Learning Collaboratives - Why?

I have been a proponent of evidence-based practice because who can argue with the idea of using good science to inform clinical practice?

There is a dark side to EBP, of course. There is always a dark side. How is it compiled? Who gets the label? What research (RCTs) get funded? Politics drive a lot of these questions. Then there is the politics of implementation.

I have mainly focused on EBP as the bridge over the chasm between research and practice, but this bridge isn't clean because of the politics that drives everything.

Politics has a bad rap - I use it here to describe the reality that there are always multiple stakeholders, each with their own interests/concerns/needs/agenda, trying to form and inform what we do. Everything is political. Because of the naturally conflicting needs of various stakeholders, the process gets a bad rap. We need PeaceMakers or Conflict Mediators for adults. Conflict isn't bad, it's natural. The problem is we don't know what to do with it. We usually try to avoid it, which doesn't help or makes things worse. It is so important for every stakeholder to stand up and use their voice. This is the best way to make sure that solutions, including policy, are comprehensive and serve the greatest good.

So where is the hope for integrating research and practice? Learning Collaboratives.

It is a model devloped by the medical community (same origins of EBP). It was created expressly for the purpose of closing the "gap between what we know and what we do."

"Sound science exists on the basis of which the costs and outcomes of current health care practices can be greatly improved, but much of this science lies fallow and unused in daily work."

This model has been used to improve asthma care for children and adults, reduce cesarean section rates, reduce delays and waiting times, reduce costs and improve outcomes in adult cardiac surgery, improve care at end of life, and so on... These areas were chosen after a national survey of clinical, policy and administrative leaders and published as "Eleven Worthy Aims for Clinical Leadership of Health System Reform."

If the field of school social work or school mental health applied this model, what practice improvements would we tackle first? What topics would you put on the following list?

"Eleven Worthy Aims for Clinical Leadership of School Mental Health/School Social Work/Child Welfare Reform"