Regenstrief Conference Doebbeling

10 th Biennial Regenstrief Conference Overview Brad Doebbeling VA Center of Excellence on Implementing Evidence-based Practice IU Center for Health Services & Outcomes Research, Regenstrief Institute, Inc. IU School of Medicine October 2-4, 2007

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Healthcare “System” Chasm ,[object Object]

How Hazardous Is Health Care? Source: Berwick, D.M.

RAND Study: Quality of Health Care Often Not Optimal ,[object Object],Percentage of time E. McGlynn, S. Asch, J. Adams, et al., The Quality of Health Care Delivered to Adults in the United States, N Engl J Med , 2003 Alcohol dependence Hip fracture Peptic ulcer Diabetes Low back pain Prenatal care Breast cancer Cataracts 11% 23% 33% 45% 69% 73% 76% 79%

New and Unprecedented Challenges ,[object Object],[object Object],[object Object],[object Object],[object Object]

Challenges ,[object Object],[object Object],[object Object],[object Object]

Healthcare Systems ,[object Object],[object Object],[object Object],Ryan J. in IOM/NAE Report, 2005.

System Transformation ,[object Object]

Challenges to System Transformation ,[object Object],[object Object],[object Object],[object Object],[object Object]

Systems Transformation ,[object Object],[object Object],[object Object],[object Object],Wang et al. Redesigning health systems for quality: lessons from emerging perspectives. Jnt Comm J Qual Safety 2007

Institute of Medicine (IOM) and National Academy of Engineering (NAE) Report ,[object Object],[object Object],Reid PP, Compton D, et al. Building a better delivery system: A new engineering/health care partnership, Natl. Acad. Press, 2005.

System Engineering ,[object Object],[object Object]

Challenges to applying system engineering to healthcare ,[object Object],[object Object],[object Object],[object Object],Reid PP, Compton D, et al. Building a better delivery system: A new engineering/health care partnership, Natl. Acad. Press, 2005.

Promoting System Redesign ,[object Object],[object Object],[object Object],[object Object],Wang et al. Redesigning health systems for quality: lessons from emerging perspectives. Jnt Comm J Qual Safety 2007

Systems Redesign ,[object Object],[object Object],[object Object]

Conceptual Frameworks ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

An IHI Framework for Spread ,[object Object],[object Object],[object Object],[object Object]

Informatics Implementation Challenges ,[object Object],[object Object],[object Object],[object Object],[object Object],Doebbeling et al. Priorities and Strategies for Implementation of an Integrated Informatics and Communications Technology System for Evidence-based Practices. J. Gen. Intern. Med. 21:S98-S105, 2006

Toward Evidence-Based Quality Improvement ,[object Object],[object Object],[object Object],[object Object],[object Object],Grimshaw et al J GIM 2006; 21:S14–20.

Strategies for Promoting Organizational and Practice Change by Advancing Implementation Research ,[object Object],[object Object],Rubenstein & Pugh J GIM 2006; 21:S58–64.

Strategies for Promoting Organizational and Practice Change by Advancing Implementation Research ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Rubenstein & Pugh J GIM 2006; 21:S58–64.

“ Taking account” of implementation science ,[object Object],Rubenstein & Pugh J GIM 2006; 21:S58–64.

Reduce duplication & promote progression of evidence into practice ,[object Object],[object Object],[object Object],[object Object],[object Object],Rubenstein & Pugh J GIM 2006; 21:S58–64.

Applying existing implementation science ,[object Object],[object Object],[object Object],Rubenstein & Pugh J GIM 2006; 21:S58–64.

Paradox ,[object Object],[object Object],[object Object],Rubenstein & Pugh J GIM 2006; 21:S58–64.

Necessary partners in initiatives to increase implementation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Rubenstein & Pugh J GIM 2006; 21:S58–64.

The Road to Healthcare Systems Transformation ,[object Object],[object Object],[object Object]

Maximize learning from past & current implementation initiatives ,[object Object],[object Object],Rubenstein & Pugh J GIM 2006; 21:S58–64.

“Business Case” for Spread ,[object Object],[object Object],[object Object]

Future Research Agenda ,[object Object],[object Object]

Future Research Agenda ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Regenstrief Conference Doebbeling

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