As a relatively new area of interest, improvement science is unknown to many researchers in the field of healthcare, and perhaps even more so to consumers and clinical staff. A group of highly regarded researchers and clinical experts, however, have formed the new Improvement Science Research Network (ISRN), an American initiative which describes itself via its website as "the first nationwide collaboration of clinical and academic leaders devoted to generating a robust science to accelerate quality improvement in hospital patient care". With such lofty aspirations, it is a boon that the ISRN has Kathleen Stevens, EdD, MS, RN, ANEF, FAAN, at its helm as the network's Principal Investigator.
Dr Stevens is Professor of Nursing at the University of Texas Health Science Center at San Antonio (UTHSCSA), where she is also Founding Director of the Academic Center for Evidence-Based Practice (ACE) at UTHSCSA's School of Nursing Center of Excellence. Through ACE, she leads efforts to advance evidence-based quality improvement through research, education, and practice, and also initiated the ongoing Summer Institute on Evidence-Based Practice, a national interdisciplinary conference, as well as the Educators Evidence Based-Practice (EBP) Workshop.
Combine this professional experience with the fact Dr Stevens holds several national-level consultant and expert roles and has served multiple terms as elected officer of the National League for Nursing (a leading nursing education organisation that sets standards for faculty and nursing education programs), and international nursing honour society Sigma Theta Tau, and you can see why she is suited to a leadership role in the ISRN. Dr Stevens' research focus is on knowledge transformation, workforce preparation for quality and safety, and the impact of evidence-based interventions. It is from this background that her work as an investigator on interprofessional projects flourishes, and the ISRN is in turn set to follow suit.
The network is working to achieve significant gains in the quest for improved quality and safety of patient care, and although this goal has been named as an American priority of national concern, little to no progress has actually been achieved, especially in hospital settings and multidisciplinary care processes. In an effort to actively effect a change, the ISRN has declared that it will aim to "select national improvement science research priorities, support multidisciplinary collaboration on improvement science projects, and build a large body of scientific findings to guide better patient care". Funded by a two-year, $3.1 million grant from the National Institute of Nursing Research of the National Institutes of Health, with funds from the American Recovery and Reinvestment Act of 2009, the network will produce studies that will focus on strategies to "build safer work cultures, engage frontline staff in improvement, and find effective ways to spread evidence-based practice in an institution". The nature of the network's structure will allow for large studies that can accommodate multisite projects and will encourage and aid in the rapid, far-reaching dissemination of its findings.
With Dr Stevens leading the way as Principal Investigator and part of the core team at the ISRN Coordinating Centre at ACE, the network is governed and guided by a Steering Council of 16 healthcare experts. The Council is comprised of visionary experts (including Dr Jack Needleman and Mary Salisbury, also featured in this issue), who hail from a variety of disciplines and whose positions span the spectrum of private and public institutions and other organisations for which improved patient outcomes are an ongoing concern. The combined expertise of the group reflects "advanced knowledge in applying systems thinking to healthcare improvement, patient safety research, participatory action research, appreciative inquiry, community engagement, science, bioinformatics and data support, and knowledge management".
As a whole, the ISRN is a team made up of national members, the ISRN Coordinating Center, and the Steering Council, who will remain connected via what the website calls a "unique technology infrastructure [that] connects the network and supports the conduct and dissemination of improvement research studies". The network recognises that medical research has traditionally gone from the laboratory to trial to medical journals, where it is often tucked away for years and forgotten, having never gained much exposure to those who could actually use it. With its web-based collaborative infrastructure, the ISRN will help medical professionals to "design, implement and share research by coordinating and facilitating interprofessional research...[and] such collaborations among clinical and academic researchers and among multiple sites can allow researchers to gather larger samples under rigorous standards to yield powerful and generalisable conclusions." Essentially, the ISRN looks forward to making it "easier for clinical and academic researchers to collaborate and to collect, process, analyse, and communicate data" through the availability of online tools for members, such as:
* a web portal providing secure communication, storage, and sharing of documents and data
* a technical support line offering access to expert guidance in conducting research and using statistics, and
* web events that provide opportunities to collaborate and learn.
With all of these benefits and more, the Dr Stevens and the ISRN are sure to fill the national gap in research approaches in improvement science in the US, creating a central structure upon which to build a network that is sustainable, comprehensive, and perhaps one day, international.