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Transcript of TRIPP: ENLIGHTENING THE ACCIDENTAL TOURIST Sandi Isaacson, Director Division of User Liaison and...
TRIPP: ENLIGHTENING THE ACCIDENTAL TRIPP: ENLIGHTENING THE ACCIDENTAL TOURISTTOURIST
Sandi Isaacson, DirectorDivision of User Liaison and Research TranslationU.S. Agency for Healthcare Research and Quality
September 26, 2003
Travelers’ QuotesTravelers’ Quotes
I thought my job was over once I submitted my analysis and report.
Policymakers work in a fact free environment.
Major Changes UnderwayMajor Changes Underway
Current MissionCurrent Mission– To support researchTo support research designed to improve the designed to improve the
outcomes and quality of health care, reduce its costs, outcomes and quality of health care, reduce its costs, address patient safety and medical errors, and address patient safety and medical errors, and broaden access to effective services. broaden access to effective services.
Proposed MissionProposed Mission– To improve the quality, safety, efficiency, and To improve the quality, safety, efficiency, and
effectiveness of health care for all Americans. effectiveness of health care for all Americans.
User Liaison Program (ULP)User Liaison Program (ULP)
Disseminates health services research findings for State and local health policymakers in easily understandable and usable formats through interactive onsite workshops, teleconferences, distance learning programs, and research syntheses.
Serves as a bridge between State and local health policymakers and the health services research community, by bringing back to the Agency the research questions being asked by key policymakers.
ULP Guiding PrinciplesULP Guiding Principles
User drivenUser driven Objective and politically balancedObjective and politically balanced Syntheses: “Translated” story telling and skill Syntheses: “Translated” story telling and skill
buildingbuilding Networking and relationships—cultivate a communityNetworking and relationships—cultivate a community Safe environmentSafe environment
2001 ULP Evaluation Findings2001 ULP Evaluation Findings
Timeliness and relevance of topics affects Timeliness and relevance of topics affects attendance.attendance.
Majority of those surveyed use the Majority of those surveyed use the information.information.
Participants would like follow up activities.Participants would like follow up activities.
Abt Associates, 2001
Detailed Rather than Broad Detailed Rather than Broad Information is PreferredInformation is Preferred
0
2
4
6
8
10
12
Broad Detailed Both Depends
Executives
Legislators
Executive staff N=27Legislators N=9
Notebooks Viewed as Good Notebooks Viewed as Good ResourceResource
0
10
20
30
40
Used Shared
Executives
Legislators
Executives N=35Legislators N=15
It WorksIt Works
Executive BranchN=35
LegislatorsN=15
Had a direct application to their work
12 6
Added to knowledge base on health matters
13 5
Both direct application and increasedknowledge base
6 1
Did not use the information 4 3
Information Used in Many WaysInformation Used in Many Ways
Introduced legislationIntroduced legislation Developed legislative recommendationsDeveloped legislative recommendations Briefed colleaguesBriefed colleagues Planned servicesPlanned services Evaluated State problemsEvaluated State problems
““6 Touch Program”6 Touch Program”
Used information in presentation to Governor Used information in presentation to Governor encouraging him to announce a “Childrens encouraging him to announce a “Childrens Cabinet”Cabinet”
Educated legislator leading to their approving Educated legislator leading to their approving 3 new drug classes. 3 new drug classes.
State-specific SeminarsState-specific Seminars
Evaluation of State-specific Medical Error Evaluation of State-specific Medical Error and Patient Safety Seminarsand Patient Safety Seminars
Research Triangle Institute, 2001Research Triangle Institute, 2001
States StudiedStates Studied
In PersonIn Person– New YorkNew York– UtahUtah
Telephone InterviewsTelephone Interviews– MinnesotaMinnesota– GeorgiaGeorgia– WisconsinWisconsin
Logic & purposive sampling guided state selection including:Geographic dispersion, meeting size, pre-existing infrastructure, medical error reporting system, etc.
Intermediate Outcomes: Events Intermediate Outcomes: Events Following AHRQ-Sponsored SeminarFollowing AHRQ-Sponsored Seminar
StateState
Expand Expand Involved Involved Stake-Stake-
holdersholders
Error/Error/Safety Safety
Reports Reports DisseminatDisseminat
eded
Work/Work/User User
Groups Groups CreatedCreated
Safety Safety Research Research FundingFunding
Reporting Reporting System System Imple-Imple-
mentedmented
Leap-Leap-frogfrog
Web Web Site Site
CreatedCreated
Subse-Subse-quent quent
Statewide Statewide MeetingMeeting
GAGA xx xx xx
MNMN xx xx xx xx
NYNY xx xx
UTUT xx xx xx xx xx xx
WIWI xx xx xx
Perceived Role of AHRQ-Sponsored Perceived Role of AHRQ-Sponsored Seminars: Stepping StonesSeminars: Stepping Stones
Relationship building: bringing key stakeholders together
Education: learning what others are doing Unifying forum: examining intra-State activities Focus: keeping a focus on error reduction and
enhanced safety
RecommendationsRecommendations
Match state’s stage of evolution on a topic (i.e., Match state’s stage of evolution on a topic (i.e., patient safety) with agency’s intended purpose.patient safety) with agency’s intended purpose.
Continue with tailored approach: there is no one-Continue with tailored approach: there is no one-size fits all mentality.size fits all mentality.
Task states to include action items/next steps as Task states to include action items/next steps as part of seminars whenever possible to directly part of seminars whenever possible to directly assess success.assess success.
Knowledge Transfer ContractKnowledge Transfer Contract
The New ULPThe New ULP– Explicitly based on knowledge Explicitly based on knowledge
transfer/utilization/integration conceptstransfer/utilization/integration concepts– Building on strategies, partnerships, and Building on strategies, partnerships, and
communities of practicecommunities of practice– Skill building, tools, and technical assistance Skill building, tools, and technical assistance
stressedstressed– Expanded AudienceExpanded Audience
"What we really want to get at is not how many "What we really want to get at is not how many reports have been done, but how many people's lives reports have been done, but how many people's lives are being bettered by what has been accomplished. are being bettered by what has been accomplished. In other words, is it being used, is it being followed, is In other words, is it being used, is it being followed, is it actually being given to patients?…it actually being given to patients?…
[W]hat effect is it having on people?”[W]hat effect is it having on people?”Congressman John Porter, 1998Congressman John Porter, 1998
Chairman, House Appropriations Subcommittee on Labor, HHS, Chairman, House Appropriations Subcommittee on Labor, HHS, and Educationand Education
AHRQ’s Challenge
AHRQ DirectorAHRQ Director
Disturbing delays and embarrassing failures existin translating research into practice.
Dr. Carolyn Clancy, July 22, 2003
Giving Translation ProminenceGiving Translation Prominence
Increase partnerships and intermediary Increase partnerships and intermediary relationships.relationships.
Create syntheses/storiesCreate syntheses/stories Change the rules of researchChange the rules of research Impress upon others the importance of translating Impress upon others the importance of translating
evidence into practice and policyevidence into practice and policy
Strategies for Technology BrokeringStrategies for Technology Brokering
Seize one-time opportunitiesSeize one-time opportunities Remain focused on existing markets and Remain focused on existing markets and
customers, but create smaller groups internally customers, but create smaller groups internally that are focused on building innovations, orthat are focused on building innovations, or
Commit the entire organization.Commit the entire organization.
How Breakthroughs Happen: The Surprising Truth About How Companies Innovate, Andrew Hargadon, Kathleen M. Eisenhardt, Harvard Business School Press, 2003
What is the Next Stop?What is the Next Stop?
Developing new internal systemsDeveloping new internal systems Educating knowledge brokersEducating knowledge brokers Adventure travel instead of accidental tourist: Adventure travel instead of accidental tourist:
exploring promising new roads exploring promising new roads