Oregon Rural Practice-based Research Network at Oregon Health ...

Oregon Rural Practice-based Research Network at Oregon Health ...

Multi Network Research Collaboration: Steps to Success IRENE OCHIN ORPRN QPBRN SNOCAP WREN Meta-Network Learning And Research Center (Meta-LARC) June 18, 2013 NAPRG PBRN Meeting Bethesda, MD WORKSHOP OUTLINE Introductions AHRQ P30 RFA Meta-LARCwho we are and how we communicate and make decisions Rapid Response System to theAHRQ FOA: Practice-based Research to Improve SelfManagement Support (PRISMS)INSTTEP How could you advance PBRN research using a multi-network setttingFocused Conversation Method (FCM) Small group discussion using the (FCM), What research questions could be answered by multi-network research networks Wrap Up and Discussion AHRQ RFA, RESEARCH CENTERS IN PRIMARY CARE PRACTICE BASED RESEARCH AND LEARNING P30S Requirementsmore than 3 successful regional PBRNs, >120 practices, >10 states

Two coresadministrative and research Infrastructure to promote novel and innovative dissemination and implementation strategies Leveraging common resources to improve productivity, efficiency, more generalizable results and more attractive to funders Minimal infrastructure to support the two cores for 5 years Eight AHRQ Centers announced in September 2012 META-LARC MISSION To sustain a consortium of PBRNs dedicated to increasing the quality, effectiveness and safety of primary care through accelerated research and collaborative learning Specific Aims Aim 1: Foster the capabilities of six PBRNs (533 primary care practices with 6,600 clinicians caring for 3 million patients) through a robust collaboration designed to conduct research to improve the quality, effectiveness and safety of primary care. Aim 2: Accelerate the conduct of PBRN research through a well designed, high functioning common infrastructure that enables the efficient conduct of research.

Aim 3: Promote continuous learning and sharing across Meta-LARC networks and practices to accelerate the dissemination of knowledge and bi-directional communication. Network & Headquarters Location Institution al Affiliations ORPRN Portland, OR Oregon Health & Science University IRENE Iowa City, IA Principal Investigator Lyle Fagnan, MD (Consortium PI)

Meta-LARC Coordinators Expertise LeAnn Michaels Nancy Rollins Community-based participatory research & practice change University of Barcey Levy, Iowa College MD, PhD of Medicine Jeanette Daly, RN, PhD Preventive health service delivery & cancer prevention/screening QPBRN Quebec City, Quebec University of Laval

France Lgar, Medical MD, PhD School Ghislaine Tre, MSC, PhD Shared decision making & Knowledge transfer OCHIN Portland, OR OCHIN, Kaiser NW, OHSU Vance Bauer Practice quality improvement University of Colorado Donald Nease, School of MD Medicine Tabria Winer, MPH

Practice quality improvement University of Wisconsin David Hahn, School of MD, MS Medicine Melody Bockenfeld, MPH Practice work flow & Health IT SNOCAP (Consortium of Three Networks) Denver, CO WREN Madison, WI Christine Nelson, PhD META-LARC INFRASTRUCTURE

Administrative Core Research Core Communication Data Shared Library Study leadership applications Agendas, minutes, ShareCenter Governance analysis plans of Survey instruments Clinic

and patient database Recruitment IRB methods oversight SOP for data collection and transfer Biostatistics Core META-LARC GOVERNANCE Common agenda Shared measurement system Mutually reinforcing activities

Continuous communication Backbone support organization Steering Committee PIs, MLCs, one key clinician from each network Clinician Advisory Committee 2-4 clinicians from each network called on as needed Evaluation of Performance Annually through online survey in REDCap Request for Grant Application Notice Posted to ShareCenter & Creation of Study Workspace Email

Notification to Coordinators Survey Network Practices for Interest Rapid Response Plan Steering Committee and Potential Collaborators Conference Call Confirms Interest Steering Committee Identifies PI, Collaborators and Study Team; Creates Learning Group Networks Recruit Practices Create Grant Generation Action Plan Based on SOP & Post on ShareCenter Create Grant/Contract Application PI accesses Research Core & Atlas Data Coordination &

Management Biostats Recruitment Plan IRB PIs, Co-Investigators, Coordinators, Clinicians, Consultants Contribute LEARNING COMMUNITY Learning Groups Develop framework and methodology for each study Data interpretation Dissemination activities Grand Rounds Learning across networks and sharing between researchers and clinicians Each

network leads one training session per year Saved on ShareCenter BUILDING META-LARC @ NACPRG IN THE BIG EASY, 1 DECEMBER 2012 CONSENSUS WORKSHOP METHOD CONTEXT, BRAINSTORM CONTEXT Provide necessary background Introduce the Focus Question BRAINSTORM Individual Highlight top 3-5 responses Share time to think and write responses

in small group (3-5 people) Discuss ideas for clarity Write ideas Use 3-5 words Write boldly One idea per card CONSENSUS WORKSHOP METHOD CONTEXT BRAINSTORM Explain outcome Brainstorm individually Outline process Select your best ideas

Highlight focus question Bring to small group CLUSTER NAME Gather ideas from each group Discern focus of each cluster Develop clusters Discuss cluster for clarity and insights Name each cluster RESOLVE Focused conversation

Create a product from the consensus Reflect on the experience CONSENSUS WORKSHOP METHOD: The Canadian Institute of Cultural Affairs, 1985, 1995, 1998, 2003, 2004 CONSENSUS WORKSHOP METHOD CLUSTER, NAME, RESOLVE CLUSTER Gather cards from each group Ask for interpretation when needed Accept and acknowledge all responses Ask the group to group similar cards Place into a column and use symbol to head the column Relate all extra cards and collect all of them

NAME Discern the focus of each cluster Group to name each cluster RESOLVE Pull together whole picture with focused conversation A FOCUSED CONVERSATION What is needed to ensure Meta-LARCs success? Communication Effective Shared Leadership Accelerated Processes Nimble, Effective Communication Governance

Accelerated Processes Communication Tools Share Leadership Based on Network Strengths Rapid Decision Making Efficient and Sustained Communication Flexibility and Openness Face-to-Face Exchanges Resources Measuring and Building Success

PIs to Write Grants (Fundable) Measures of our Own Success Close Collaboration Funding Enhanced Research Productivity Shared Goals Everyone Contributes! Capacity Building Shared Learned and Best Practices Resources and People and $$

Early Successful Projects Common Goals/Vision Adequate Resources Meta-LARC meeting December 1, 2012 NPCRG New Orleans Collaboration RESPONDING TO PRISMS AHRQ FOA: Practice-based Research to Improve Self-Management Support Meta-LARC response: Implementing Networks Self-management Tools Through Engaging Patients and Practices (INSTTEPP) TIMELINE RFA announced- 12/07/12 Initial email discussion- 12/12/12

Discussion that we need to involve as many networks as possible, perhaps piggybacking is not the best-Phone call12/17/12 Internal discussions at CU- 12/19/12 Don, Perry, Jack and Jodi - could we piggyback on just launching Connection to Health project? Phone call with Perry and Meta LARC Decided to not piggyback so most networks could participate IDEA AND PROPOSAL DEVELOPMENT Development and initial presentation of bootcamp concept- Meta-LARC phone call on 12/21/12 Buy in from other networks/Email finalization of participating networks (4)- 12/22/13

Proposed budget and draft research plan Discussion1/4/13 Don and LJ Presentation of research plan and budgets to participating networks- 1/8/13 Title finalization- 1/9/13 SUBMISSION AND... 6 letters of support from network practices in each network sent to OHSU- 1/16/13 Budgets, budget justifications, scope of work, letter of intent for each network sent to OHSU- 1/17/13 OHSU submission- 1/18/13

Final prep at each site AHRQ Submission- 1/30/13 Critique responses- 4/15/13 IRB work- in progress How could you advance PBRN research using a multi-network setting? What research questions could be answered by multi-network research networks?

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