Closing the CSD Research-Practice Gap
Two-day IHP virtual conference brings speech-language pathologists from around the world to discuss ways in which Implementation Science can improve the time between discovery and applying those findings to improve patient outcomes.
Nearly 400 clinicians and researchers from across the country attended the MGH Institute of Health Professions conference, “Implementation Science IS for All: A CSD Practice-Research Exchange,” on April 28 and 29.
Co-organized and co-hosted by Dr. Tiffany P. Hogan, Director of the school’s Speech and Literacy Lab (SAiL), and Dr. Sofia Vallila Rohter, Co-Director of its Cognitive Neuroscience Group, the virtual conference focused on the role Implementation Science can play in Communication Sciences and Disorders. The topic certainly resonated as the conference attracted health professionals from 41 different states and from as far away as Australia, Brazil, England, Israel, and Ireland.
“Conferences that focus on implementation science aren’t new,” said Hogan, “but a conference focused solely on implementation science for CSD? Well, that is new.”
Hogan’s presentation focused on school-based research projects and how implementation science helped strengthen both research and outcomes. “When you do implementation science well, the impact can be immediate,” she said. "If you develop the process up front with the community you are partnering with on your research, say with clinicians, then all the little decisions you make about the intervention should inherently fit with the practice. The closer it matches the clinical context, the more likely it's going to be implemented and sustained over time.”
Hogan reminded attendees that every research project has a community that should be invited in to help shape shared research goals. She shared several important lessons learned from her own projects, not least of which was, “Partnerships are critically important, but they’re also hard.” She then added a little Jedi-like wisdom to inspire attendees: “Ships are always safer in the harbor, but that’s not what ships are for.”
Vallila Rohter opened her presentation with a story of when Brigham & Women’s Hospital moved to the Epic medical records system. It would become her first encounter with implementation science.
She was part of the team that examined the Epic system and asked the tough questions that would identify redundancies and other time-consuming aspects of its implementation, which did not immediately bring the improvements that were expected.
She reminded attendees that there are inherent benefits in “naming the work that you are doing,” and that implementation science provides a vocabulary and structure to do just that. “Having that vocabulary from implementation science to identify what we had accomplished and what next steps should be was invaluable.”
Vallila Rohter co-presented with Laura Kasparian, clinical supervisor at Brigham & Women’s, who talked about starting a monthly research meeting for the Brigham’s speech-language pathology team and the inherent benefits that came from this initiative, such as a host of new re-search ideas and better conversations among colleagues about how to improve outcomes.
Two Days of Expertise
Day One of the conference featured four different keynote presentations from experts in the field, starting with Dr. Charles Ellis, Jr., Chair of the Department of Speech, Language, and Hearing Sciences at the University of Florida. Ellis stressed the critical importance of research partnerships, a theme that was revisited throughout the conference. He emphasized how keeping equity front and center with all partnerships is paramount for success because they are only as good as the trust that is built with a team.
Dr. Natalie Douglas, an Associate Professor in the Department of Communication Sciences & Disorders at Central Michigan University, provided a history of implementation science, starting with the 329-year gap between finding and implementing a cure for scurvy. She noted that, on average, it still takes 17 years for a new practice to gain widespread use.
Dr. Howard Goldstein, Associate Dean of Research and Professor of Communication Sciences and Disorders at the University of South Florida, shared his many experiences and lessons learned, such as the best ideas come from talented practitioners, and that some administrators will always advocate for continued research over implementation of new practices.
Dr. Holly Storkel, a Professor of Speech-Language-Hearing at the University of Kansas, wrapped up day one presenters by discussing how implementation science has shaped her work and the importance of involving all team members because, as she said, implementing change takes a village.
Day Two began with a presentation from Dr. Megan Schliep, an Assistant Professor in the MGH Institute’s Department of Communication Sciences and Disorders, and Dr. Rouzana Komesidou, a post-doctoral fellow who works with Hogan. Their presentation included a litany of great re-source material and then a discussion on the importance of developing “frameworks” for new implementations—such as identifying what constitutes success. A big hurdle, according to Schliep and Komesidou, is when researchers don’t work closely with the community members who will be mostly impacted by the change.
That idea was explored in depth by keynote speaker Dr. Nichole Patton Terry, who took time to show the various complexities behind research partnerships and why it’s important to recognize these complexities. “Context matters in how well you live and learn,” she said, reminding at-tendees that “we now know that our zip codes are more important than our genetic code when it comes to health and treatment. Systemic racism infects systems, so it’s vital that we as re-searchers ask community members to take the lead on many of these conversations.”
Kelly Farquharson, PhD, CCC-SLP, an Associate Professor at Florida State University, dis-cussed using social media to bring research to life. It included basics such as how to choose a social media platform to advanced tactics such as building cross-promotional partnerships. She also provided attendees with posting ideas and resources pages with links to other research sites to emulate and learn from.
The last presentation of the conference was from Amy Izen, M.S., CCC-SLP, who invited colleagues Dr. Komesidou and Carmen Vega-Barachowitz, MS, CCC-SLP, Director of Mass General’s Speech, Language & Swallowing Disorders and Reading Disabilities Department, to join her. The three researchers shared their experience helping to launch the new Practice-Based Research Group at Massachusetts General Hospital’s Department of Speech, Language & Swallowing Disorders. With over 50 speech-language pathologists on staff, the re-search group has generated numerous ideas and questions that have led to research projects.
Izen also pointed to the work being done at the MGH Chelsea Healthcare Center and how successful that research partnership has been. “Our research at MGH Chelsea was built with community input and community participation so it’s focused on community issues,” she said. “This gave us a chance to do frontline research with clinician partners who were very focused on the community. So, we’ve been able to evaluate implementation in real time all the way from clinic to patient to home.”
Izen was asked by one of the attendees in the chat room how she grew the research team so quickly. “I found that just asking people, ‘Whatcha working on?’ was a great conversation start-er, as successes and frustrations usually follow which can lead to some interesting conversations.”
Which, as it turned out, is exactly what happened next. The presentations at the conference end-ed, but everyone was invited to a virtual social hour, allowing attendees to mingle online, to find out what each other was working on, to bounce ideas, network, and continue asking the kind of questions that lead to better outcomes.