Establishing a Community of Practice for Continuous Quality Improvement, New South Wales, Australia
Trauma is the leading cause of death among people under 44 years of age. Significantly, it is not only the nature of the injury that influences survivor outcomes but also the system within which care is delivered. Participation in a comprehensive, multicomponent, statewide quality improvement collaborative was associated with positive changes in hospital safety culture, group interactions and deeper commitment for improving clinical care and service delivery.
The Trauma Learning Collaborative was intended to close the evidence-practice gap and improve outcomes for the traumatically injured. Specific objectives were to strengthen the evidence base for practice change and increase the opportunities for learning and coordination across the trauma and rehabilitation service network. The vision was to create a “community of practice” (CoP) of clinicians, researchers, policy makers, insurers and service users (patients) to build trust, share knowledge and generate empirical evidence for use in quality improvement initiatives. The approach represents a fundamental paradigm shift in that it actively sought to bridge disciplinary silos and address knowledge gaps within and across the trauma rehabilitation delivery system.
Participants were enrolled from across sectors, institutions and disciplines to participate in the production of valid and reliable evidence for sustainable quality improvement. TRIC combined the expertise to develop valid research projects with the capability to implement and effect change in practice. It supported the creation of an integrated research and implementation continuum stretching from pre-hospital care to long-term rehabilitation that could transform the service across the system.
During twelve months of activity the TRIC was able to:
• Develop a broad network of professionals in the research, clinical and policy arenas;
• Form a strong multidisciplinary Leadership Group;
• Create a web-based communications platform; and,
• Devise an integrated program of quality improvement research.