Agency for Healthcare Research and Quality, Rockville, Maryland
Agency for Healthcare Research and Quality, Rockville, Maryland.
Ann Fam Med. 2018 Apr;16(Suppl 1):S5-S11. doi: 10.1370/afm.2196.
The mission of the Agency for Healthcare Research and Quality (AHRQ) is to generate knowledge about how America's health care delivery system can provide high-quality care, and to ensure that health care professionals and systems understand and use this evidence. In 2015 AHRQ invested in the largest primary care research project in its history. EvidenceNOW is a $112 million effort to disseminate and implement patient-centered outcomes research evidence in more than 1,500 primary care practices and to study how quality-improvement support can build the capacity of primary care practices to understand and apply evidence.EvidenceNOW comprises 7 implementation research grants, each funded to provide external quality-improvement support to primary care practices to implement evidence-based cardiovascular care and to conduct rigorous internal evaluations of their work. An independent, external evaluator was funded to conduct an overarching evaluation using harmonized outcome measures and pooled data. The design of EvidenceNOW required resolving tensions between implementation and implementation research goals.EvidenceNOW is poised to develop a blueprint for how stakeholders can invest in strengthening the primary care delivery system and to offer a variety of resources and tools to improve the capacity of primary care to deliver evidence-based care. Federal agencies must maximize the value of research investments to show improvements in the lives and health of Americans and the timeliness of research results. Understanding the process and decisions of a federal agency in designing a large clinical practice transformation initiative may provide researchers, policy makers, and clinicians with insights into future implementation research, as well as improve responsiveness to funding announcements and the implementation of evidence in routine clinical care.
美国医疗保健研究与质量署（AHRQ）的使命是生成关于美国医疗保健提供系统如何提供高质量护理的知识，并确保医疗保健专业人员和系统理解并使用这些证据。2015 年，AHRQ 投资了其历史上最大的初级保健研究项目。EvidenceNOW 是一项耗资 1.12 亿美元的努力，旨在在 1500 多家初级保健实践中传播和实施以患者为中心的结果研究证据，并研究质量改进支持如何能够增强初级保健实践理解和应用证据的能力。
EvidenceNOW 包括 7 项实施研究赠款，每项赠款都旨在为初级保健实践提供外部质量改进支持，以实施基于证据的心血管护理，并对其工作进行严格的内部评估。为了使用协调的结果衡量标准和汇总数据进行总体评估，还资助了一名独立的外部评估员。
EvidenceNOW 的设计需要解决实施和实施研究目标之间的紧张关系。
EvidenceNOW 有望为利益相关者如何投资于加强初级保健提供系统制定蓝图，并提供各种资源和工具，以提高初级保健提供基于证据的护理的能力。联邦机构必须最大限度地提高研究投资的价值，以显示美国人的生活和健康以及研究结果的及时性的改善。了解联邦机构在设计大型临床实践转型计划中的过程和决策，可能为研究人员、政策制定者和临床医生提供未来实施研究的见解，并提高对资金公告的响应能力和在常规临床护理中实施证据的能力。
