Combining Lean and Applied Research methods to improve rigor and efficiency in acute care outcomes research: A case study

Hospital care is the single, largest contributor to health spending, yet evidence to guide value transformation is lacking. The large, real-world studies required to fill this void are challenging to conduct in the complex and fast-paced acute care environment. To address these challenges, we create...

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Bibliographic Details
Main Authors: Andrew McWilliams, Maximilian Schoen, Constance Krull, Justin Bilancia, Marguerite Bacon, Edwin Pena, Andrea McCall, Daniel Howard, Jason Roberge
Format: Article
Language:English
Published: Elsevier 2019-06-01
Series:Contemporary Clinical Trials Communications
Online Access:http://www.sciencedirect.com/science/article/pii/S2451865418301327
Description
Summary:Hospital care is the single, largest contributor to health spending, yet evidence to guide value transformation is lacking. The large, real-world studies required to fill this void are challenging to conduct in the complex and fast-paced acute care environment. To address these challenges, we created a framework that combines Lean manufacturing methodology and Applied Research principles. We deployed this framework to design, pilot, and iteratively improve a study protocol testing the effectiveness of an innovative care pathway for patients hospitalized with acute exacerbations of Chronic Obstructive Pulmonary Disease. Over a three month period, the protocol was successfully piloted and refined at a single site, subsequently becoming the basis for a large system-wide randomized controlled trial. This framework combining Lean and Applied Research methods resulted in synergies that neither method could accomplish alone and may serve as a template for learning healthcare systems to efficiently generate real-world evidence in the acute care setting. Keywords: Applied research, Pragmatic research, Value-based care, Lean, Quality improvement
ISSN:2451-8654