Dissemination and Implementation: Putting Evidence into Practice Moderator: Joanna Siegel, ScD Director, Dissemination and Implementation, PCORI September 20, 2019
PCORI vs. Traditional Research Approach 2
Why the focus on dissemination and implementation of research results? “It now takes an average of 17 years for new knowledge generated by randomized controlled trials to be incorporated into practice, and even then application is highly uneven.” - Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. 2001. “…on average, Americans receive about half of recommended medical care processes….the gap between what we know works and what is actually done is substantial…” - McGlynn et al., NEJM 2003 3
PCORI’s Mandate – from PCORI’s authorizing legislation 4
Dissemination and Implementation • Dissemination: The intentional, active process of identifying target audiences and tailoring communication strategies to increase awareness and understanding of evidence and to motivate its use in policy, practice, and individual choices. • Implementation: The deliberate, iterative process of integrating evidence into policy and practice by adapting evidence to different contexts and facilitating behavior change and decision making based on evidence, across individuals, communities, and healthcare systems. 5
PCORI Dissemination & Implementation Program Activities 6
Implementation initiatives focus on: • Integrating evidence-based interventions into clinical settings • Adapting interventions • to non-research settings • to different healthcare delivery environments • to different geographic locations, patient populations • Assuring buy-in and sustainability at implementation sites • Documenting the continued effectiveness of an intervention through the implementation • Building a pathway for broader implementation 7
Implementation: PCORI Funding Initiatives To facilitate the uptake and integration of evidence from PCORI-funded studies into real- world practice, in the context of other relevant evidence • Implementation of PCORI-Funded PCOR Results Provides PCORI investigator teams the opportunity to propose next steps to put their findings into practice (up to ~$1.4M per project) • Implementation of Effective Shared Decision Making Approaches in Practice Settings Promotes the implementation and systematic uptake of shared decision making in practice settings (up to $1.5M per project) • Implementation of Findings from PCORI’s Major Research Investments Provides a broad applicant pool the opportunity to put evidence from specific, high- priority PCORI initiatives into practice, in the context of related evidence (up to $2.5M per project) 8
Snapshot of Funded Implementation Awards First awards: December 2016 Number funded: 27 Total PCORI investment: $31M Project budgets: $500K to $2.2M Implementation sites : in 31 states 9
Still to come… Figure shows highlighted topics only; For a complete list of PCORI studies, visit PCORI.org 10
Today’s Presenters: • Sairam Parthasarathy • Meg Simione and Holly Frost • Chris Landrigan and Sharon Cray 11
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