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份报告和30份出版物。 其中9人已毕业，7人获得学术任命，2人仍在完成博士培训。这 竞争更新利用机会，在创新和 转型，因为波士顿医疗中心(BMC)过渡到自己的责任关怀组织和 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已经 成为波士顿责任关怀组织(BACO)的中心。BACO预计将是 负责18.5万人的生活，使其成为培训研究人员的理想环境。我们的 跨学科的博士后和博士后奖学金旨在产生家庭医学，普通内科 医学、儿科学和公共卫生研究人员将领导改善医疗保健服务的努力 服务不足的病人。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、获取机会和 (2)为博士后和博士后研究员提供全面的 研究培训；。(3)培养将在医疗质量、获取和医疗保健方面进行研究的毕业生。 为低收入人群提供服务，并将其研究转化为系统变革；以及(4)评估我们的 持续改进计划。该项目由Megan Bair-Merritt博士领导，他是一位经验丰富的 研究员和导师，由资深科学家组成的跨学科团队共同指导。我们已经确立了 培训研究人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)课程最终获得卫生服务研究硕士学位 博士后研究员和博士后研究员博士学位；(3)跨学科学术研讨会；(4) 监督至少两个研究项目的实施。在这场竞争更新中，我们为每个 结构化学习，包括：将受训人员与传统研究导师和医院领导层配对 导师；质量改进和实施科学方面的培训；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个 教授博士学位的几年。博士后培训为2年。每年，我们将培养3名博士后和3名 博士后研究员。研究员将成为专注于医疗质量、交付、 以及对低收入人口的影响。我们对毕业生毕业后1年、5年和10年进行跟踪(目标：&gt；85% 进入专注于改善医疗质量的研究职业；&gt；70%的人在从事医疗服务研究后留在那里 3年；&gt；50%带头努力实施新的护理模式，并在5年内资助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).