SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.
BMJ Open. 2020 Oct 26;10(10):e038779. doi: 10.1136/bmjopen-2020-038779.
Over the past three decades, extensive research has been undertaken to understand the elements of what constitutes high quality in healthcare. Yet, much of this research has been conducted on individual elements and their specific challenges. Hence, goals other than understanding the complex of factors and elements that comprises quality in healthcare have been privileged. This lack of progress has led to the conclusion that existing approaches to research are not able to address the inherent complexity of healthcare systems as characterised by a significant degree of performance variability within and across system levels, and what makes them resilient. A shift is, therefore, necessary in such approaches. Resilience in Healthcare (RiH) adopts an approach comprising a comprehensive research programme that models the capacity of healthcare systems and stakeholders to adapt to changes, variations and/or disruptions: that is, resilience. As such, RiH offers a fresh approach capable of capturing and illuminating the complexity of healthcare and how high-quality care can be understood and advanced.
Methodologically, to illuminate what constitutes quality in healthcare, it is necessary to go beyond single-site, case-based studies. Instead, there is a need to engage in multi-site, cross-national studies and engage in long-term multidisciplinary collaboration between national and international researchers interacting with multiple healthcare stakeholders. By adopting such processes, multiple partners and a multidisciplinary orientation, the 5-year RiH research programme aims to confront these challenges and accelerate current understandings about and approaches to researching healthcare quality.The RiH research programme adopts a longitudinal collaborative interactive design to capture and illuminate resilience as part of healthcare quality in different healthcare settings in Norway and in five other countries. It combines a meta-analysis of detailed empirical research in Norway with cross-country comparison from Australia, Japan, Netherlands, Switzerland and the UK. Through establishing an RiH framework, the programme will identify processes with outcomes that aim to capture how high-quality healthcare provisions are achieved. A collaborative learning framework centred on engagement aims to systematically translate research findings into practice through co-construction processes with partners and stakeholders.
The RiH research programme is approved by the Norwegian Centre for Research Data (No. 864334). The empirical projects selected for inclusion in this longitudinal research programme have been approved by the Norwegian Centre for Research Data or the Regional Committees for Medical and Health Research Ethics. The RiH research programme has an embedded publication and dissemination strategy focusing on the progressive sharing of scientific knowledge, information and results, and on engaging with the public, including relevant patient and stakeholder representatives. The findings will be disseminated through scientific articles, PhD dissertations, presentations at national and international conferences, and through social media, newsletters and the popular media.
在过去的三十年中，人们进行了广泛的研究，以了解构成高质量医疗保健的要素。然而，其中的大部分研究都是针对单个要素及其特定挑战进行的。因此，除了了解构成医疗保健质量的复杂因素和要素之外，其他目标都被赋予了特权。由于缺乏进展，人们得出的结论是，现有的研究方法无法解决医疗保健系统固有的复杂性，因为医疗保健系统在系统内部和系统之间存在着显著的绩效差异，并且使它们具有弹性。因此，这种方法需要转变。医疗保健弹性（RiH）采用一种包含全面研究计划的方法，该计划对医疗保健系统和利益相关者适应变化、变化和/或干扰的能力进行建模：即弹性。因此，RiH 提供了一种新的方法，能够捕捉和阐明医疗保健的复杂性，以及如何理解和推进高质量的医疗保健。
为了阐明医疗保健中的质量构成，有必要超越单一地点、基于案例的研究。相反，需要进行多地点、跨国研究，并在国家和国际研究人员与多个医疗保健利益相关者之间进行长期的多学科合作。通过采用这种过程、多个合作伙伴和多学科方向，为期 5 年的 RiH 研究计划旨在应对这些挑战，并加速当前对医疗保健质量的研究和方法的理解。RiH 研究计划采用纵向协作互动设计，以在挪威和其他五个国家的不同医疗保健环境中捕捉和阐明弹性作为医疗保健质量的一部分。它结合了对挪威详细实证研究的荟萃分析和来自澳大利亚、日本、荷兰、瑞士和英国的跨国比较。通过建立一个 RiH 框架，该计划将确定旨在捕捉如何实现高质量医疗保健服务的结果的过程。以参与为中心的协作学习框架旨在通过与合作伙伴和利益相关者共同构建的过程，将研究结果系统地转化为实践。
RiH 研究计划已获得挪威研究数据中心的批准（编号为 864334）。选择纳入这项纵向研究计划的实证项目已经得到了挪威研究数据中心或区域医学和健康研究伦理委员会的批准。RiH 研究计划有一个嵌入式的出版和传播策略，重点是逐步分享科学知识、信息和成果，并与公众、包括相关的患者和利益相关者代表进行接触。研究结果将通过科学文章、博士论文、在国内外会议上的演讲以及通过社交媒体、时事通讯和大众媒体进行传播。
