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7 Strategic Opportunities
Pages 44-52

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From page 44...
... These principles, however, do not necessarily govern quality improvement research because it is not evident that much work has been done to determine what the ethical principles underlying quality improvement research are, Cohen said. IRBs make decisions about what must be reviewed by considering the definition of regulations as inclusive of two parts: research and human subjects.
From page 45...
... IRBs have the flexibility to efficiently and effectively review nonbiomedical research. Some believe the regulations do not match social science research, but Cohen does not believe regulations to be problematic for social science or quality improvement research.
From page 46...
... To make information gleaned from meta-analyses and synthetic review more accessible and to train people how to use that evidence appropriately, Shortell suggested the development of a National Center for Evidence-Based Health Care Management, following the examples of similar centers in Canada and the United Kingdom. This center would identify the best evidence about effective strategies found in the organizational behavior and social science literature and would be shared with clinical and managerial leaders in a meaningful manner.
From page 47...
... Highlighting a recommendation from a joint National Academy of Engineering and IOM report, Shortell suggested the development of approximately 10 centers for engineering and improving health care delivery. These centers would house interdisciplinary groups of engineers, health services researchers, social scientists, managers, and clinical and managerial leaders to work together in certain settings to work on these largely interdisciplinary issues.
From page 48...
... Although these are hypothesis generating, they often help in the practice of medicine or health care. These types of studies are difficult to conduct, but worthwhile.
From page 49...
... Improvements in the health care delivery system's commitment to train researchers and facilitate collaboration with other researchers are also needed. Improving the quality of research is a multidimensional issue in which journals have a role, Mittman said.
From page 50...
... FUNDING Agency for Healthcare Research and Quality Funding for quality improvement has not been well funded federally, said Dougherty of AHRQ. Although funding has increased over time due to investments in patient safety and health information technology, AHRQ's budget of $318 million is used toward achieving its mission to improve quality and the safety, efficiency, and effectiveness of health care for all Americans.
From page 51...
... Bau encouraged potential grantees to consider developing ideas within particular levels of the health care system -- the individual provider, the health care team, the organization, and the system. Developing ideas in this context of a specific level will help grantees understand the challenges facing both research and implementation
From page 52...
... If health care delivery and research were more patient centered, the system could begin to break down the barriers to providing coordinated care. Quality improvement should not be based on condition, disease, or procedure, but on people interacting with the health care system.


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