While creating health care innovations is a formidable task, what is often more challenging is the successful and rapid adoption of innovation into the practice of health care. Many in the health care sector have successfully shared best practices within their own organizations, professions and sometimes across communities of care such as paediatrics or mental health. However, as a health care system, Ontario has yet to realize the full potential of sharing best practices and systematizing efforts to move research evidence into practice. Too often, we have found pathways to improve care and drive quality improvement in the health care system, but that knowledge never leaves the organization that created it.
In 2010, CAHO resolved to address this challenge. Committed to fostering better collaboration and trying to establish a systematic approach to moving research evidence from the bench to the bedside, CAHO launched the Adopting Research to Improve Care (ARTIC) Program. The aim of the program is to move research evidence into practice from one hospital across the CAHO community in order to drive quality improvement and benefit the health care system as a whole. The goal is to learn from this experience in order to help build a systematic and sustainable implementation pathway for evidence adoption across the province.
CAHO is committed to continuing our journey of learning through the ARTIC Program. CAHO believes the development of this knowledge should not be experienced by our community alone. Working with the Ministry of Health and Long-Term Care (MOHLTC), Health Quality Ontario (HQO) and world-renowned experts in knowledge translation, we aspire to build a sustainable pathway for implementing evidence that can improve care and Ontario’s health care system.
In 2012, the CAHO ARTIC Program has focused its call for proposals on the health system priority of Transitions in Care. Transitions in Care refers to the movement patients make between health care practitioners, clinical services and/or settings as their needs change throughout the course of their treatment and care.
In early 2012 CAHO issued a call to CAHO member hospitals with a focus on Transitions in Care to initiate the next round of projects for implementation. All submissions were assessed using a rigorous evaluation methodology modeled on CIHR’s merit review process based on the ARTIC Program’s criteria of high potential impact, robust research evidence, implementation plan/feasibility and an evaluation plan.
The ARTIC Program Selection Panel, made of up members from the CAHO Community, Health Quality Ontario, and Ministry of Health and Long-Term Care – Health Quality Branch, Knowledge Translation experts independently reviewed submissions and invited eight applicants to provide full submissions by early August 2012. From these submissions, three were invited to proceed to the Readiness Assessment stage which is checklist of critical resources and success factors that need to be available within the participating hospital prior to implementing the project. The ARTIC Program Selection Panel recommended two projects for implementation which were endorsed by the CAHO Council in September 2012.
The CAHO community funded the implementation of 2010 ARTIC Projects directly. For each project, participating hospitals are sharing the costs of implementation and are also providing significant in-kind contributions (i.e. providing dedicated staff to support the projects’ implementation).
In July 2011, recognizing the power of this platform to test systematic implementation of new evidence and the ARTIC Program’s alignment with the goals of the Excellent Care for All Strategy, CAHO received $6.3 million over three years to support implementation of the CAHO ARTIC Program.
CAHO is committed to measuring the return on investment of adopting research evidence into practice through the ARTIC Program. To this end, project evaluations have been integrated within the project plans all of the CAHO ARTIC Projects.
In addition, CAHO previously supported a dedicated Knowledge Translation (KT) evaluation on the ARTIC Program to inform our community on how to advance the adoption of research evidence into practice across the province. This evaluation explored what factors influenced sites to participate (or not participate) in each ARTIC Project and what factors influenced the implementation of each project. With the launch of the two newest CAHO ARTIC Projects a program evaluation may be planned.
In March 2012, CAHO invited member hospitals to submit proposals that focused on the health system need priority of Transitions in Care. After a rigorous selection process, CAHO approved two projects for implementation. One project focuses on improving the transition from hospital to the community for clients accessing inpatient mental health services. The second project focuses on coordination of care in the complex and multidisciplinary hospital setting for colorectal surgery patients.
In November 2011, CAHO approved the implementation of two ARTIC Projects – one meeting the challenge of improving antimicrobial use in intensive care units and the second helping older patients maintain function through early mobilization.
Collectively, CAHO implemented two ARTIC projects in 2010 – the first addressing wait times in the ER by making better use of our inter-professional resources and the second meeting the challenge of infection control and hand washing compliance.