将医疗保健组织转变为学习型健康系统使用了哪些实施策略和结果衡量措施？一项混合方法综述研究方案。

What implementation strategies and outcome measures are used to transform healthcare organizations into learning health systems? A mixed-methods review protocol.

机构信息

IWK Health, Halifax, NS, Canada.

School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada.

出版信息

Health Res Policy Syst. 2022 Sep 6;20(1):97. doi: 10.1186/s12961-022-00898-z.

DOI:10.1186/s12961-022-00898-z

PMID:36068563

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9446707/

Abstract

BACKGROUND

A learning health system (LHS) framework provides an opportunity for health system restructuring to provide value-based healthcare. However, there is little evidence showing how to effectively implement a LHS in practice.

OBJECTIVE

A mixed-methods review is proposed to identify and synthesize the existing evidence on effective implementation strategies and outcomes of LHS in an international context.

METHODS

A mixed-methods systematic review will be conducted following methodological guidance from Joanna Briggs Institute (JBI) and PRISMA reporting guidelines. Six databases (CINAHL, Embase, MEDLINE, PAIS, Scopus and Nursing & Allied Health Database) will be searched for terms related to LHS, implementation and evaluation measures. Three reviewers will independently screen the titles, abstracts and full texts of retrieved articles. Studies will be included if they report on the implementation of a LHS in any healthcare setting. Qualitative, quantitative or mixed-methods study designs will be considered for inclusion. No restrictions will be placed on language or date of publication. Grey literature will be considered for inclusion but reviews and protocol papers will be excluded. Data will be extracted from included studies using a standardized extraction form. One reviewer will extract all data and a second will verify. Critical appraisal of all included studies will be conducted by two reviewers. A convergent integration approach to data synthesis will be used, where qualitative and quantitative data will be synthesized separately and then integrated to present overarching findings. Data will be presented in tables and narratively.

CONCLUSION

This review will address a gap in the literature related to implementation of LHS. The findings from this review will provide researchers with a better understanding of how to design and implement LHS interventions. This systematic review was registered in PROSPERO (CRD42022293348).

摘要

背景

学习型卫生系统（LHS）框架为卫生系统结构调整提供了提供基于价值的医疗保健的机会。然而，几乎没有证据表明如何在实践中有效地实施 LHS。

目的

本研究拟采用混合方法综述，在国际背景下确定并综合现有关于 LHS 有效实施策略和结果的证据。

方法

本研究将遵循 Joanna Briggs 研究所（JBI）和 PRISMA 报告准则的方法学指南进行混合方法系统综述。将在 6 个数据库（CINAHL、Embase、MEDLINE、PAIS、Scopus 和 Nursing & Allied Health Database）中搜索与 LHS、实施和评估措施相关的术语。将由 3 位评审员独立筛选检索到的文章的标题、摘要和全文。如果研究报告了任何医疗保健环境中 LHS 的实施情况，则将其纳入研究。将纳入定性、定量或混合方法研究设计。对语言或出版日期没有限制。将考虑纳入灰色文献，但将排除综述和方案论文。将使用标准化的提取表从纳入的研究中提取数据。一位评审员将提取所有数据，第二位评审员将进行验证。将由两位评审员对所有纳入的研究进行批判性评估。将采用趋同综合方法对数据进行综合，即分别对定性和定量数据进行综合，然后整合呈现总体结果。将以表格和叙述的形式呈现数据。