As the editor-in-chief, one of my responsibilities is to stay current with both trends in and calls for changes to editorial policies. Editorial policies regarding the style and substance of a manuscript result in the detailed "Instructions to Authors." Admittedly, as an author, I have had my share of following the instructions, with some under the breath grumbling. I simply wanted to get my manuscript out and under review. However, as the editor-in-chief, I must consider whether and how Health Care Management Review (HCMR) editorial policies and the corresponding Instructions to Authors might affect the quality of our science, in a broader sense.
The need to consider the body of evidence across the discipline was brought home to me during my attendance at an annual research meeting in June. One of the sessions I attended addressed the theme of comparative effectiveness research, now widely known as CER. In 2009, CER received considerable attention as the American Reinvestment and Recovery Act provided additional funds for conducting this type of research. The purpose of CER is to conduct a systematic review of treatment options and ultimately disseminate the best clinical practice. A key point made during the CER session was the need to be able to understand under what conditions and processes different treatments have the most effect. For clinicians, taking into consideration the context of an individual's life and the processes related to delivering the treatment can directly influence the decision of which treatment might be most beneficial to a patient. The session presenters were clinicians as well as researchers conducting the systematic reviews, making them particularly cognizant of the clinician's decision-making process. They sought information from the published reports on the organizational context in which the studies were conducted. That information was frequently missing. The question that clinicians ask is how similar is my patient and organization to the one in which the study was conducted. CER focuses on comparisons of medical treatments, yet the concept has great relevance to health care administration research. Clearly, the question of context under which a study was conducted is of keen relevance to health care administrators.
I therefore strongly encourage future HCMR authors to reflect on the issue of similarity, a question that is likely on the minds of HCMR readers. To address this issue, authors need to have a brief narrative in the description of the sample or a table explaining key organizational characteristics that could bear upon the outcome. This suggestion comes as a counterbalance to the recent trend I have seen among HCMR submissions to give very little attention to the organizational characteristics in which the study was conducted. My intent is not to be prescriptive, but authors must be sensitive to the significance of context and provide readers with the essential and relevant information to assess translation into practice.
Equally important is attention to generation by health administration researchers of more studies that fall in the realm of quasi-experimental rather than descriptive designs. A systematic review of administration practices can be conducted only if a sufficient number of primary quasi-experimental studies exist. As with CER, the ultimate purpose is to identify the evidence indicating the best administration practice and then to translate that evidence into health administration practice. HCMR is committed to supporting this goal.
L. Michele Issel, PhD, RN
Editor-in-Chief