The document discusses essential components for transforming healthcare delivery systems. It identifies leadership, collaboration, balancing regulation and creativity, health information systems, and research as key elements. It provides examples of research studying the adoption of evidence-based practices and the impact of interventions on outcomes like costs, falls, and pain management.

1. Transformation in Healthcare Delivery: Essential Components Marita G. Titler, PhD, RN, FAAN Director of Research, Quality and Outcomes Management Department of Nursing Services and Patient University of Iowa Hospitals and Clinics Clinical Professor University of Iowa College of Nursing Senior Scientist – CRIISP VA HSR Center Iowa City, IA

4. Comparisons Binary, market mediated Triangular third-party-controlled market Electronic, information based Paper based Use genetic, outcomes-based knowledge to create a preventive, self-managed, and health-oriented system of continuous involvement using the nutrition-activity-attitude model Care is reactive, episodic, and disjointed Rapid innovation and speed of diffusion Slow diffusion of innovation Knowledge intense Knowledge disconnected Value Driven Price Driven Individual Centered Provider centered Transformed System Current System

5. Comparisons (Gingrich, 2003) Overall cost decrease Overall cost increase Fair, affordable system of health justice that protects individuals and encourages access to quality care Expensive, predatory trial lawyer-enriching system of dispute resolution Outcomes measured and improved Outcomes undermeasured and ignored Increased choice Limited choice Collaborative government manages by outcomes Adversarial government manages by process Transformed System Current System

12. The National Nursing Practice Network for EBP and Translation Science NNPN represents a commitment to the promotion and implementation of evidence-based practices through a collaborative model designed to promote shared learning and participation.

14. About Us: NNPN Represents 15 states

22. TRIP Intervention Saves Healthcare Dollars and Improves Quality of Care University of Iowa Iowa City, Iowa Principal Investigator Marita G. Titler, PhD, RN, FAAN Co-Principal Investigator Keela Herr, PhD, RN Project Director Gail Ardery, PhD, RN Investigators John Brooks, PhD Kathleen C. Buckwalter, PhD, RN, FAAN William Clarke, PhD Linda Everett, PhD, RN J. Lawrence Marsh, MD Margo Schilling, MD Bernard Sorofman, PhD Toni Tripp-Reimer, PhD, RN, FAAN Xianjin Xie, MS Funded by AHRQ RO1 HS10482

31. Center Grants

32. What factors should one consider in designing a research study to make it ready for translation, assuming efficacy and effectiveness are found? Nature of the intervention being tested Population Health care system Public Policy

33. Disseminate Knowledge Generate New Knowledge Quality Clinical Practice Apply Findings in Practice Conduct Research Identify Questions

40. Institute for Healthcare Improvement This document is in the public domain and may be used and reprinted without permission provided appropriate reference is made to the Institute for Healthcare Improvement. Studying Current Transformations