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A Teleconference Series to Accelerate Health Care Improvement

Catherine D. DeAngelis, MD, MPH; Donald M. Berwick, MD, MPP

JAMA. 2005;293:1004.

Translating the results of published studies into clinical action is a challenge. JAMA readers know, and we acknowledge, that the devil is in the details in taking useful knowledge from page to patient—just as it is in moving basic scientific insights from bench to bedside. This is one of the reasons for the frustrating and recurring finding that important clinical research innovations rarely reach all the patients who potentially could benefit.

Thanks to a grant from The Robert Wood Johnson Foundation, JAMA, in partnership with the Institute for Healthcare Improvement (IHI), is pleased to announce an 18-month test of a new resource called Author in the Room. This program is designed to help our readers explore specific, peer-reviewed articles directly with the articles’ authors so that the reported clinical science can be more effectively and quickly incorporated into clinical practice. This initiative will comprise 12 conference calls, roughly 1 call per month, each call focusing on the practical application of a potentially useful research finding that has recently been published in JAMA.

Each month, we will select a JAMA article containing evidence-based ideas ready for action in real-world clinical practice settings and will invite readers to join in a scheduled, interactive, national conference call with the author of that article. The purposes of the call will be to clarify the findings in the article, to encourage participants to take action based on those findings, and to explore detailed issues and challenges involved in implementing the changes in various clinical settings. Joining the author on each call will be a moderator and a clinician skilled in quality improvement processes who will also help coach participants on ways to incorporate the related changes into practice. Each call will be followed by a Web-based discussion group. During the evaluation phase of this program, participants will be surveyed to determine the degree to which they believe they have implemented change within their practice.

The theory behind Author in the Room is that the social or geographical distance between the investigator/author and clinician/reader is often too great to allow for the active, real-time discussion that can help guide evaluation and implementation. Even when clinicians have the will to act, using new knowledge requires a process of identifying the patients to whom the study results apply, having the relevant resources available when the patient is in the office, educating patients, and initiating the new treatment. Implementing these steps usually goes beyond what the printed word can offer. In addition, appropriately cautious readers may have questions about the validity, reliability, and generalizability of the published study that the author can address.

The Author in the Room series is an attempt to narrow the gap between JAMA’s authors and JAMA’s readers, to allow the latter to act with more confidence and accuracy on the advice of the former. Using modern electronic conference technologies, individuals at hundreds of sites can be simultaneously listening to the author firsthand and can ask questions and hear answers in real time. The author can leave the boundaries of the printed page and become a coach and consultant to those who would use the author’s work to advance their own.

We begin this series with the article "Effects of Estrogen With and Without Progestin Therapy on Urinary Incontinence" by Hendrix et al in this issue of JAMA.¹ The Author in the Room interactive conference call will be on Wednesday, March 23, 2005, from 2 to 3 PM eastern time. We will study the degree to which readers who participate report implementing this change within their practice, and participants will be asked to complete 3 short surveys (at registration, immediately after the call, and 3 months after the call) that will assess clinical application. To register for this Author in the Room call, please visit http://www.ihi.org/IHI/Programs/ConferencesAndTraining/Author+in+the+Room.htm. We invite you to join us in this new initiative and look forward to your feedback.

Editorials represent the opinions of the authors and JAMA and not those of the American Medical Association.

Author Affiliations: Dr DeAngelis is Editor-in-Chief, JAMA; Dr Berwick is president of the Institute for Healthcare Improvement, Boston, Mass.

REFERENCE
1. Hendrix SL, Cochrane BB, Nygaard IE, et al. Effects of estrogen with and without progestin therapy on urinary incontinence. JAMA. 2005;293:935-948. FREE FULL TEXT

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