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How alignment between health systems and their embedded research units contributes to system learning.

Michael I Harrison1, Amanda E Borsky2

  • 1Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, 5600 Fisher's Lane, Rockville, MD, 20850, USA.

Healthcare (Amsterdam, Netherlands)
|April 1, 2023
PubMed
Summary

Embedded researchers in learning health systems (LHS) face challenges but can improve care when well-organized and funded. Effective collaboration with clinicians and leaders is key for system-wide learning and advancing healthcare delivery.

Keywords:
Care delivery systemsEmbedded researchImprovementLearning health systems

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Area of Science:

  • Healthcare Management
  • Health Services Research
  • Translational Science

Background:

  • Growing interest in embedded research within healthcare delivery systems.
  • Learning Health Systems (LHS) aim to integrate research into routine care.
  • Understanding the organization of LHS research units is crucial for their effectiveness.

Purpose of the Study:

  • To examine the organizational structures of LHS research units.
  • To identify conditions influencing LHS contributions to system improvement and learning.
  • To compare successful and challenging LHS projects and units.

Main Methods:

  • Conducted 12 key-informant and 44 semi-structured interviews across six healthcare delivery systems.
  • Employed rapid qualitative analysis to identify themes.
  • Compared different types of research units and projects within and across systems.

Main Results:

  • LHS units function both independently and as subunits within larger research centers.
  • Contributions to system improvement are influenced by alignment of factors within units, the system, and between units and the system.
  • Key factors include internal funding, researcher alignment with operational needs, supportive subcultures, external funding alignment, and executive leadership.

Conclusions:

  • Embedded researchers encounter significant challenges in contributing to system improvement and learning.
  • Effective leadership, organization, and internal funding are critical for LHS success.
  • Collaboration between researchers, clinicians, and leaders advances care delivery towards the learning health system ideal.