Science policy fellow uses evidence to engineer change

18 April 2012

Electrical and computer engineering may seem an unlikely background with which to study health system change, but for Noreen Kamal the connection is clear.

“Engineers really like to take things – systems, if you will – whether they’re human systems, computer systems, or process systems, and make them work better, faster, cheaper,” says the third-year UBC doctoral student. “So we’re really looking at efficiency and quality, as well as the cost savings that can be realized.”

Kamal will soon have the opportunity to apply her analytical, systems-oriented perspective to health care as the first recipient of a new MSFHR award offered in partnership with the Canadian Institutes of Health Research (CIHR) and the BC Ministry of Health. The MSFHR/CIHR Science Policy Fellowship will embed Kamal for six months in the Ministry of Health to develop policy recommendations for emergency department care informed by research evidence and best practice.

The fellowship supports ongoing Ministry efforts to improve the quality and efficiency of BC’s emergency departments, which collectively account for a majority of acute care costs and inpatient admissions. Many overlapping issues, including congestion, patients with chronic illnesses, and physician supply impact the quality of care in emergency departments.

The policy assignment is a natural fit for Kamal, who has worked previously with the Evidence 2 Excellence initiative on quality improvement in BC’s emergency department operations.

“We initially looked at the triage process to make sure that triage was done efficiently, and then we moved on to the entire emergency department flow,” she says. “It was a great sort of foundational work where I really became interested in emergency departments.”

For Kamal, the fellowship offers a unique opportunity to build on this foundation and gain first-hand understanding of how policy decisions are made in the Ministry of Health and implemented throughout the health care system.

Moving research into practice

The science policy fellowship marks an important opportunity for MSFHR to support the increased use of research evidence in health policy decision-making.

“There’s a significant gap between what we know to improve health and what we do to improve health,” says Gayle Scarrow, manager, knowledge translation at MSFHR.

“What’s really exciting about this fellowship is that it gives a health researcher an opportunity to learn about the science-policy interface, and it gives the Ministry of Health timely and very relevant research evidence on an issue they’ve identified as important.”

Studies have identified a 17-year gap between the collection of research evidence and its full implementation in practice. Scarrow believes MSFHR has a role to play in narrowing this gap by facilitating dialogue between researchers and policy-makers. She anticipates the Foundation will develop further activities and opportunities to use health research to improve health as part of its increased focus on knowledge translation.

“Moving forward, we are going to be developing more programs along this line to facilitate evidence-informed practice and policy-making,” Scarrow says.

Kamal agrees that good health policy cannot be developed in a vacuum. She is excited to play a role in building evidence-based accountability into health-care practice.

“I think what we need to do, rather than just printing guidelines and making them available to physicians, is to have a feedback mechanism with data,” says Kamal. “Taking the evidence that’s gained from research and linking it with policy decisions in health care, I think would be critical to ensuring that the safety and quality of patient care in British Columbia moves forward.”