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Reinvigorating stagnant science: implementation laboratories and a meta-laboratory to efficiently advance the science of audit and feedback.

Grimshaw JM, Ivers N, Linklater S, Foy R, Francis JJ, Gude WT, Hysong SJ, Audit and Feedback MetaLab. Reinvigorating stagnant science: implementation laboratories and a meta-laboratory to efficiently advance the science of audit and feedback. BMJ quality & safety. 2019 May 1; 28(5):416-423.

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Abstract:

Audit and feedback (AandF) is a commonly used quality improvement (QI) approach. A Cochrane review indicates that AandF is generally effective and leads to modest improvements in professional practice but with considerable variation in the observed effects. While we have some understanding of factors that enhance the effects of AandF, further research needs to explore when AandF is most likely to be effective and how to optimise it. To do this, we need to move away from two-arm trials of AandF compared with control in favour of head-to-head trials of different ways of providing AandF. This paper describes implementation laboratories involving collaborations between healthcare organisations providing AandF at scale, and researchers, to embed head-to-head trials into routine QI programmes. This can improve effectiveness while producing generalisable knowledge about how to optimise AandF. We also describe an international meta-laboratory that aims to maximise cross-laboratory learning and facilitate coordination of AandF research.




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