Reinvigorating stagnant science: Implementation laboratories and a meta-laboratory to efficiently advance the science of audit and feedback
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2019-05-01
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BMJ Quality and Safety
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BMJ PUBLISHING GROUP
Melbourne Authors
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Melbourne School of Health Sciences
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Journal Article
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Grimshaw, J. M., Ivers, N., Linklater, S., Foy, R., Francis, J. J., Gude, W. T. & Hysong, S. J. (2019). Reinvigorating stagnant science: Implementation laboratories and a meta-laboratory to efficiently advance the science of audit and feedback. BMJ Quality and Safety, 28 (5), pp.416-423. https://doi.org/10.1136/bmjqs-2018-008355.
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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.