The Learning Cycle method: an approach to rapidly bring evidence to the point of decision-making for health system...

Health systems often struggle to integrate local and published evidence into timely policy decisions, particularly in complex and rapidly evolving environments such as primary care. While learning healthcare systems (LHS) principles advocate for continuous learning through real-world application, practical methods for operationalizing this without infrastructure can be challenging. To address this gap, we developed the Learning Cycle method in collaboration with the British Columbia Ministry of Health to help drive action-oriented, evidence-informed change and support decision-making.

A Learning Cycle is a low-barrier, rapid (8-12 weeks) knowledge mobilization approach that collects evidence and brings it into policy and/or planning decisions through participatory action methods. The process is initiated by a business owner who has a question that guides the focus of the cycle. The Learning Cycle Lead then manages the cycle, which has two phases: (1) a learning phase - where mixed sources of evidence are rapidly synthesized to address partner defined questions and (2) an action phase - where results are shared in a structured, constructive workshop with decision-makers to facilitate evidence-based planning. The business owner provides input and takes the feasible change ideas into implementation.

To date, 25 Learning Cycles have been completed by the British Columbia (BC) primary care Innovation Support Unit (ISU). Four illustrative case studies are presented to demonstrate the method's flexibility, responsiveness and utility in policy development, planning and system redesign. Contributors to successful Learning Cycles include securing buy-in and continued engagement from the business owner, aligning the cycle to a clear initial question, timing it right to a decision point and adapting to system conditions.

The Learning Cycle model demonstrates adaptability to different contexts, capacity to rapidly align evidence with decision-making needs and potential to embed learning functions across jurisdictional levels. The Learning Cycle is a lightweight method to mobilize evidence into policy and practice with minimal infrastructure, thus making it suitable for low-resource or structurally diffuse contexts, and complements more robust LHS approaches. Its structured yet flexible design advances core LHS strategies - continuous improvement, evidence integration and stakeholder co-production - making it a promising model for responsive and equity-focused health system transformation.