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Collaboratory ePCT Training Workshop
Doug Zatzick, MD, University of Washington School of Medicine
Topic 8: Dissemination
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The scientific study of targeted distribution of information and intervention materials to a specific public health or clinical practice audience. The intent is to understand how best to spread and sustain knowledge and the associated evidence-based interventions.
Dissemination research defined
Source: NIH Dissemination and Implementation Research in Health PAR-16-238
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The scientific study of the use of strategies to adopt and integrate evidence-based health interventions into clinical and community settings in order to improve patient outcomes and benefit population health
Implementation research reviewed
Source: NIH Dissemination and Implementation Research in Health PAR-16-238
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• REDUCE MRSA/ABATE• STOP CRC• TSOS
Putting it together: NIH Collaboratory dissemination case examples
Source: NIH Collaboratory Workshop Demonstration Projects May 24, 2017
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• REDUCE MRSA trial: decolonization in ICUs• 37% reduction in MRSA clinical cultures• 44% reduction in bloodstream infections
• Post-publication response• Protocol inquiries• Detailed implementation issues not in paper
REDUCE MRSA dissemination lessons learned
Source: Huang, Septimus et al NEJM 2013
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REDUCE MRSA toolkit on AHRQ website
Source: http://www.ahrq.gov/professionals/systems/hospital/universal_icu_decolonization.html
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REDUCE dissemination manuscript
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Toolkit contents• Introduction and Welcome• Universal ICU Decolonization Protocol
Overview• Scientific Rationale• References• Appendices include training and educational
materials
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Active Bathing to Eliminate Infection (ABATE) PRECIS-2 wheel
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STOP CRC
Dissemination
Implementation
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TSOS dissemination
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American College of Surgeons Committee on Trauma Guideline Dissemination & Verification Process
• 1976 1st Book • 2006 “Green Book”• 2014 “Orange
Book”
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American College of Surgeons Resources Guide revision process
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Two decades of orchestrated clinical trials & American College of Surgeons policy partnership builds practice change momentum into ePCT design & implementation
TSOS end-of-study policy summit
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American College of Surgeons Resources Guide PTSD & comorbidity:“The incorporation of routine trauma center–based screening and intervention for PTSD & depression is an area that could benefit from the ongoing integration of emerging data and evolving expert opinion.”
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American College of Surgeons guidelines• Main outcome paper & other publications aim
to be cited in College Resources Guide• End-of-study policy summit aims to integrate
findings into College regulatory/verification processes
TSOS publications: dissemination aims to “nudge” practice change through regulatory policy
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Considerations specific to ePCTs
PCT reporting guidelines
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Important things to know
• Dissemination & implementation science can inform the translation of ePCT results into HCS practice change
• Case examples from NIH Collaboratory trials suggest a number of possible approaches to the dissemination of trial results
• Data sharing can be an essential element of dissemination
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• Consider plans for dissemination of ePCT results
• How do these dissemination plans meld with NIH data sharing guidelines?
Important things to do