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Welcome to ESCALATES


Thank you for visiting the ESCALATES website. ESCALATES (Evaluating System Change to Advance Learning and Take Evidence to Scale) is the National Evaluation grantee for the EvidenceNOW initiative funded by the federal Agency for Healthcare Research and Quality (AHRQ). My colleagues on this team and I are honored to be responsible for conducting the national evaluation across seven regional projects. During this work, we work collaboratively with them in this very large and important initiative to help 1,800 small practices across the country improve the heart health of their patients.

The majority of people in the United States receive care in small practices – practices with less than 10 clinicians. These small practices have limited resources and experience with quality improvement and are often the last to adopt evidence based change. In conjunction with the challenges facing small practices, heart disease still kills over 600,000 Americans every year, most of which could be prevented if all the risk factors contributing to it were eliminated. With these national challenges in mind, AHRQ has funded seven regional cooperatives across the country that will work with 250-300 small primary care practices to help improve their care for heart health risk factors. These practices will receive different types and combinations of support for improvement with the aim of improving the appropriate use of aspirin, and controlling high blood pressure, cholesterol, and smoking (the ABCS of heart health).

EvidenceNOW is a uniquely large study, fostering learning on a national level by funding a national evaluation of the seven regional cooperatives, ESCALATES. The national evaluation will enable learning on a scale that would be impossible for a single regional cooperative to do alone. Working closely with each of the regional cooperatives, ESCALATES will study which practice support methods and quality improvement strategies are most effective in improving the implementation of new evidence. We will achieve this with a mixed method approach; we will be collecting a range of qualitative and quantitative data, including important information about the practices and their external contexts to ensure the generalizability of our findings. We will also be working with a wide variety of organizations and initiatives to spread those lessons, in part through this website. ESCALATES will pioneer and disseminate methods that will be useful to other researchers, so that the entire field of quality improvement will benefit.

Together with AHRQ and our regional collaborators, my team and I look forward to this ambitious journey that will hopefully revolutionize the way we evaluate, disseminate, and implement evidence in practice.


Deborah Cohen, PHD
Principal Investigator, ESCALATES