Funding research translation: how we got here and what to do next

• Published in: Australian and New Zealand journal of public health 2021-10, Vol.45 (5), p.420-423
• Main Authors: Zurynski, Yvonne, Smith, Carolynn L., Knaggs, Gilbert, Meulenbroeks, Isabelle, Braithwaite, Jeffrey
• Format: Article
• Language: English
• Subjects: Best practice; Budgets; Clinical medicine; Corporate culture; Cost analysis; Finance; Forecasts and trends; Guidelines; Health care; Health care delivery; Health care expenditures; Health care policy; Health policy; Health services; Health Services Research; Hospitals; Humans; Innovations; Medical research; Patients; Public health; Research funding; Translation; Translational research
• ISSN: 1326-0200; 1753-6405
• DOI: 10.1111/1753-6405.13131

In 2019, avoidable patient harm cost Australian public hospitals more than AU$4.1 billion – that's nearly 9% of the total yearly healthcare expenditure in Australia.1 This occurred despite the extensive evidence base that is designed to support improved patient care, which is growing every day.2 Poor adherence to best practice guidelines and delays in translating new evidence into clinical practice and health policy, and the improvement challenge that is a wicked problem,3 mean that these harms are likely to continue.4The alarming reality of research translation is that it takes approximately 17 years for only 14% of medical research evidence to affect clinical practice.5 Moreover, it has been estimated that nearly 85% of medical research evidence never enters clinical practice,6 and fewer than 50% of clinical innovations are ever integrated into clinical practice.7 The 17/14%/85%/50% equation needs attention.Ensuring societal and economic returns on medical research – making sure research guides practice and improves patient treatments, population outcomes and health system cost-effectiveness – has as a consequence become an international priority.8 However, attempts made to shift the status quo have generally resulted in more of the same. In Australia, the UK and the US, the proportion of clinical care delivered in line with best practice guidelines remains at approximately 60%; care that is of little or no value to the patient (waste) accounts for 30%; and 10% of care results in harm.9 These numbers have remained stuck for the past 30 years,9 while increasing proportions of national budgets have been spent on healthcare.10 It has been postulated that to shift this 60–30–10 ‘status quo’ we need to ramp up translational pathways by making research relevant and useable to those implementing new knowledge in the health system.9 This is easier said than done.