ESCALATES bridges key gaps in quality improvement

John_SaultzJohn W. Saultz, MD – Professor, and Former Chairman, DepartmentDepartment of Family Medicine, Oregon Health & Science University

Methodologically rigorous research at the community level is more feasible than ever, and we are proud that ESCALATES is leading the way.

Few problems facing American medicine are more daunting than the challenge of improving community primary care practices and maximizing our learning from such efforts.
Efforts in this area have traditionally fallen into two broad strategies, both with substantial limitations: generalizable research followed by continuing education for clinicians, and continuous quality improvement at the practice level. Generalizable research is expensive and time consuming, and its results may not be applicable to every population.  Continuous practice improvement requires innovation at the local level, which is difficult to apply from one community to the next. Bridging this gap is the challenge for ESCALATES.
ESCALATES combines the local focus of data collection and practice improvement in hundreds of community practices, with a rigorous evaluation of how change takes place in seven regional networks of such practices. Significantly, the focus of this work is the reduction of cardiac risk factors to lower death rates from heart disease, America’s leading cause of death.  Primary care research now has information sciences tools we could not have imagined even a decade ago. Methodologically rigorous research at the community level is more feasible than ever, and we are proud that ESCALATES is leading the way.