PBRN CONFERENCE HIGHLIGHTS STAKEHOLDER ENGAGEMENT AND DANGEROUS IDEAS

LJ Fagnan; Rowena Dolor

doi:10.1370/afm.1861

The 2015 NAPCRG Pratice-Based Research Network (PBRN) Conference brought together the energy of 232 participants (a new record!) with patients, clinicians, researchers, and PBRN teams networking in Bethesda, Maryland from June 29–30. Conference co-chairs, Rowena Dolor and LJ Fagnan provided the welcome and orientation. Rebecca Roper, Director of the AHRQ PBRN Initiative, described AHRQ’s continuing support for the PBRN community—174 PBRNs across 29,455 practices where 153,736 clinicians serve 86 million patients. AHRQ’s role in convening the PBRN learning community, creating communication channels, and supporting collaboration is strong.

Three plenary talks provided the framework for 2 days of nonstop engagement—“What is Engagement,” “Patient and Clinician Engagement Project (PaCE),” and “A Primer on Engaging Health Systems in Research.” The first plenary established the growing evidence and importance for bidirectional engagement of patients, clinicians, and other stakeholders across the continuum of research. Consuelo Wilkins, along with Jaye Bea Smalley and Sarah Daugherty from the Patient-Centered Outcomes Research Institute (PCORI), discussed their rubric guiding patient engagement and the principles of reciprocal relationships, co-learning, partnership, trust, transparency, and honesty. The PaCE project plenary included patients, community members, and clinicians (Maret Felzien, Ned Norman, Rebecca Borchers, Cynthia Wolff, and Jack Westfall) working together in an effort to create relevance and meaning for PBRN research to reach patients and their communities. The third plenary by Jerry Krishnan presented the value opportunities that exist for the PBRN community when the needs and objectives of health systems are intertwined with PBRN research.

The 16-member PBRN Planning Committee reviewed 125 abstracts leading to 60 poster presentations, 12 workshops, and 42 oral presentations. Each submitter was asked to include a statement of why the research is relevant to clinical practice and patients. The 6 oral presentation tracks included stakeholder engagement, clinical topics, electronic medical records, PBRN methods, patient-centered medical home, and quality improvement/practice facilitation. The planning committee allowed for substantial time to accommodate 12 workshops. The workshop topics covered a variety of topics:

The evolution of practice based research networks into community-based research and multidisciplinary networks
Boot Camp Translation and Community Engagement Studio to engage communities
The perspectives of practice facilitators in meeting practices on their terms and effective approaches to dissemination
Creating the value proposition to engage practices and clinicians in PBRN studies of practice change and improvement
The utility of qualitative comparative analysis in PBRN research
Engaging parents in PBRN research by creating a parent research advisory board
Reducing disparities by collecting sexual orientation and gender demographics in clinical practice
PBRN best practices regarding stakeholder engagement
Integrating Maintenance of Certification Part IV requirements in PBRN research

The poster sessions were well attended with ample opportunity for extended conversations and networking. Conference participants voted for the top posters receiving the David Lanier poster awards. There was a tie for third place with “A Novel Method for Achieving Covariate Balance in Cluster Randomized Trials” (Sean O’Leary, Jennifer Pyrzanowiski, and Norma Allred) and “Use of the Automated Remote Monitoring System (ARMS) in Los Angeles County: Wrapping Our ARMS Around Chronic Disease and Prevention” (Laura Myerchin Sklaroff, Nina Park, and Sandra Gross-Schulman). In second place was “Vaccine Reminder Messages and Direct-to-Adolescent Messaging: Does Gender Matter?” (James Roberts, Paul Darden, and Erin Hinton). Winning first place was “Identifying Primary Care Measures that Matter” (Rebecca Etz, Marshall Brooks, and Martha Gonzalez).

This year we launched a new format on “daring and dangerous” ideas. We borrowed the concept from our primary care colleagues in the United Kingdom. In a fast paced and interactive session, 5 presenters shared their dangerous PBRN research or clinical care idea that they think needs to be heard in the PBRN community. David Hahn presented, “Guidelines are Dangerous Beasts Requiring Proof of Value Before Being Released.” David proposed that all guidelines should be subjected to randomized comparative effectiveness research (CER) in PBRNs prior to being released into the wilds of primary care. Jonathan Tobin, Kevin Fiscella, and Jennifer Carroll dared us to think about a new approach to ethical oversight in quality improvement and quality improvement research. Their idea is to create a new review process to rebalance oversight, appropriate to risk. This approach includes a 2-step review with a much shorter turnaround time. Mark Stephens presented the daring idea that burnout can be identified among physicians by creating masks and describing meaning to the mask. Betsy Escobar’s dangerous idea was that we disrupt the current pattern of “permanently hospitalizing” undocumented immigrants and provide a new model of providing social support and long term care aid, thus saving our health system dollars. Lindsay Kuhn dared us to think about moving beyond the traditional supervising physician-PA relationship to embrace PAs as first-line research colleagues. The audience applause response meter indicated that each of these daring ideas was well received. We all agreed that encouraging out-of-the-box thinking made for a stimulating conference.

The enthusiasm and engagement at the 2015 PBRN Conference was high from start to finish and people are excited about coming back next year. The 2016 PBRN Conference will be July 11–12, 2016 in Bethesda, Maryland with the theme of “Dissemination and Implementation: Ensuring PBRN (and Patient-Centered Outcomes) Research Evidence is Understood and Used.” See you next year!