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Research and quality enhancement: the context of dissemination and implementation

Moos R. Research and quality enhancement: the context of dissemination and implementation. Paper presented at: Australasian Professional Society on Alcohol and Other Drugs Annual Conference; 2003 Nov 1; Brisbane, Australia.

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Although they are sometimes uneasy partners, the prevailing paradigm in health care is that research should lead and inform clinical practice. The idea is that research identifies efficacious treatments that are disseminated to clinicians, who readily learn and incorporate these treatments into practice. But the dissemination process is often inadequate and incomplete. Thus, there is an extensive gap between evidence-based or best practice and actual clinical care. This gap pervades not only substance abuse and psychiatric care, but also medical care.To address these issues, I describe the Quality Enhancement Research Initiative being conducted in the US Department of Veterans Affairs, consider the six steps involved in the dissemination and implementation process, focus especially on documenting that apparent best practices improve outcomes, and that better outcomes are associated with improved quality of life.

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