SUSTAINABILITY OF EVIDENCE-BASED HEALTHCARE: THE CONCEPTUAL AND METHODOLOGICAL AG

描述（由申请人提供）：这个小型会议拨款提案解决了我们这个时代最重要的转化研究问题之一：尽管循证医学取得了快速进展，但我们对医疗保健创新一旦付诸实践，在多大程度上或在什么条件下能够持续知之甚少。根据2010年由人权理事会支持的关于扩大和传播的会议的建议，我们提议召开一次工作会议，将公共政策领导人、捐助者、从业者和研究人员聚集在一起，讨论“保持成果”这一主题。我们将介绍可持续发展的成功和失败的现实世界的例子，流行的概念和方法方法，以及实证研究结果关于可持续性的循证医疗保健。本次小型会议基金申请有三个目的：1.小型会议基金；通过确定关于循证医疗保健可持续性的关键概念和方法工作，了解该领域的现状；2. 召开一次思想领袖和利益攸关方的密集工作会议，共同投资于有效医疗保健做法的可持续性；和3。制定和传播研究可持续发展的详细议程，包括对研究、政策和实践行动计划的建议，为持续有效的医疗创新建立证据基础。这些产品可用于为各种卫生保健干预措施的可持续性提供信息并帮助形成实证研究。这项工作还将为未来的政策、实践、卫生服务研究人员的培训以及研究人员与社区之间形成合作关系提供信息。会议的具体成果包括，在实施或实验性试验之后，现有证据清楚地说明在常规护理中维持循证医疗保健的频率和条件；对用于研究可持续性的主要研究方法的批判性评估；以及一套针对研究议程的具体建议，以帮助围绕可持续性研究中的四个关键方法论挑战建立经验基础。会议成果将通过国家卫生研究院传播和实施科学会议，通过实施科学培训网络，向资助机构和CMS的联邦项目工作人员，以及通过关键卫生和公共卫生政策和实践领导者的网络传播。

DESCRIPTION (provided by applicant): This small conference grant proposal addresses one of the most significant translational research problems of our time: in spite of rapid advances in evidence-based medicine, we know very little about how well or under what conditions healthcare innovations are sustained once they are put into practice. Building on recommendations from a 2010 AHRQ-supported conference on scale up and spread, we propose a working meeting to coalesce public policy leaders, donors, practitioners, and researchers around the topic of "sustaining the gains". We will present real-world examples of sustainability successes and failures, prevailing conceptual and methodological approaches, and empirical findings regarding the sustainability of evidence-based healthcare. This small conference grant application pursues three aims: 1. To capture the state of the field by identifying key conceptual and methodological work on the sustainability of evidence-based healthcare; 2. To convene an intensive working meeting of thought leaders and stakeholders with a shared investment in the sustainability of effective healthcare practices; and 3. To produce and disseminate a detailed agenda for studying sustainability, including recommendations for research and policy and practice action plans to build the evidence-base for sustaining effective healthcare innovations. These products can be used to inform and help shape empirical study of sustainability around a variety of health care interventions. This work will also inform future policy, practice, training of health services researchers, and formation of collaborative relationships between researchers and communities. Specific conference outcomes include a clear picture of existing evidence about how often and under what conditions evidence-based healthcare is sustained in usual care, following its implementation or experimental trial; a critical assessment of prevailing research methods used to study sustainability; and a set of specific recommendations for a research agenda to help build an empirical base around four key methodological challenges in sustainability research. Conference products will be disseminated through the NIH conference on the science of dissemination and implementation, through implementation science training networks, to federal program staff of funding agencies and CMS, and through networks of key health and public health policy and practice leaders. PUBLIC HEALTH RELEVANCE: Project Narrative Billions of U.S. tax dollars are spent each year on research and hundreds of billions are spent on service delivery programs, but we know very little about how to sustain healthcare innovations once they are implemented. This conference will produce an agenda for empirical study of sustainability, which in turn will lead to a solid understanding of how to sustain high quality healthcare.