How can primary care cross the quality chasm?
Open accessAbstract
The chasm between knowledge and practice decried by the Institute of Medicine (IOM) is the result of other chasms that have not been addressed. They include the chasm between what we know and what we need to know to improve care; the chasm between those who provide primary care and those who do not fund, study, support, or publish practical primary care studies; and the chasm between research and quality improvement (QI). These chasms are a result of problematic concepts, attitudes, traditions, time frames, and financing approaches among the various participants. If we are to facilitate the production and use of the knowledge needed for primary care to cross IOM's chasm, major changes are needed. These changes include the following: (1) admission by all primary care professions that we have quality problems that require our unified attention and action; (2) conversion of the paradigm from "translate research into practice" to "optimizing health and health care through research and QI"; (3) development and facilitation of more partnerships among clinicians, researchers, and care delivery leaders for engaged scholarship in both research and QI; (4) modification of the agendas and methods of funders and researchers so they emphasize the problems of patients and patient care and support practical time frames and research designs; and (5) facilitation by funders and journals of the dissemination and implementation of lessons from QI and practical research.
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A significant delay exists between the generation of new knowledge and its application into the medical/dental community and patients.
“A significant delay exists between the generation of breakthroughs and their transfer through applications serving individual patients when science is not efficiently translated to daily clinical practice.”
From Translating research into everyday clinical practice: Lessons learned from a USA dental practice-based research network (2013) · cites this paper as [3]
The Abstract and Introduction describe a substantial chasm between knowledge and patient care, and Practical Barriers says researchers rarely have support to implement findings in practice. But Concepts and Attitudes cautions that the problem is not simply delayed translation of existing breakthroughs: relevant evidence is often lacking. The paper addresses primary care, not the dental community. Page numbers are unavailable in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredEnhancing the delivery of established therapies would save more lives than pursuing additional innovations in therapy.
“Enhancing the delivery of established therapies would save more lives than pursuing additional innovations in therapy [6,3].”
From Translating research into everyday clinical practice: Lessons learned from a USA dental practice-based research network (2013) · cites this paper as [3]
The Concepts and Attitudes section treats improving the implementation of care as important. It does not say that better delivery of established therapies would save more lives than developing new therapies; instead, it cautions that knowledge is also lacking for many patient-care decisions. No page number is available in our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measuredA substantial difference exists between the health care patients may be eligible for and the health care they actually receive.
“Therefore, a substantial difference exists between the health care that patients may be eligible for and the health care that they actually receive [3-5].”
From Translating research into everyday clinical practice: Lessons learned from a USA dental practice-based research network (2013) · cites this paper as [3]
Experimental — accuracy not yet measured
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- Authors
- Solberg, L. I., Elward, K. S., Phillips, W. R., Gill, J. M., Swanson, G., Main, D. S., Yawn, B. P., Mold, J. W., Phillips, R. L., & for the Napcrg Committee on Advancing the Science of Family Medicine
- Affiliations
- Regions Hospital (US)
- University of Virginia (US)
- University of Washington (US)
- McMaster University (CA)
- University of Colorado Denver (US)
- Olmsted Medical Center (US)
- University of Oklahoma (US)
- HealthPartners (US)
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2009-03-01
- Volume
- 7
- Issue
- 2
- Pages
- 164-169
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC2653967
- OpenAlex
- W2135304030
- Cited by
- 24
- References
- 39
- Citations by year
- 2021: 2 · 2019: 1 · 2017: 1 · 2016: 3 · 2014: 1 · 2013: 2 · 2012: 5
- FWCI
- 8.47
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Keywords
- primary care, quality improvement, knowledge-practice gap, research utilization, research funding, engaged scholarship, dissemination and implementation, research design, quality of care
- MeSH terms
- Decision Making, Diffusion of Innovation, Humans, Primary Health Care, Quality Assurance, Health Care, Organizational Culture, Evidence-Based Medicine
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