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Introduction

The ultimate goal of clinical research is to maximize the effectiveness of practice. To that end, health professionals have recognized the necessity for generating and applying evidence to clinical practice through rigorous and objective analysis and inquiry.

The purpose of this text is to provide a frame of reference that will bring together the comprehensive skills needed to promote critical inquiry as part of the clinical decision-making process for the varied and interdependent members of the healthcare team.

This chapter develops a concept of research that can be applied to clinical practice, as a method of generating new knowledge and providing evidence to inform healthcare decisions. We will also explore historic and contemporary healthcare frameworks and how they influence the different types of research that can be applied to translate research to practice.

The Research Imperative

The concept of research in health professions has evolved along with the development of techniques of practice and changes in the healthcare system. All stakeholders (including care providers and patients, policy analysts, administrators, and researchers) have an investment in knowing that intervention and healthcare services are effective, efficient, and safe.

Clinical research is essential to inform clinical judgments, as well as the organization and economics of practice. We must all exercise a commitment to scientific discovery that will lead to improvement in standards of care and patient outcomes. The task of addressing this need is one that falls on the shoulders of all those engaged in healthcare (whether we function as scientific investigators who collect meaningful data and analyze outcomes, or as consumers of professional literature who critically apply research findings to promote optimal care (see Box 1-1).

Box 1-1 Addressing the Triple Aim

Issues related to evidence-based practice (EBP) and population health are especially important in light of the economic, quality, and access challenges that continue to confront healthcare. In 2008, the Institute for Healthcare Improvement (IHI) proposed the Triple Aim framework to highlight the need to improve the patient experience and quality of care, to advance the health of populations, and to reduce the per capita cost of healthcare.2 This goal will require extensive research efforts to collect data over time, understand population characteristics and barriers to access, and identify the dimensions of health and outcomes that are meaningful to providers and patients.

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Several organizations have proposed a Quadruple Aim, adding the clinician experience (avoiding burnout),3 as well as other priorities, such as health equity.4

The importance of engaging in collaborative and interprofessional efforts cannot be overemphasized, as researchers and clinicians share the responsibility to explore complex theories and new approaches, as well as to contribute to balanced scientific thought and discovery.

Defining Clinical Research

Clinical research is a structured process of investigating facts and theories and of exploring connections, with ...

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