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Effective and timely translation of research into health care practice is essential to the delivery of high quality care. Despite a substantial literature establishing the evidence base of effective clinical care, and a growing body of work assessing diffusion of innovation in clinical practice, problems in successful integration of research into health care persist, and widespread adoption and sustaining of innovative models of care has not kept pace with their development (Bradley et al., 2004).
Practice-oriented translational research (T2) is central to closing the gap between research and practice. This type of research focuses on strategies for effective dissemination and adoption of evidence-based guidelines, new technologies, practice redesign, and novel and effective models of care. This is in contrast to (T1) research, which focuses on the transfer of knowledge from the laboratory or bench to clinical trials and the establishment of scientific evidence of a given practice's effectiveness. T2 research is focused on overcoming barriers to the dissemination, adoption and sustainability (in the real world of practice), on the effective implementation of evidence-based effective medical practice, on the establishment of effective and economical models of care, and effective and economical health promotion strategies (AHRQ 2002, Cabana et al., 1999; Clancy, 2002; Woolf, 2000). Central to the T2 research agenda are the following types of investigations:
The T2 research agenda requires a highly diverse and wide range of expertise in: communications, behavioral and organizational change theory, health information technology (HIT), medicine, methods of clinical research and statistical methods for the measurement and analysis of multi-site, longitudinal data, as well as strategies for applying probabilistic methods, such as decision theory, to the systematic measurement of health care operations in order to measure the cost effectiveness and sustainability of interventions. T2 research is an integral tool of health policy research: it provides information that is particularly relevant for the formulation, implementation and evaluation of policy. It speaks specifically to the question of whether health policy is effective in applying our best information to clinical decisions for the health of patients. As such, it requires a partnership between the T2 Researcher and policymakers and/or responsible caregivers to frame research questions relevant to the actual operations of healthcare delivery, to systematically measure performance and outcomes, and to analyze information so as to formulate findings that are actionable for the improvement of patient care, systems of healthcare delivery, and broader healthcare policy. The development of the Researcher/Caregiver or Policymaker partnership is the hallmark of successful T2 Research. It requires careful collaboration, the establishment of trust, the development of preliminary and test studies, the formulation of precisely conceived research designs, and the deliberate review ("implementation") of research findings that leads to the improvement of care and the revision of health care policy.
Agency for Healthcare Research and Quality. Translating Research into Practice [on-line]. Available at: http://grants.nih.gov/grants/guide/pa-files/PA-02-066.html. Accessed March 31, 2006.
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