Bridging the gap between research and practice

Canada has rightfully earned a reputation around the world for excellence in health research. But is health research evidence making its way to the bedside?

Currently, 50 per cent of patients do not get treatments of proven effectiveness and up to 25 per cent get care that is not needed – or potentially harmful.  This care is also expensive.  Between 2000 and 2010, public spending on health care increased by seven per cent per year.

Canadian health providers want to ensure they are using the best possible evidence to make informed choices about care for patients.  At the same time, Canadian patients want to participate in the management of their own health, contributing to discussions involving care decisions, and providing input into research priorities.

Canada’s Strategy for Patient-Oriented Research (SPOR) was created to respond to this need to better integrate research into care.

SPOR is a national coalition of federal, provincial and territorial partners (patient advocates, provincial health authorities, academic health centres, charities, philanthropic organizations, pharmaceutical sector, etc.) dedicated to ensuring that the right patient receives the right treatment at the right time.

Patient-oriented research focuses on patient-identified priorities.  It produces information for decision makers and health care providers that will improve health care practices, therapies, and policies.  It ensures that new and innovative diagnostic and therapeutic approaches are applied when and where needed.

For Canada’s health providers, this means they are able to easily access timely and relevant evidence and integrate this evidence into care decisions.  For Canada’s patients, it means they are active, informed, and motivated participants in their own care and have opportunities to define research priorities.

How does patient-oriented research work in practical terms?  A great example comes from a recent study of neonatal intensive care units.

The study was called the EPIQ (Evidence-based Practice for Improving Quality) Project.  It began as a pilot project in 12 sites, outlining new practices for care.  This was followed by a national scale-up of the new practices, implemented in 30 hospitals and 17 universities across Canada.

Doctors and nurses know that babies born prematurely face many risks as they begin life.  Great care must be taken by hospital staff when treating these most fragile patients.

However, researchers found that there were large variations in the care provided by Canada’s hospitals – and large discrepancies in the resulting health and wellbeing of the babies.

Using the principles of patient-oriented research, a national network was created that allowed hospitals to work together and learn the best practices for caring for premature babies.

For example, hospitals that had low infection rates would demonstrate to other hospitals the best techniques for reducing infections.

Emphasis was also placed on directly involving parents in the patient care, as research has shown that premature babies thrive when they are held and nurtured by their parents.

In the end, this patient-oriented approach resulted in saved lives, healthier babies, and cost savings:

• Decreased infection rates (by 32%)

• Decreased chronic lung disease (by 15%);

• Average reduction in length of NICU stay: 2 days;

• Cost savings to Canadian NICUs: $7 million annually.

This is just one example of how patient-oriented research is bridging the gap between research evidence and health care practice.  It provides health professionals with the very best policies, practices, and therapies.  Most importantly, it enhances the health care experience for patients and improves health outcomes for Canadians.

Patient-oriented research also provides economic benefits by optimizing spending on health-care systems, reinvesting resources where the evidence shows that these can have greatest impact, and attracting private investments in evaluative research.  In addition, it drives innovation in patient-centred care, in such areas as e-health, implementation science, and clinical practice.

Canada’s Strategy for Patient-Oriented Research (SPOR) is an exciting new approach to health research.  It is a new way of doing business that shifts the focus from a researcher-driven agenda to a patient-driven agenda.  Through SPOR, the Government of Canada and the provinces and territories are working in collaboration with partners and stakeholders.  Together, they are learning from one another and translating best practices into patient-centred care across Canada – for the benefit of all Canadians.