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

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.