Advancing Rehabilitation Practice Using Embedded Learning Health System Researchers
Advancing Rehabilitation Practice Using Embedded Learning Health System Researchers
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DOI：
10.1093/ptj/pzab029
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发表时间：
2021-01-29
期刊：
影响因子：
3.2
通讯作者：
Freburger, Janet K.
中科院分区：
文献类型：
--
作者：
Johnson, Joshua K.;Stilphen, Mary;Freburger, Janet K.
卫生服务研究人员和临床业务负责人有着相似的目标，即解决卫生保健服务的低效率和可变性，以改善结果，但传统上他们使用不同的范例进行工作，其中大部分是相互分离的。卫生服务研究人员通常在较长的时间框架内工作——通常与拨款资助周期有关——系统地解决问题并在科学期刊上发表研究结果，而较少考虑研究结果的实施。临床操作领导者在问题识别、分析和行动的快速循环中工作，以改善护理过程，而不太强调方法的严谨性。另一种模式是将学术研究的严谨性与临床操作的实用性相结合。学习型卫生系统（lhs）为支持这种模式提供了环境和基础设施。LHS的目标是通过发现和实施的循环不断和常规地改善健康。这是通过建立信息学、激励、文化和科学相结合的基础设施来实现的。LHS的“科学”包括有目的地汇总和严格分析作为常规护理一部分收集的卫生保健系统数据，并结合外部证据，以确定和实施最佳实践。这项工作既复杂又费时。8 .在卫生系统基础设施中安排一名卫生服务研究人员可以促进卫生保健工作的完成和质量提高。
Health services researchers and clinical operations leaders share similar goals to resolve inefficiencies and variability in health care delivery to improve outcomes, but have traditionally conducted their work using distinct paradigms, mostly separate from one another. Health services researchers often work on extended timeframes—typically tied to cycles of grant funding—methodically addressing a problem and publishing the findings in scientific journals with less consideration to the implementation of the findings. Clinical operations leaders work in rapid cycles of problem identification, analysis, and action to improve care processes with less emphasis on methodological rigor. An alternative paradigm is one that blends the rigor of academic research with the practicality of clinical operations. Learning health systems (LHSs) provide an environment and infrastructure to support such a paradigm. The aim of an LHS is to continuously and routinely improve health through cycles of discovery and implementation. 1 This is accomplished by the creation of an infrastructure in which informatics, incentives, culture, and science are aligned. 2 The “science” of an LHS includes purposeful aggregation and rigorous analysis of health care system data collected as part of usual care, combined with external evidence, to identify and implement best practices. 3–7 This work is complex and time-intensive. 8 Embedding a health services researcher into the health system infrastructure can facilitate the completion and quality of LHS work.