DQ2 What is the difference between research studies and quality improvement studies?

DQ2 What is the difference between research studies and quality improvement studies

DQ2 What is the difference between research studies and quality improvement studies

After mixed results from the Millennium Development Goals (MDGs) strategy, the global agenda recognized the critical role of ensuring not just access but quality of health care delivery. As a result, quality and improvement have become a core focus within the Universal Health Coverage movement to achieve the goal of better population health and Sustainable Development Goals (SDGs)[1–3]. In low- and middle-income countries, quality improvement (QI) is used to identify performance gaps and implement improvement interventions to address these problems at the local, sub national and national levels. Methods used by these improvement interventions range from process improvements using incremental, cyclically implemented changes appropriate to the local context, to system-level interventions and policies to improve and sustain quality. Regardless of the scope of improvement efforts and methods employed, the impact and spread of QI has often fallen short. Causes of these lost opportunities include how decisions about improvement interventions are made, the methodology for measuring the effectiveness of the intervention, what data are collected and used and how the information on both the implementation and the intervention is communicated to drive spread and knowledge translation [4, 5]. Practitioners engaged in improvement in their organizations are frustrated by research reviews which often show a lack of conclusiveness about the effectiveness of QI when many of them see the local benefits from their work. Researchers complain about the lack of rigor in the application of QI methods in practice sittings and about poor documentation of the implementation process [6].

There is a growing realization of the need for common ground between implementers and researchers that promotes use of more systematic and rigorous methods to assess the improvement intervention effectiveness when appropriate but does not demand that all QI implementations be subject to the experimental methods commonly considered to be the gold standard of evidence. To explore the causes of this gap and address how to bridge the gap and better engage the targeted consumers of generated knowledge, including communities, governments and funders, a session ‘Better Health Care: How do we learn about improvement?’ was organized by Salzburg Global Seminar (SGS) [7]. The session brought together experts from a range of fields and organizations, including researchers, improvement implementers from the field, policy makers, and representatives from countries and international organizations.

For a partnership between researchers and implementers to become more consistent in improvement projects and studies, the incentives and priorities of each of these groups need to be better aligned in QI work and its evaluation. In this paper, we build on the Salzburg discussions, existing literature, and our own experience to explore the barriers to collaboration and offer suggestions on how to start to address these barriers. In the spirit of quality improvement, we hope that these recommendations are adopted and tried by groups interested in advancing the research and the practice of QI.

DQ2 What is the difference between research studies and quality improvement studies

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Why the gap exists

Both groups use data to evaluate whether improvements have taken place and are interested in the question of ‘did it work’. However, these gaps have occurred in part because of differences in goals, evidence needs and methods used and incentives for results and dissemination.

Goals

As we consider the major differences between researchers and implementers, we should recognize that there is not a clearly defined dichotomy between these two groups. Rather, those who are focused on in improvement are part of a continuum and are driven by a range of goals from driving and demonstrating local improvements to a focus on attributing these improvements to QI methods that can be generalized and spread, as illustrated in Table Table1,1, which also describes differences in incentives, discussed further below. Organization-based implementers focus on quality improvement projects, where the primary goal is driving change to a local problem to improve care. Policy and decision makers’ goals are broader improvement, needing evidence for current and future decision on what methods and implementation strategies to use. Researchers have a goal of developing new and generalizable knowledge about the effectiveness of QI

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DISCUSSION RUBRIC

DQ2 What is the difference between research studies and quality improvement studies Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements *per discussion thread*	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement *per discussion thread*	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

methods.