XVI Eccuentro Internacional deInvestigacion en Cuidados

16th International Nursing Research Conference

Cartagena, Espana6-9 November 2012Evaluation and accreditation of health care

research in clinical practiceDr Ann McMahonRCN Research & Innovation Adviser

Evaluation and accreditation of health care research

Evaluation and accreditation of health care research

Evaluation and accreditation of health care research

The purpose of health care is to

improve and sustain public health and wellbeing and prevent ill health

assure positive patient / service user experiences of health care systems and services

achieve positive health outcomes and maximise the quality of life of health service users

assure a peaceful deathThis is our common purpose

Evaluation and accreditation of health care research

Assumption: the purpose of health care research is togenerate knowledge to increase understanding of :

the underlying determinants of optimal health and wellbeing poor health

the conditions in which optimal health and wellbeing is realisedpoor health is prevented

in order for decision makers to improve and sustain public health and wellbeing and prevent ill health

Evaluation and accreditation of health care research

Assumption: the purpose of health care research is togenerate knowledge to increase understanding of :

what constitutes an optimal health care experience, in which conditions and how it is created and sustainedthe conditions in which patients are put at risk, and how risk can be mitigated

in order to make decision that seek to assure positive patient / service user experiences of health care services (and do no harm)

Evaluation and accreditation of health care research

Assumption: the purpose of health care research is togenerate knowledge to increase understanding of :

what interventions work, in which conditions and at what costhow ‘what works’ is translated into routine clinical practice

in order to enable decision makers to achieve positive health outcomes, maximise the quality of life of health service users and assure a peaceful death

Evaluation and accreditation of health care research

Research does not

improve and sustain public health and wellbeing and prevent ill health

assure positive patient / service user experiences of health care systems and services

achieve positive health outcomes and maximise the quality of life of health service users

assure a peaceful deathPeople do

Evaluation and accreditation of health care research in clinical practice

How do we assess the value of health care research in practice?

Accredited research evidenceCochrane Collaboration (open access)

Cochrane ReviewsHow do you know if one treatment will work better than another, or if it

will do more harm than good?

Cochrane reviews are systematic reviews of primary research in human care and health policy, and are internationally recognised as the highest standard in evidence based health care. They investigate the effects of interventions for prevention, treatment and rehabilitation..... .

Accredited evidenceJoanna Briggs Institute (subsciption service)

The Joanna Briggs Institute (JBI) is an international not-for-profit, research and development organisation based within the Faculty of Health Sciences at the University of Adelaide, South Australia.

JBI collaborates internationally with over 70 entities across the world. The Institute and its collaborating entities promote and support the synthesis, transfer and utilisation of evidence through identifying feasible, appropriate, meaningful and effective healthcare practices to assist in the improvement of healthcare outcomes globally

JBI aims to provide the best available evidence to inform clinical decision-making at the point of care.

Evaluation and accreditation of health care research in clinical practice

demonstrating what works (the pursuit of certainty)Randomised controlled trials (Gold Standard)Systematic reviewsHealth Technology Assessment (HTA)

- The production of evidence to inform clinical decision making (EBP)

limitationsUncertainty (DUETs)Translation gap

Evaluation and accreditation of health care research in clinical practice

translate knowledge of what works into clinical practiceTranslational research is the process of taking current scientific knowledge and ensuring it is applied in routine clinical care

implementation research (the acknowledgement of complexity)‘… the scientific study of methods to promote the systematic uptake of clinical research findings and other evidence-based practices into routine practice, and hence to improve the quality…..of health care. It includes the study of influences on healthcare professional and organisational behaviour.’Mixed methodsAction research

Evaluation and accreditation of health care research in clinical practice

How do we ensure that health care research is relevant in clinical practice?

Key messages:Demand:

public demand and debate / media exposure is important in stimulating the research agenda, and motivating and engaging practitioners in EBPcredibility is a key driver, with demand needing to come from practitioners to drive / advance practice standards

Methodthe privileging of RCT methodology can be a barrier important to differentiate between primary research and evaluation of innovationpractitioner scientists need to be embedded in services

Use:in take up, brevity often plays an important part getting evidence noticed involved demonstrating how it is applicable to practice, saves wasted effort, achieves cost savings and fits with the changing system

Evaluation and accreditation of health care research in practice

Despite these challenges there is evidence of an innovative culture within today’s health services for example, in the UK, nurses are testing out innovations in practice

in the RCN we are working to build nursing capability in economic assessment

local innovations, themselves driven by evidence of need in clinical practice and by national policy developments should be driving national and international research agendas

Evaluation and accreditation of health care research in practice

Evaluation and accreditation of health care research in practice

The health research and development workforceRecognise the contribution of all stakeholders and realise the potential of the multidisciplinary research workforce

build capability in research and developmentresearch trainingmentorshippublic and patient involvement

assure strong links between research, practice, policy and research commissioning communities

clinical-academic career frameworkInternships‘sandpit’ events

Evaluation and accreditation of health care research in clinical practice

How do we maximise the value of health care research in practice?

XVI Eccuentro Internacional deInvestigacion en Cuidados

16th International Nursing Research Conference

Cartagena, Espana6-9 November 2012Evaluation and accreditation of health care

research in clinical practiceDr Ann McMahonRCN Research & Innovation Adviser