The Role of Implementation Science in Changing Clinician Behavior

Establishing the effectiveness of a clinical innovation is not sufficient to guarantee its uptake into routine use. Implementation Science activities enhance the uptake of clinician change in evidence-based practice. Implementation science shares many characteristics, and the rigorous approach, of clinical research. However, it is distinct in that it attends to factors in addition to the effectiveness of the clinical innovation itself, to include identifying and addressing barriers and facilitators to the uptake of evidence-based clinical innovations.

Yale Smilow Cancer Center (Yale) in New Haven, CT and Projects In Knowledge (PIK) engaged in an Implementation Science program that enabled patients and clinicians to partner in a robust shared decision making (SDM) initiative. The pilot served up patients’ values, goals, and preferences to their clinicians.  In turn, their clinicians provided patients with unbiased medical evidence about the risks and benefits of each of the various treatment options, critical for informed decisions and improved patient-centered care.

A breast-cancer SDM training module was developed based on quality measures and the shared decision-making process. The intervention closed gaps in knowledge related to the evidence-based quality measures/guidelines in place at Yale Smilow Cancer Center.

This panel discussion will be presented by key members of Yale and PIK teams.  They will discuss the goals of the activity and what was learned along the way.  Impressive outcomes will be shared with the audience as encouragement to engage in similar pilot activities.  At the conclusion of the pilot, impressive outcomes included:

< !- Clinicians determined their patients’ decision style preference (how they liked to make decisions) – 188% improvement

< !- Clinicians engaged patients in trade-off discussions based on their personal goals – 104% improvement

< !- Clinicians engaged in communications with their patients to discuss how involved they are in their own health – 297% improvement

Innovation:

The PIK Intelligent Dashboard^TM enabled participating clinicians to measure the quality of care provided and improved the transparency of health-related data and care by offering clinicians, care coordinators, and members of the healthcare team the opportunity to engage patients and provide real-time feedback through graphic representation of patients’ self-reported health information, profile and demographic details, along with shared decision making and patient centered care related preferences. All reports are HIPAA compliant and protect patient confidentiality.