Practice-based research networks add value to evidence-based quality improvement.

Area of Science:

• Implementation Science
• Health Services Research
• Clinical Quality Improvement

Background:

• Evidence-Based Quality Improvement (EBQI) is a systematic approach to integrate research evidence into clinical practice.
• The effectiveness of EBQI within Practice-Based Research Networks (PBRNs) is not well understood.
• This study evaluates EBQI implementation within a PBRN to assess the added value of the PBRN infrastructure.

Purpose of the Study:

• To evaluate the implementation of EBQI within the VA Women’s Health Practice-Based Research Network (WH-PBRN).
• To determine how the PBRN infrastructure influenced EBQI processes and outcomes.
• To understand the added value of PBRN context in facilitating evidence-based practice change.

Main Methods:

• A four-site cluster randomized trial of an EBQI approach to tailor a gender awareness curriculum was conducted.
• Qualitative methods, including review of project minutes and debriefing calls, were used to identify PBRN impacts on EBQI.
• Site feedback was mapped to the Replicating Effective Programs implementation phases.

Main Results:

• The WH-PBRN's existing research-clinician relationships facilitated stakeholder engagement and buy-in during the pre-condition phase.
• PBRN site variations allowed for diverse tailoring of EBQI elements during pre-implementation.
• The PBRN Coordinating Center addressed complexities, and dissemination amplified efforts during maintenance.

Conclusions:

• The Practice-Based Research Network infrastructure significantly strengthened multi-site Evidence-Based Quality Improvement activities.
• PBRNs are valuable for promoting the uptake of evidence into routine clinical practice.
• PBRNs can be a key component in the future implementation of evidence-based initiatives.