Grant: CIHR Clinician Scientist - Phase 1

Quality of care is at the heart of health care renewal in Canada. The rise of chronic disease, with its emphasis on the active involvement of patients and communities, means that patients and the public are becoming key players in quality improvement. However, the growing call for their involvement in quality initiatives is hampered by a poor evidence base. Knowledge tools, such as quality indicators and clinical practice guidelines, help define how practice should be organized and delivered to provide quality health care. This doctoral thesis will document how patients and the public can be most effectively involved in the development of knowledge tools used in quality improvement. We will: 1) conduct a realist review of evidence, based on existing literature and consultation with an international working group of experts; 2) conduct a cluster randomized controlled trial to assess the impact of a patient and public involvement program on the process of knowledge tool development, its validity, responsiveness to public expectations, and implementation by decision-makers. This doctoral program is conducted under the direction of leading experts in quality of care and public involvement: Richard Grol and Jako Burgers (Scientific Institute for Quality of Healthcare, the Netherlands), and Pascale Lehoux (Université de Montréal, my nominating institution in Canada). Empirical work will be carried in rural Quebec in close collaboration with local decision-makers, thus strengthening capacity for primary care research while laying the foundation for a clinician-researcher career of international standard. This thesis will advance the evidence that supports patient and public involvement in defining quality of care, thus fostering upstream engagement of Canadians¿ in clinical practice improvement.