General Description

Clinical Practice Improvement (CPI) is a methodology that uses data from actual practice about patient characteristics, treatments, and patient outcomes and applies statistical analyses to determine significant associations between practice and better medical outcomes, while controlling for patient differences.  Using these associations, clinicians can evaluate interventions based on data and decide how those interventions should be delivered most effectively to produce better clinical outcomes for the least necessary cost over the continuum of a patient’s care.

Clinical Practice Improvement methodology addresses some of the most important questions that challenge today’s health care communities:  What information is necessary to support cost-effective clinical decision-making?  How can we improve health care outcomes while reducing costs?  How can the information be compiled reliably?  How can multidisciplinary clinicians integrate information successfully across the continuum of care?

Purposes of the Seminar

1.   To train health care providers and researchers in outcomes research using the CPI methodology.  CPI goes beyond the usual outcomes research, beyond the usual methods used to create guidelines, and beyond the limitations in randomized controlled trials.  The emphasis is on improving quality, appropriateness, and effectiveness of health care services.

 2.   To develop interdisciplinary team strategies that promote change in clinical practice based on research-based dynamic protocols.

 3.   To learn how to take the next step after Clinical Pathways.  Have you created or used clinical pathways?  Do you know the best treatments for patients who fall off a pathway?

Content

·        Content includes in-depth training in CPI methodology using recent studies as didactic examples.

·        Providers learn to evaluate and improve practice based on patients’ specific diseases and severity of illness. 

·        The CPI methodology includes statistical analyses applied to data from the provider’s own setting.  Data analyses are used to determine how to go beyond Clinical Pathways (where the day is the unit of treatment) to CPI protocols (where the patient sign or symptom triggers the best treatment so no one falls off the pathway).  The CPI methodology can be used in any health care setting across the continuum of care.

Between Session I and II, participants are invited to begin the development of a CPI study design and data collection instrument that could be used in their own clinical setting.

Seminar Schedule and Agenda

The Advanced Seminar in Design and Application of Clinical Practice Improvement (CPI) Studies has been given successfully by ICOR on many occasions since 1995.

Session 1 and Session 2 are presented about one month apart:  three days the first month and three days the second month.  Between the Sessions, participants begin development of a CPI project.  At the start of the Session 2, each participant or group of participants describes the initial CPI study objectives, study questions, and key variables to be collected for their project; the rest of the participants make suggestions.

On the first day of Session 1 we welcome senior leadership participants (CEOs, CFOs, CIOs, medical directors, etc.) in addition to the full-seminar participants. The purpose is to give senior leaders an overview and a working understanding of Clinical Practice Improvement and its relationship to outcomes research, guidelines development, and randomized controlled trials.  They see examples of how Clinical Practice Improvement study findings have improved quality of care while reducing cost in other settings and how they can help their staff implement Clinical Practice Improvement successfully in their home setting.

Please refer to the seminar brochure for further information.  Scheduled dates and tuition are described on the registration form.

The Seminar can be presented at an institution's site, typically for up to 35 full-time participants and 35 additional first-day-only participants. Please email ISIS for further information about an on-site seminar.

Composition of the Audience

Attendees have included physicians, nurses, researchers, psychologists, speech and language pathologists, employment specialists, physical therapists, occupational therapists, recreational therapists, case managers, educators, social workers, vocational rehabilitation counselors, and epidemiologists.  Professionals who are clinicians, researchers, or both, are welcome.

Benefits of the Seminar 

The seminar begins the process of peering into the array of patient, process, and outcome variables needed to determine how to improve quality of care.  CPI study methodology allows one to identify and analyze specific components of the treatment process to determine how each component contributes to outcomes.  CPI analyzes the content and timing of individual steps of the health care process, with the goal of improving clinical outcomes at the least necessary cost.  It involves the development of a comprehensive database linking patient characteristics, treatment factors, environment factors, and outcomes in order to examine simultaneously all factors that influence the care process.  Making the right match between a patient’s needs and the appropriate services is a challenge.  Failure to find the right fit can result in too little or too much care for a patient’s individual needs.  In order to allocate appropriate services to patients responsibly, we need scientific evidence demonstrating the effectiveness of interventions.

The CPI methodology is an example of Participatory Action Research, which involves clinicians at the front line of patient care.  All disciplines involved in the care of patients in a particular clinical area are included in the iterative process to define the outcome (dependent) variables as well as the patient and treatment (independent) variables to study.  Clinicians are also involved in portions of the data collection process, and participate actively in data analyses.  Involvement in all aspects of the research process stimulates interest and support of the project in the setting where it takes place.  Clinician participants often find valuable unexpected benefits of participating in a data-intensive research project.