Translating Research Into Practice: Quality, Measurement, and Improvement
Improving Children's Health
Through Health Services Research was a special 1-day meeting held June 26, 1999, in Chicago. The state of the science in children's health services research
was explored, including public and private funding opportunities, networks for
conducting research, and uses of research in policy and practice. The meeting
was co-sponsored by the National Association of Children's Hospitals and Related
Institutions (NACHRI), with the Agency for Health Care Policy and Research (AHCPR),
the American Academy of Pediatrics (AAP), the David and Lucille Packard Foundation, the
Association for Health Services Research (AHSR), the Robert Wood Johnson Foundation, and Data
Dr. Weiss discussed the translation of children's health services research into practice, and identified critical issues for approaching research and its application to the care of children. He compared and contrasted biomedical and translational research concepts and methods. He noted that the field of child health services research has only begun to characterize and test the design principles of translational research.
Four design issues were identified for translational research:
- The importance of taking aim at boundary crossings. For example, translational research takes place in the real world, and part of the researcher's role is to provide information to facilitate change and improve practice. Translational research may also require more investment in qualitative research.
- The importance of constructing appropriate tools. In translational research, design and methods should reflect the real world. In addition, robust outcome and process measures are required.
- The real world is a moving target, with treacherous currents. For example, in a study involving multiple managed care organizations (MCOs), medical directors and MCO policies changed over time. Research teams must plan for these and other changes in their design, and account for changes in interpretation of their findings.
- Children are "moving systems" too.
Dr. Weiss illustrated these points by describing the Pediatric Asthma Care Patient Outcome Research Team (PAC PORT) study. This quality improvement study, funded primarily by the Agency for Healthcare Research and Quality, is a randomized controlled trial (RCT) "plus." The "plus" relates to additional studies to advance the measurement science for children's health services research. Dr. Weiss also noted that there are huge gaps in knowledge about pediatric asthma and other childhood illnesses and care, and concluded that we must rethink how we conduct research on children.
Weiss, Kevin, M.D. Translating Research Into Practice: Quality, Measurement, and Improvement.. Presentation Summary, Improving
Children's Health Through Health Services Research, Chicago, June 26, 1999.