We have our differences, but clinicians, administrators, policy-makers, and health care funders share a common core goal: to provide the best possible care to patients, and to improve that care continuously. The tools they use differ, and may even appear to be in conflict. Clinical research seeks to determine in as rigourous a manner as possible, which of several options yields better patient-centered clinical results, and to disseminate these findings to clinicians. Administrators use quality improvement tools to ensure that accepted best practice approaches are routinely applied in clinical care. Research focuses on a small population of patients, requires their informed consent prior to engagement, is funded from sources outside of the provision of care, and determines whether one of two or more approaches is better. Quality improvement implements conclusions of variable scientific rigour across a broad group of patients, assumes benefit and so does not seek consent, is funded from clinical funds, and focuses on clinician compliance rather than patient benefit. Evolving research designs such as the stepped wedge cluster trial or the platform trial provide a mechanism to bridge the gulf between research and quality improvement, and to ensure that new knowledge that benefits patients is incorporated rapidly into clinical care.
By the end of this lecture, the attendee will be able to:
- Describe the processes of clinical research and quality improvement, and the differences between them
- Identify the limitations of each in developing and applying new knowledge to improve patient care
- Describe novel emerging research models that integrate clinical research and quality improvement, and discuss their implications for the conduct of research and quality improvement
This lecture is equal to 1 CE Contact Hour and 1 CPD Hour
Duration 1 hour(s).
Prof. John Marshall
John Marshall is a Professor of Surgery at the University of Toronto, and a trauma surgeon and intensivist at St. Michael’s Hospital in Toronto, Canada. His academic interests are sepsis, trauma, and the innate immune response. His laboratory studies the cellular mechanisms that prolong neutrophil survival in critical illness by preventing neutrophil programmed cell death, or apoptosis. He has published more than 260 manuscripts, and 70 book chapters, and is the editor of 2 books. He is the founding chair of the International Forum of Acute Care Trialists (InFACT) – a global network of investigator-led critical care clinical research groups, and a member of the Council of the World Federation of Societies of Intensive and Critical Care Medicine and of the executive committee of the International Severe Acute Respiratory Infections Consortium. He is past-chair of the International Sepsis Forum, past-President of the Surgical Infection Society, and past-chair of the Canadian Critical Care Trials Group. He has given invited lectures at more than 400 meetings around the world, and is a member of the editorial boards of seven journals.