جستجوی مقالات مرتبط با کلیدواژه "learning health systems" در نشریات گروه "پزشکی"

As embedded researchers in Northern Ontario, Canada, we offer our reflections on Kasaai and colleagues’ 2023 “Early Career Outcomes of Embedded Research Fellows: An Analysis of the Health System Impact Fellowship Program.” In our commentary, we draw on our experiences and what is known about embedded research training to examine how to build and strengthen the workforce for equity-centered learning health systems. Does our narrow understanding of outcomes and impacts of embedded research training in Canada affect who benefits and which systems can realize the potential of learning health systems? We identify three areas for deeper analysis: outcomes and impacts at the individual, partnership, and system level, knowledge on the social identities and needs of individuals in embedded research partnerships, and research generalism as a complement to embedded research. Our recommendations suggest tailored approaches to strengthen the workforce capacity for equity-centered learning health systems in Canada.

Learning health systems (LHSs) are designed to systematically integrate external evidence of effective practices with internal data and experience to put knowledge into practice as a part of a culture of continuous learning and improvement. Researchers embedded in health systems are an essential component of LHSs, with defined competencies. However, many of these competencies are not generated by traditional graduate/post-graduate training programs; evaluation of new LHS training programs has been limited. This commentary reviews and extends results of an evaluation of early career outcomes of fellows in one such program designed to generate impact-oriented career pathways embedded in healthcare systems. Discussion considers the need for increasingly rigorous evaluation methods to ensure production of high-quality professionals ready for system engagement, the importance of training and preparing other LHS stakeholders as effective partners and evidence users, and the promise and challenges in advancing the science and practice of embedded research in LHSs.

Saulnier’s review, “Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic,” analyzes health systems resilience in the first two years of the COVID-19 pandemic. A key finding was the importance of learning. In this commentary, we argue that strengthening systems-level learning capabilities could build resilient health systems. Drawing on learning theories and evidence from organizational resilience and management scholarship, we link the concept of learning loops with Blanchet’s resilience capacities framework, demonstrating the importance of higher levels of learning to build adaptive and transformative resilience capacities. We also argue for an increased focus on power analysis to analyze what is learned, who learns it, and who responds as determining factors to adaptation and transformation. Future research should empirically investigate the extent to which different types of learning supports – or impedes – the building of resilient health systems.

Brown et al show that research investments in an organization with a research and translation mandate can make important gains for research impact across domains, including quality of care and patient outcomes. Their multistage mixed methods evaluation provides insight into research capacity development in rural health systems in Australia and draws attention towards persistent geographic inequities. In extension of this important contribution, here, a focus on the “what and the why” of embedded research is offered. Specific attention is paid to the sustainability potentials of systematized data capture systems, funding-operational mandate alignments, researcher-scientist career pathways, and networked approaches to mentorship.

As the Canadian Institutes of Health Research (CIHR) leads in designing and implementing the new Health System Impact (HSI) Fellowship program, we congratulate Sim et al for their thoughtful contribution to the nascent literature on embedded research, and for advancing our own learning about the HSI Fellowship experience. In our commentary, we describe the HSI Fellowship and its key components, discuss the factors that motivated and inspired the creation of the program, and highlight successes thus far.

Learning health systems necessitate interdependence between health and academic sectors and are critical to address the present and future needs of our health systems. This concept is being supported through the new Canadian Institutes of Health Research (CIHR) Health System Impact (HSI) Fellowship, through which postdoctoral fellows are situated within a health system-related organization to help propel evidence-informed organizational transformation and change. A voluntary working group of fellows from the inaugural cohort representing diversity in geography, host setting and personal background, collectively organized a panel at the 2018 Canadian Association for Health Services and Policy Research Conference with the purpose of describing this shared scholarship experience. Here, we present a summary of this panel reflecting on our experiential learning in a practice environment and its ability for impact.