Durham Veterans Affairs Health Care System, Durham, NC, USA.
Department of Medicine, Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA.
J Gen Intern Med. 2021 Jul;36(7):2100-2104. doi: 10.1007/s11606-020-06587-3. Epub 2021 Feb 2.
In order for health care innovations to be effective and actionable, they must align with the needs and practice patterns of those delivering care at the bedside. While research has started to incorporate the patient voice, it has yet to fully invest in the expertise of frontline clinicians. Frontline clinicians carry a wealth of clinical knowledge and the lived experience of providing real-world medical care that the research community seeks to improve. We consider options for clinicians as research stakeholders along a continuum of engagement as outlined by the UCSF Clinical and Translational Science Institute from minimal to supportive to participatory. In order to make an effective value proposition to support reallocation of clinician time to research engagement, we advocate evaluating the impact of clinicians as stakeholders at both the process level (e.g., clinician satisfaction, study recruitment rates) and endpoint level (e.g., clinical outcomes). Investing in clinicians as research stakeholders can offer benefits for the individual, health system, and population by increasing the generalizability, adoption, and sustainability of effective interventions.
为了使医疗保健创新有效且可行,它们必须符合在床边提供护理的人员的需求和实践模式。虽然研究已经开始纳入患者的意见,但尚未充分利用一线临床医生的专业知识。一线临床医生拥有丰富的临床知识和提供实际医疗护理的经验,这是研究界希望改进的。我们考虑了将临床医生作为研究利益相关者的各种选择,这些选择沿着 UCSF 临床和转化科学研究所概述的参与度连续体,从最低限度的支持到参与式。为了向支持重新分配临床医生时间用于研究的提议提供有效的价值主张,我们主张在过程层面(例如,临床医生满意度、研究招募率)和终点层面(例如,临床结果)评估临床医生作为利益相关者的影响。通过提高有效干预措施的普遍性、采用率和可持续性,将临床医生作为研究利益相关者进行投资可以为个人、医疗系统和人群带来好处。