1. Will It Work Here? Cindy Brach Agency for Healthcare Research and Quality Center for Delivery, Organization, and Markets September 9. 2008

2. Advancing Excellence in Health Care Innovation ≠ Adoption ≠ Implementation Innovation – A new way of doing things Innovation – A new way of doing things Adoption – The decision to take up an innovation that has been developed elsewhere Adoption – The decision to take up an innovation that has been developed elsewhere Implementation – Putting an innovation into practice Implementation – Putting an innovation into practice

3. Advancing Excellence in Health Care Will It Work Here? Decisionmaker’s Guide to Adopting Innovations Decisionmaker’s Guide to Adopting Innovations Web-based – Hyperlinks to Web-based Tools Web-based – Hyperlinks to Web-based Tools Case Studies – Illustrate lessons learned Case Studies – Illustrate lessons learned Modular – Allows users to focus on most pertinent sections Modular – Allows users to focus on most pertinent sections

4. Advancing Excellence in Health Care Four Modules Module I: Does this innovation fit? Module I: Does this innovation fit? Module II: Should we do it here? Module II: Should we do it here? Module III: Can we do it here? Module III: Can we do it here? Module IV: How can we do it here? Module IV: How can we do it here?

5. Advancing Excellence in Health Care Why This Matters Assessing the feasibility of adopting a particular innovation begins with an understanding of how the innovation works and the scope of the innovation. Decisionmakers should also examine other organizations’ experiences with the innovation. What may work effectively in one setting may not work as well in another, so it is important to consider factors such as context, setting, and circumstances, along with evidence of success. Key Questions to Consider  How does the innovation work?  What is the scope of the innovation?  Where has the innovation been implemented?  What is the evidence that the innovation worked? What Is the Innovation?

6. Advancing Excellence in Health Care Evidence that an innovation did not work is as important as evidence it did work. For an example of evidence on a failed innovation, look at Faxed Physician Reminders Fail to Improve Antidepressant Adherence on AHRQ’s Health Care Innovation Exchange: http://www.innovations.ahrq.gov/content.aspx?id=66 http://www.innovations.ahrq.gov/content.aspx?id=66 Before you decide to adopt an innovation, consider the evidence that the innovation is likely to achieve its goals. To embark on evidence-based decisionmaking, you will need to: Find the evidence. Searches of the Web, databases of research articles and syntheses, and networking with professional colleagues are common methods for unearthing evidence. Evaluate the evidence. Consider how credible the evidence is in terms of rigor of the analysis, trustworthiness of the source, and applicability to your situation. For example, consider for how long and in how many places the innovation had been implemented when judging the relevance of evaluation data. Judge whether there is sufficient evidence. Is the information complete? Are there important perspectives that are not represented? Assess the alternatives. Is there more than one viable option? What tradeoffs are associated with each alternative? For a series of tools designed to support informed managerial decisionmaking, visit the Informed Decisions Toolbox. It includes modules on how to assess the accuracy, applicability, and actionability of the available evidence: http://toolbox.berkeley.edu/tools/ Question 4. What is the evidence that the innovation worked?

7. Advancing Excellence in Health Care You can find Will It Work Here? A Decisionmaker’s Guide to Adopting Innovations at: www.innovations.ahrq.gov/resources/resources.aspx Hard copies can be ordered from AHRQ Publications Clearinghouse: 800-358-9295