Training in Health Services Research for Vulnerable Populations

摘要 我们目前的AHRQ T32计划已经成功地招募了不同的研究员，并为他们的健康做好了准备 服务研究职业。我们培训了13名研究人员，发表了29篇演讲和30篇出版物。 9人已经毕业，7人获得学术任命，2人仍在完成博士培训。这 竞争性更新利用机会在创新环境中培训研究员， 波士顿医疗中心（BMC）转型为自己的责任医疗组织， 成为一个学习健康系统。在过去的一年里，新英格兰最大的安全网医院BMC 波士顿责任关怀组织（Boston Accountable Care Organization，BACO）BACO预计将在 负责185，000所覆盖的生命，使其成为培训研究人员的理想环境。我们 跨学科的博士前和博士后奖学金的目的是生产家庭医学，一般内部 医学、儿科和公共卫生研究人员，他们将领导改善医疗保健服务的努力， 缺医少药的病人我们计划的四个目标是：（1）招聘和留住高素质， 对研究职业感兴趣的不同候选人，专注于提高医疗保健质量，获取， 为服务不足的患者提供服务;（2）为博士前和博士后研究员提供全面的 研究培训;（3）培养将对卫生保健质量，获得和 为低收入人群提供服务，其研究转化为系统变革;以及（4）评估我们的 持续改进计划。该计划由Megan Bair-Merritt博士领导，他是一位经验丰富的 研究员和导师，并由资深科学家组成的跨学科团队共同指导。我们建立 培养研究员所必需的四种教学结构：（1）强化指导;（2）波士顿大学 公共卫生学院（BUSPH）课程最终在卫生服务研究硕士学位， 博士后研究员和博士学位前研究员;（3）跨学科学术研讨会;以及（4） 至少完成两个研究项目。在这次充满竞争的续约中，我们为每一个 结构化学习，包括：将学员与传统的研究导师和医院领导配对 导师;质量改进和实施科学方面的培训;以及至少进行一项研究 利用临床数据解决医疗服务问题的项目。博士前培训包括前3名 博士课程的教学年。博士后培训2年。每年，我们将培养3名博士预科生和3名 博士后研究员将成为卫生服务研究人员，专注于卫生保健质量，交付， 和低收入人群的成果。我们跟踪毕业生毕业后1年，5年和10年（目标：>85% 进入专注于提高医疗质量的研究职业; >70%的人在医疗服务研究之后仍然留在医疗服务研究领域。 3年; >50%的人领导实施新的护理模式，并在5年内资助了>1项研究）。

ABSTRACT Our current AHRQ T32 program has successfully recruited diverse fellows and prepared them for health services research careers. We have trained 13 researchers, resulting in 29 presentations and 30 publications. Nine have graduated, with 7 obtaining academic appointments, and two still completing their PhD training. This competitive renewal capitalizes on the opportunity to train fellows in an environment of innovation and transformation, as Boston Medical Center (BMC) transitions to its own Accountable Care Organization and becomes a Learning Health System. Over the past year, BMC, New England’s largest safety-net hospital, has become the epicenter of the Boston Accountable Care Organization (BACO). BACO is projected to be responsible for 185,000 covered lives, making it an ideal setting in which to train researchers. Our interdisciplinary predoctoral and postdoctoral fellowship aims to produce Family Medicine, General Internal Medicine, Pediatrics, and Public Health researchers who will lead efforts to improve health care delivery for underserved patients. The four objectives of our program are to: (1) Recruit and retain high-quality, diverse candidates interested in research careers focused on improving health care quality, access, and delivery for underserved patients; (2) Provide predoctoral and postdoctoral fellows with comprehensive research training; (3) Produce graduates who will conduct research on health care quality, access and delivery for low-income populations and whose research translates to systems change; and (4) Evaluate our program for continuous improvement. The program is led by Dr. Megan Bair-Merritt, an experienced researcher and mentor, and Co-Directed by an interdisciplinary team of senior scientists. We have established four pedagogical structures essential to training research fellows: (1) Intensive mentoring; (2) Boston University School of Public Health (BUSPH) courses culminating in a Master’s in Health Services Research for postdoctoral fellows and a PhD for predoctoral fellows; (3) Interdisciplinary academic seminars; and (4) Supervised conduct of at least two research projects. In this competitive renewal, we have added to each structured learning, including: pairing trainees with traditional research mentors and a hospital leadership mentor; training in quality improvement and implementation science; and the conduct of at least one research project leveraging clinical data to address a health delivery question. Predoctoral training includes the first 3 didactic years of the PhD program. Postdoctoral training is 2 years. Each year, we will train 3 predoctoral and 3 postdoctoral fellows. Fellows will become health service researchers focused on health care quality, delivery, and outcomes for low-income populations. We track graduates 1, 5, and 10 years after graduation (goal: >85% enter research careers focused on improving healthcare quality; >70% remain in health services research after 3 years; >50% lead efforts to implement new care models and have >1 funded research within 5 years).