds forward,’ starting with a hypothesis of whether one therapy is better than another and then testing the hypothesis by building a corpus of knowledge about the mechanism of disease and the effectiveness of the therapies. In contrast, improvement science ‘feeds backward,’ starting with the goal, drawing upon theory, and then designing a multifaceted intervention to achieve the goal. In other words, biomedical research focuses on solving puzzles whereas improvement science focuses on solving problems. When biomedical research has sufficiently matured the science and evidence pertaining to a particular problem, improvement science can design, apply, and evaluate a package of interventions to achieve the desired goal (e.g., reducing or eliminating these infections).’’


“Improvement science encompasses more than a local improvement project; it is a comprehensive approach that draws on social science theory to produce and implement multifaceted interventions for the purpose of accelerating the translation of biomedical research into practice. It brings policymakers and clinicians together, aligning all parties around a common purpose and coordinating efforts at national, organizational, local, and sociocultural levels to achieve a goal. Linking improvement science to biomedical research makes it possible for those in health care to both think like engineers to solve problems and think like biomedical researchers to solve puzzles. While extrinsic motivators such as pay for performance and public reporting can help to engage hospital leaders, intrinsic motivators such as the faces of patients who have been harmed and the belief among clinicians that they can prevent harm will accelerate improvement. In the end, change progresses at the speed of trust, and policymakers and clinicians must create mutually respectful relationships that assume positive intent and are guided by shared leadership accountability.’’

To read the full article, please hit this link.


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