Creating a National Research Agenda for Improvement Science

Stevens, Kathleen R.

Background: The key function of the National Institutes of Health-funded Improvement Science Research Network (ISRN) is to advance the science of quality improvement, safety, and efficiency through transdisciplinary research addressing health care systems, patient-centeredness, and integration of evidence into practice. Research priorities are crucial in order to steer this new field. To establish the first national priorities, academic and practice scholars systematically reached consensus on improvement research priorities in order to ensure that research resources would be applied to the nation’s most urgent knowledge gaps in improvement science.

Methods: Consensus on the research agenda was accomplished in three phases. First, an online survey reflecting 33 research topics categorized into nine dimensions of quality and safety was developed for gathering input regarding importance of the topics. Second, the survey was used to gather data from a broad group of stakeholders representing multiple health care disciplines, academicians, and clinicians. Consensus was formed using a Delphi approach. An expert panel considered stakeholder survey results, their own ratings, and were guided through multiple iterations toward consensus.

Results: Analysis of survey data showed variations in stakeholder respondents’ impressions of the importance of the 33 quality improvement topics. Ultimately, the expert panel outlined four broad topics considered to be top improvement research priorities, accompanied by descriptions and examples.

Conclusion: The process led to stakeholder-based national consensus on priority topics in the new field of improvement research. The four ISRN research priorities – care coordination and transitions, high-performing clinical systems and microsystems improvement approaches, evidence-based quality improvement and best practices, and a culture of quality and safety – reflect national priorities for research studies that build improvement science.