Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA.
Department of Children, Youth and Families, USC Suzanne Dworak-Peck School of Social Work, Los Angeles, CA.
Med Care. 2021 Aug 1;59(Suppl 4):S379-S386. doi: 10.1097/MLR.0000000000001564.
The expedient translation of research findings into sustainable intervention procedures is a longstanding health care system priority. The Patient-Centered Outcomes Research Institute (PCORI) has facilitated the development of "research done differently," with a central tenet that key stakeholders can be productively engaged throughout the research process. Literature review revealed few examples of whether, as originally posited, PCORI's innovative stakeholder-driven approach could catalyze the expedient translation of research results into practice.
This narrative review traces the historical development of an American College of Surgeons Committee on Trauma (ACS/COT) policy guidance, facilitated by evidence supplied by the PCORI-funded studies evaluating the delivery of patient-centered care transitions. Key elements catalyzing the guidance are reviewed, including the sustained engagement of ACS/COT policy stakeholders who have the capacity to invoke system-level implementation strategies, such as regulatory mandates linked to verification site visits. Other key elements, including the encouragement of patient stakeholder voice in policy decisions and the incorporation of end-of-study policy summits in pragmatic comparative effectiveness trial design, are discussed.
Informed by comparative effectiveness trials, ACS/COT policy has expedited introduction of the patient-centered care construct into US trauma care systems. A comparative health care systems conceptual framework for transitional care which incorporates Research Lifecycle, pragmatic clinical trial and implementation science models is articulated. When combined with Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE), employed as a targeted implementation strategy, this approach may accelerate the sustainable delivery of high-quality patient-centered care transitions for US trauma care systems.
将研究结果迅速转化为可持续的干预措施是医疗保健系统长期以来的重点。患者为中心的成果研究所（PCORI）推动了“以不同方式进行的研究”的发展，其核心原则是关键利益相关者可以在整个研究过程中得到富有成效的参与。文献回顾发现，很少有例子表明，PCORI 的创新利益相关者驱动方法是否如最初设想的那样，可以促进研究结果迅速转化为实践。
本叙述性评论追溯了美国外科医师学会创伤委员会（ACS/COT）政策指导的历史发展，这得益于 PCORI 资助的研究提供的证据，这些研究评估了以患者为中心的护理交接的提供情况。审查了促进指导的关键要素，包括具有调用系统级实施策略能力的 ACS/COT 政策利益相关者的持续参与，例如与验证现场访问相关的监管命令。还讨论了其他关键要素，包括鼓励政策决策中的患者利益相关者的声音，以及将政策峰会纳入实用比较效益试验设计。
受比较效益试验的启发，ACS/COT 政策加速了以患者为中心的护理结构引入美国创伤护理系统。阐述了一个包含过渡护理的研究生命周期、实用临床试验和实施科学模型的比较医疗保健系统概念框架。当与快速评估程序知情临床民族志学（RAPICE）相结合并作为一种有针对性的实施策略使用时，这种方法可能会加速美国创伤护理系统提供高质量以患者为中心的护理交接的可持续性。
