Building Our Blueprint for Dissemination and Implementation

Without the most recent and reliable clinical evidence, preventing, diagnosing, and treating illness is a big challenge, filled with uncertainty. That’s why PCORI is intent on expeditiously getting the results of the research we fund into the hands of patients and those who care for them.

To facilitate that effort, we are creating an action plan for the dissemination and implementation of our research findings. And, as is our practice in determining which research to fund, we’re seeking input from a broad array of experts on how to pursue dissemination activities in the most effective way.

With the goal of finalizing our action plan by next spring, we are now conducting a rigorous process that will gather established best practices in dissemination and implementation of research results—and fuse those practices with innovative solutions, informed by the perspectives of stakeholders across the healthcare community. We are following such an intensive process because we view dissemination and implementation as mission-critical activities for PCORI. After all, our research portfolio is only valuable if it gets used and improves patient outcomes.

On July 29, we took the first step on this path with a Dissemination and Implementation Roundtable, which gathered 28 experts representing many of the stakeholders whose participation is vital to close the persistent gap between research findings and improved clinical practice. In coming months, we plan to issue a Request for Proposal (RFP) to build a consortium of stakeholders that can provide guidance on how we can most effectively disseminate our research results. We expect one organization to coordinate this effort and serve as a convener of the different stakeholders, while inviting broader public input.

Our Stakeholders Help to Lay the Foundation

The July 29 roundtable had three goals:

Gather opinions from experts on what our action plan should encompass;
Identify gaps in knowledge on best practices for dissemination and implementation; and
Build consensus for an approach to our dissemination and implementation work.

Our success will be defined by how effectively we share our research findings with patients, their caregivers, and other clinical decision makers, as well as how well that information makes it into practice. Our action plan will outline processes to engage major patient groups; partner with clinician groups; build relationships with health plans, businesses, and others; and use traditional and digital media to reach patients and others where they look for trustworthy health information.

The challenge of dissemination and implementation requires us to combine our knowledge and resources with that of recognized experts who have years of experience on this issue. For example, the Agency for Healthcare Research and Quality (AHRQ), an organization specifically mentioned by PCORI's enabling legislation as a partner in our work, will play a central role in developing our action plan.

Some of the foundational work is already under way. Over the last two years, AHRQ has awarded grants and contracts to support various projects focusing on dissemination and implementation. During her presentation at the roundtable, Jean Slutsky, PA, MSPH, who directs AHRQ's Center for Outcomes and Evidence and is a member of the PCORI Methodology Committee, detailed some activities being completed through the agency’s funding portfolio.

These included one project creating tools to integrate patient-centered research findings into the training of clinicians and another promoting research findings to consumers in public spaces such as grocery stores and pharmacies.

Themes for Blueprint Development

The discussion among the roundtable participants centered on opportunities to complement existing work, the possible scope of work for the planned RFP, and elements that must be included in the final action plan. Participants also considered barriers to successful dissemination and implementation of research findings, highlighting potential areas of work for PCORI to reduce those barriers. Several themes emerged:

Our research findings should be presented differently to the diverse members of the healthcare community. For each targeted audience, we need to take into account health literacy; cultural factors, such as language and customs; and members’ experiences with the healthcare system.
Technology must be considered in making research accessible to patients and clinicians. For example, mobile device applications, or “apps,” can be a key resource for reaching audiences that do not have access to traditional sources of medical information.
As we develop the action plan, we must invite input from the stakeholders who will implement the strategy. Without buy-in from the patient and healthcare communities, even a well-constructed plan will fall short of its goals.
Giving each stakeholder group a meaningful voice in development of the action plan will help these groups to understand, and encourage them to embrace, the strategies selected.
Above all, the action plan must be simple and accessible to ensure that stakeholders with different backgrounds can participate in dissemination and implementation of findings.

Next Steps

As the next activity in the development of the action plan, PCORI will issue an RFP to uncover critical information to guide our overall approach. The roundtable participants agreed that any RFP should encourage respondents to take innovative approaches. The result may involve a review of current dissemination or implementation practices and evidence, or lead to new tactics that could be incorporated into our final strategy.

Participants stressed the importance of working with organizations—or groups of organizations—that can bring together disparate parts of the healthcare system. Collaboration will be as important in creating the action plan as in executing it. We expect to release the RFP by August 31 and announce award recipients by November 30. We will also continue to host meetings that enable patients, clinicians, and other members of healthcare community to contribute to the development of the action plan.

Thank you to the roundtable participants who share our commitment to ensuring that patients and those who care for them have timely access to useful information generated through our research. We will continue to work with each of you to achieve this key pillar of our mission. As always, I welcome your thoughts on this effort or any other aspect of our work at abeal@pcori.org.

Beal served as PCORI’s Deputy Executive Director and Chief Officer for Engagement from November 2011 – March 2014