ARTIC Program Backgrounder

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.

2010 ARTIC Program Selection Process

In order to identify research innovations ready for implementation, in January 2010, CAHO solicited submissions for CAHO ARTIC projects from CAHO members.

To support a thorough review of submissions and facilitate the selection of ARTIC Projects, the CAHO Council struck a multi-disciplinary Task Force of clinical practice and research executives to lead the selection process. Using an evaluation framework based on six selection criteria (system impact, innovation, implement-ability/quick wins, cost-effectiveness, collaborative impact and political relevance), the Task Force identified a short-list of four submissions. Subsequently, the lead investigator for each of the short-listed submissions was invited to provide additional details on their project, including a proposed implementation plan and cost-estimates, and to participate in a discussion with the Task Force to answer further questions. Based on the follow-up information provided, the Task Force recommended two ARTIC projects for implementation, which were subsequently endorsed by CAHO Council.

2010 ARTIC Program Implementation

Collectively, CAHO decided to implement 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.

Canadian C-Spine Rule to Improve ER Wait Times
HandyAudit™ to Measure and Improve Hand Hygiene Compliance

ARTIC Program Funding

The CAHO community funded the implementation of 2010 ARTIC Projects through their hospitals’ budgets. 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).

Recognizing the power of this platform to test implementation of new evidence and the ARTIC Program’s alignment with the goals of the Excellent Care for All Strategy, through its advocacy efforts, CAHO has been urging the government to partner with CAHO on this Program. In July 2011, the Ontario Ministry of Health and Long-Term Care announced they would provide CAHO with $6.3 million over 3 years to support implementation of the CAHO ARTIC Program.

2011 ARTIC Program Selection Process

Applying the lessons learned through the initial launch of the Program, in early 2011 CAHO issued a call for Letters of Intent (LOI) to initiate the next round of projects for implementation. Within their LOI, potential applicants are asked to propose potential projects that:

Present a novel innovation to address a significant health system issue
Are evidence-based (i.e. supported by robust, peer-reviewed research evidence)
Demonstrate a strong value proposition (e.g. have a positive impact on patient outcomes, be cost-effective, improve delivery of care, etc)
Implementable within a 1-2 year timeframe

CAHO received 55 LOIs from 19 members. The ARTIC Program Selection Panel independently reviewed submissions and invited 8 applicants to provide full submissions by late July 2011. Once final projects have been selected, CAHO plans to launch additional CAHO ARTIC Projects by the end of 2011.

ARTIC Program Evaluation

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 for both the Canadian C-Spine Rule and HandyAudit™ ARTIC Projects. Project evaluations are being led by the project teams implementing each project and will explore the value of implementing their respective project across the CAHO community.

In addition, CAHO is conducting and funding 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 will explore what factors influenced sites to participate (or not participate) in each ARTIC Project and what factors influenced the implementation of each project. Dr. Sharon Straus (St. Michael’s Hospital) and Dr. Jeremy Grimshaw (Ottawa Hospital Research Institute) are conducting the KT evaluation, which received Research Ethics Board (REB) approval in February 2011.