Reinvigorating stagnant science: implementation laboratories and a meta-laboratory to efficiently advance the science of audit and feedback

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 fa...

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Published in:BMJ quality & safety Vol. 28; no. 5; pp. 416 - 423
Main Authors: Grimshaw, JM, Ivers, Noah, Linklater, Stefanie, Foy, Robbie, Francis, Jill J, Gude, Wouter T, Hysong, Sylvia J, Alderson, Sarah, Boet, Sylvain, Brehaut, Jamie, Brown, Benjamin, Clarkson, Jan, Colquhoun, Heather, Keizer, Nicolette de, Desveaux, Laura, Dobell, Gail, Dunn, Sandra, Farrin, Amanda, Foy, Robbie C, Greenberg, Anna, Grimshaw, Jeremy M, Hartley, Suzanne, Horsley, Tanya, Ivers, Noah M, Landis-Lewis, Zach, London, Jane, Lorencatto, Fabiana, Michie, Susan, O’Connor, Denise, Peek, Niels, Presseau, Justin, Ramsay, Craig, Sales, Anne E, Sprague, Ann, Stanworth, Simon, Sykes, Michael, Taljaard, Monica, Thavorn, Kednapa, Walker, Mark, Walwyn, Rebecaa, Weiss, Debra, Willis, Thomas A, Witteman, Holly
Format: Journal Article
Language:English
Published: England BMJ Publishing Group Ltd 01.05.2019
BMJ Publishing Group LTD
BMJ Publishing Group
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ISSN:2044-5415, 2044-5423, 2044-5423
Online Access:Get full text
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Summary: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.
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ISSN:2044-5415
2044-5423
2044-5423
DOI:10.1136/bmjqs-2018-008355