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Rapid Transformation Requires Dismantling Silos

Partnership between clinicians and scientists raises the clinical relevance and rigor of research on improvement strategies. Through collaborative efforts the priorities of clinicians are served by the evolving research enterprise as we evaluate improvement strategies for uptake and sustainment. Unfortunately collaboration does not come easily as silos exist in healthcare.

In a previous article for the ISRN Network News1, Dr. Suzanne Beyea describes the siloed nature of the healthcare profession. “We tend to just stay within our organizations, within our fields, within our per­spectives. This makes it challenging to offer the best quality of care to patients or even to know what constitutes the best quality of care. We really need a circle so that practice informs theory and vice versa, rather than only staying in our parallel worlds,” says Beyea.

The disconnect in priorities between clinicians and researchers is a challenge to rapid transformation. In the same discussion1, Dr. Michael Parchman added that “A more participatory model of research allows academics to go to clinicians and say, ‘Here’s the evidence we have so far on what constitutes the right treatment at the right time for the right patient.  How would this work in your setting? What would you need in order to do this?’ Then de­sign a research project together to track the results and adjust the theory.” This type of collaboration makes more sense and would not only generate effective improvement strategies, but would also help spread these strategies.

Part of the solution is for clinicians and scientists to develop new competencies in team collaboration.  Principles from the Science of Team Science helps research teams overcome challenges in collaboration. The principles are woven into the studies undertaken by members of the ISRN and supported by ISRN resources.  Examples of resources include learning modules on Team Science and an evidence-based guidebook on collaboration2. Team Science is worth time and effort because transdisciplinary collaboration has been shown to increase efficiency and innovativeness. Through these strategies the siloed climate of healthcare can change and yield transformative change.

What are your thoughts on silos in healthcare?
Have you worked with transdisciplinary teams?
What was your perception of their effectiveness?


Please share your experiences in the comments section below.


1Improvement Science Research Network. (2012). Expert Perspectives: Dismantling Silos. Network News, Vol.1 (1), p1. http://isrn.net/sites/isrn.net/files/documents/newsletter/ISRN_Newsletter_Jul10_508.pdf
2 Stevens, KR, Puga, F, and Patel, DI (2012) Building Successful Research Collaboratives for Healthcare Improvement. San Antonio, TX: Academic Center for Evidence-Based Practice, UTHSCSA.

*Suzanne Beyea, PhD, RN, FAAN, Director of Geriatric Nursing Education and Research, Dartmouth Hitchcock Medical Center and Emeritus Steering Council
*Michael L. Parchman, MD, MPH, FAAFP, Director, MacColl Center for Healthcare Innovations, Group Health Research Institute

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