You are here

  • Home
  • Archive
  • Volume 28, Issue 5
  • Reinvigorating stagnant science: implementation laboratories and a meta-laboratory to efficiently advance the science of audit and feedback

Article Text

Article menu

Download PDFPDF

Research and reporting methodology
Reinvigorating stagnant science: implementation laboratories and a meta-laboratory to efficiently advance the science of audit and feedback
  1. JM Grimshaw1,2,
  2. Noah Ivers3,4,
  3. Stefanie Linklater1,
  4. Robbie Foy5,
  5. Jill J Francis6,
  6. Wouter T Gude7,
  7. Sylvia J Hysong8,9
  8. on behalf of the Audit and Feedback MetaLab
    1. 1 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
    2. 2 Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
    3. 3 Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
    4. 4 Department of Family Medicine and Community Medicine, University of Toronto, Toronto, Ontario, Canada
    5. 5 Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
    6. 6 Health Services Research and Management Division, City University of London, London, UK
    7. 7 Department of Medical Informatics, Academic Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
    8. 8 Center for Innovations in Quality Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, United States
    9. 9 Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, United States
    1. Correspondence to Dr JM Grimshaw, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa ON K1Y 4E9, Canada; jgrimshaw{at}ohri.ca

    Abstract

    Audit and feedback (A&F) is a commonly used quality improvement (QI) approach. A Cochrane review indicates that A&F is generally effective and leads to modest improvements in professional practice but with considerable variation in the observed effects. While we have some understanding of factors that enhance the effects of A&F, further research needs to explore when A&F is most likely to be effective and how to optimise it. To do this, we need to move away from two-arm trials of A&F compared with control in favour of head-to-head trials of different ways of providing A&F. This paper describes implementation laboratories involving collaborations between healthcare organisations providing A&F at scale, and researchers, to embed head-to-head trials into routine QI programmes. This can improve effectiveness while producing generalisable knowledge about how to optimise A&F. We also describe an international meta-laboratory that aims to maximise cross-laboratory learning and facilitate coordination of A&F research.

    • audit and feedback
    • implementation science
    • quality improvement
    • randomised controlled trial

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0

    https://doi.org/10.1136/bmjqs-2018-008355

    Statistics from Altmetric.com

      Request Permissions

      If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

      View Full Text

      Footnotes

      • Correction notice This article has been corrected since it published Online First. The 'on behalf of' clause has been reinstated as it got ommitted in the previous version.

      • Collaborators On behalf of the Audit & Feedback MetaLab. Sarah Alderson, Sylvain Boet, Jamie Brehaut, Benjamin Brown, Jan Clarkson, Heather Colquhoun, Nicolette de Keizer, Laura Desveaux, Gail Dobell, Sandra Dunn, Amanda Farrin, Robbie C Foy, Jill J Francis, Anna Greenberg, Jeremy M Grimshaw, Wouter T Gude, Suzanne Hartley, Tanya Horsley, Sylvia J Hysong, Noah M Ivers, Zach Landis-Lewis, Stefanie Linklater, Jane London, Fabiana Lorencatto, Susan Michie, Denise O’Connor, Niels Peek, Justin Presseau, Craig Ramsay, Anne E. Sales, Ann Sprague, Simon Stanworth, Michael Sykes, Monica Taljaard, Kednapa Thavorn, Mark Walker, Rebecaa Walwyn, Debra Weiss, Thomas A Willis and Holly Witteman.

      • Contributors This paper is the product of the A&F MetaLab. The named authors are the current Steering Group of the MetaLab. The group authors have contributed consistently to the development of these ideas over the last 3 years during several national and international meetings (Ottawa Canada 2016, Leeds UK 2017, Calgary Canada 2017). All authors have been involved in drafting of the paper and have approved the final version. JMG is the guarantor for the paper.

      • Funding This study was funded by the Canadian Institutes of Health Research (FDN-143269).

      • Competing interests None declared.

      • Patient consent for publication Not required.

      • Provenance and peer review Not commissioned; externally peer reviewed.