Our ability to improve care quality depends on our ability to influence.
Consider that for a moment. Our ability to improve care quality depends on our ability to influence. When you think about it, in order to truly effect change on a large scale we need more than just a good idea or some anecdotes. And in fact, we need more than well-designed projects, sound methods, and robust analyses. To truly change how care is provided or paid for, we need: the resources to plan and conduct effective projects and the ability to get the results in front of the right people and convince them to act on our findings. That is, whether we are trying to convince a department or organization to fund our research or quality improvement project, or whether we are trying to convince a physician or policymaker why practice, process, or even policy should be changed, our success in those endeavors is dependent on our ability to influence the intended audience. We may hope that a funder will be convinced if we show why our study or project is valid, feasible, and has the potential to detect what we say it will. We may also hope that the physician or policymaker will simply view the results of our study or project and decide to change something about the way they care for patients or the way policy incentivizes or pays for care. But, unfortunately…that’s often not enough.
In reality, we also need to demonstrate need, value, and consequence, and we need to be seen as credible. It is critical to place the project within the larger context and paint a picture of not only how things are but how they could be, in order to motivate, inspire, and move. Consider the first two sections NIH requires in their grant application: Significance and Innovation. They are basically saying, “Tell us why this is important and how it is novel,” and do it before you talk about study design or clinically meaningful change.
Doing this effectively requires creativity, imagination, and storytelling.
If you question whether “influence” is really that important, ask the physician who has a brilliant idea of how to improve care for her patients but cannot get her study funded. How many patients will she really be able to affect? Or consider the fact that collaborative dementia care models have been proven in two randomized clinical trials to not only results in better patient outcomes but also less burden and stress of family caregivers, and yet current reimbursement policy makes their implementation difficult and therefore rare. These demonstrate that knowing and even proving something improves care does not, on its own, translate into better care. What is also necessary is to convince those who control funding and can make changes to practice patterns, guidelines, and policy that a change is warranted.
“So,” you may ask, “how can I increase my influence to ultimately have a bigger effect on care quality and value?” Through careful inspection of what is involved in crafting a highly influential proposal or summary report and identifying where you can grow and develop your skills.