TRIPP: ENLIGHTENING THE ACCIDENTAL TOURIST

1. TRIPP: ENLIGHTENING THE ACCIDENTAL TOURIST Sandi Isaacson, Director Division of User Liaison and Research Translation U.S. Agency for Healthcare Research and Quality September 26, 2003

2. Travelers’ Quotes I thought my job was over once I submitted my analysis and report. Policymakers work in a fact free environment.

3. Major Changes Underway • Current Mission • To support research designed to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, and broaden access to effective services. • Proposed Mission • To improve the quality, safety, efficiency, and effectiveness of health care for all Americans.

4. User Liaison Program (ULP) • Disseminates health services research findings for State and local health policymakers in easily understandable and usable formats through interactive onsite workshops, teleconferences, distance learning programs, and research syntheses. • Serves as a bridge between State and local health policymakers and the health services research community, by bringing back to the Agency the research questions being asked by key policymakers.

5. ULP Guiding Principles • User driven • Objective and politically balanced • Syntheses: “Translated” story telling and skill building • Networking and relationships—cultivate a community • Safe environment

6. 2001 ULP Evaluation Findings • Timeliness and relevance of topics affects attendance. • Majority of those surveyed use the information. • Participants would like follow up activities. Abt Associates, 2001

7. Detailed Rather than Broad Information is Preferred Executive staff N=27 Legislators N=9

8. Notebooks Viewed as Good Resource Executives N=35 Legislators N=15

9. It Works

10. Information Used in Many Ways • Introduced legislation • Developed legislative recommendations • Briefed colleagues • Planned services • Evaluated State problems

11. “6 Touch Program” • Used information in presentation to Governor encouraging him to announce a “Childrens Cabinet” • Educated legislator leading to their approving 3 new drug classes.

12. Evaluation of State-specific Medical Error and Patient Safety Seminars State-specific Seminars Research Triangle Institute, 2001

13. States Studied • In Person • New York • Utah • Telephone Interviews • Minnesota • Georgia • Wisconsin Logic & purposive sampling guided state selection including: Geographic dispersion, meeting size, pre-existing infrastructure, medical error reporting system, etc.

14. Intermediate Outcomes: Events Following AHRQ-Sponsored Seminar

15. Perceived Role of AHRQ-Sponsored Seminars: Stepping Stones • Relationship building: bringing key stakeholders together • Education: learning what others are doing • Unifying forum: examining intra-State activities • Focus: keeping a focus on error reduction and enhanced safety

16. Recommendations • Match state’s stage of evolution on a topic (i.e., patient safety) with agency’s intended purpose. • Continue with tailored approach: there is no one-size fits all mentality. • Task states to include action items/next steps as part of seminars whenever possible to directly assess success.

17. Knowledge Transfer Contract • The New ULP • Explicitly based on knowledge transfer/utilization/integration concepts • Building on strategies, partnerships, and communities of practice • Skill building, tools, and technical assistance stressed • Expanded Audience

18. AHRQ’s Challenge "What we really want to get at is not how many reports have been done, but how many people's lives are being bettered by what has been accomplished. In other words, is it being used, is it being followed, is it actually being given to patients?… [W]hat effect is it having on people?” Congressman John Porter, 1998 Chairman, House Appropriations Subcommittee on Labor, HHS, and Education

19. AHRQ Director Disturbing delays and embarrassing failures exist in translating research into practice. Dr. Carolyn Clancy, July 22, 2003

20. Giving Translation Prominence • Increase partnerships and intermediary relationships. • Create syntheses/stories • Change the rules of research • Impress upon others the importance of translating evidence into practice and policy

21. Strategies for Technology Brokering • Seize one-time opportunities • Remain focused on existing markets and customers, but create smaller groups internally that are focused on building innovations, or • Commit the entire organization. How Breakthroughs Happen: The Surprising Truth About How Companies Innovate, Andrew Hargadon, Kathleen M. Eisenhardt, Harvard Business School Press, 2003

22. What is the Next Stop? • Developing new internal systems • Educating knowledge brokers • Adventure travel instead of accidental tourist: exploring promising new roads