School of Population Health, Curtin University, Perth, Western Australia, Australia
School of Population Health, Curtin University, Perth, Western Australia, Australia.
BMJ Open. 2022 Jun 13;12(6):e045172. doi: 10.1136/bmjopen-2020-045172.
Sustainability at a system level relates to the capacity of the system to be able to service the ongoing health needs of the population. It is a multifaceted concept encompassing both the affordability and efficiency of a system and the system's ability to adapt and change.To address issues that currently threaten health system sustainability, healthcare leaders, policy makers, clinicians and researchers are searching for solutions to ensure the delivery of safe, value-based care into the future. The timely translation of research evidence into sustainable interventions that can be adopted into the health system is one way of bolstering the sustainability of the system as a whole. We present a protocol for the realist evaluation of a research translation funding programme to understand how the research translation process contributes to health system sustainability and value-based healthcare.
Underpinned by the realist evaluation framework, we will: (1) Develop the Initial Program Theory (IPT) of the research translation process; (2) Test the program theory through case study analysis; and (3) Refine and consolidate the theory through stakeholder consultation. The evaluation uses a case example of a research translation programme, chosen for its representation of a microcosm of the broader health system and the heterogeneity of service improvement activities taking place within it. Across the three phases, analysis of data from documents about the research translation program and interviews and focus groups with stakeholders and program users will draw on the context (C), mechanism (M), outcome (O) formula that is core to realist evaluation. In addition, system dynamic methods will capture the feedback loops and complex relationships among the IPT and context-mechanism-outcome configurations. This approach to evaluation of a research translation funding programme may be adapted to similar programmes operating in other settings.
Curtin University Human Research Ethics Committee, Western Australia, approved this study (approval number: HRE2020-0464). Results will be published in scientific journals, and communicated to respondents and relevant partners.
系统层面的可持续性与系统为满足人口不断增长的健康需求提供服务的能力有关。这是一个多方面的概念,既包括系统的负担能力和效率,也包括系统适应和变革的能力。为了解决当前威胁卫生系统可持续性的问题,医疗保健领导者、政策制定者、临床医生和研究人员正在寻找解决方案,以确保未来提供安全、基于价值的护理。及时将研究证据转化为可持续的干预措施,以便纳入卫生系统,是增强整个系统可持续性的一种方法。我们提出了一个研究翻译资助计划的现实主义评估方案,以了解研究翻译过程如何有助于卫生系统的可持续性和基于价值的医疗保健。
在现实主义评估框架的基础上,我们将:(1)制定研究翻译过程的初始方案理论(IPT);(2)通过案例研究分析检验方案理论;(3)通过利益相关者协商完善和整合理论。该评估使用研究翻译计划的案例示例,选择该示例是因为它代表了更广泛的卫生系统的缩影,以及其中发生的服务改进活动的异质性。在这三个阶段中,对研究翻译计划的文件以及对利益相关者和计划使用者的访谈和焦点小组的数据分析将借鉴现实主义评估的核心的上下文(C)、机制(M)、结果(O)公式。此外,系统动力学方法将捕捉 IPT 和上下文-机制-结果配置之间的反馈回路和复杂关系。这种对研究翻译资助计划的评估方法可以适用于其他环境中的类似计划。
西澳大利亚科廷大学人类研究伦理委员会批准了这项研究(批准号:HRE2020-0464)。研究结果将发表在科学期刊上,并传达给受访者和相关合作伙伴。