Wilson Michael G, Lavis John N, Gauvin Francois-Pierre
McMaster Health Forum, McMaster University, Hamilton, Canada.
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada.
Syst Rev. 2015 Mar 11;4:25. doi: 10.1186/s13643-015-0009-3.
There is currently no mechanism in place outside of government to provide rapid syntheses of the best available research evidence about problems, options and/or implementation considerations related to a specific health system challenge that Canadian health system decision-makers need to address in a timely manner. A 'rapid-response' program could address this gap by providing access to optimally packaged, relevant and high-quality research evidence over short periods of time (i.e. days or weeks).
We prepared an issue brief that describes the best available research evidence related to the problem, three broad features of a program that addresses the problem and implementation considerations. We identified systematic reviews by searching for organization-targeted implementation strategies in Health Systems Evidence ( www.healthsystemsevidence.org ) and drew on an existing analytical framework for how knowledge-brokering organizations can organize themselves to operationalize the program features. The issue brief was then used to inform a half-day stakeholder dialogue about whether and how to develop a rapid-response program for health system decision-makers in Canada. We thematically synthesized the deliberations.
We found very few relevant systematic reviews but used frameworks and examples from existing programs to 1) outline key considerations for organizing a rapid-response program,, 2) determine what can be done in timelines ranging from 3 to 10 and 30 business days, and 3) define success and measure it. The 11 dialogue participants from across Canada largely agreed with the content presented in the brief, but noted two key challenges to consider: securing stable, long-term funding and finding a way to effectively and equitably manage the expected demand. Recommendations and suggestions for next steps from dialogue participants included taking an 'organic' approach to developing a pan-Canadian network and including jurisdictional scans as a type of product to deliver through the program (rather than only syntheses of research evidence).
Dialogue participants clearly signalled that there is an appetite for a rapid-response program for health system decision-makers in Canada. To 'organically' build such a program, we are currently engaging in efforts to build partnerships and secure funding to support the creation of a pan-Canadian network for conducting rapid syntheses for health system decision-makers in Canada.
目前,除政府之外,尚无机制能够快速整合关于特定卫生系统挑战(加拿大卫生系统决策者需要及时应对的问题、选项和/或实施考量)的最佳可得研究证据。一个“快速反应”项目可以填补这一空白,通过在短时间内(即数天或数周)提供经过优化整合、相关且高质量的研究证据。
我们编写了一份问题简报,描述了与该问题相关的最佳可得研究证据、解决该问题的项目的三个主要特征以及实施考量。我们通过在“卫生系统证据”网站(www.healthsystemsevidence.org)上搜索针对组织的实施策略来识别系统评价,并借鉴了一个现有的分析框架,该框架涉及知识中介组织如何进行自我组织以落实项目特征。然后,这份问题简报被用于为一场为期半天的利益相关者对话提供信息,该对话围绕是否以及如何为加拿大卫生系统决策者制定一个快速反应项目展开。我们对讨论内容进行了主题综合。
我们发现相关的系统评价很少,但利用了现有项目的框架和实例来:1)概述组织快速反应项目的关键考量;2)确定在3至10个工作日以及30个工作日的时间范围内可以开展哪些工作;3)定义成功并对其进行衡量。来自加拿大各地的11名对话参与者在很大程度上认同简报中呈现的内容,但指出了两个需要考虑的关键挑战:确保稳定的长期资金以及找到有效且公平地管理预期需求的方法。对话参与者对下一步的建议包括采取一种“有机”的方式来发展一个泛加拿大网络,并将辖区扫描作为一种通过该项目交付的产品类型(而不仅仅是研究证据的综合)。
对话参与者明确表示,加拿大卫生系统决策者对快速反应项目有需求。为了“有机地”构建这样一个项目,我们目前正在努力建立伙伴关系并确保资金,以支持创建一个泛加拿大网络,为加拿大卫生系统决策者进行快速综合分析。