Groot Gary, Witham Stephanie, Badea Andreea, Baer Susan, Dalidowicz Michelle, Reeder Bruce, Froh John, Carr Tracey
Department of Community Health and Epidemiology University of Saskatchewan Saskatoon Saskatchewan Canada.
Saskatchewan Health Authority Royal University Hospital Saskatoon Saskatchewan Canada.
Learn Health Syst. 2023 Jul;7(3):e10350. doi: 10.1002/lrh2.10350. Epub 2022 Oct 9.
Evaluating a learning health system (LHS) encourages continuous system improvement and collaboration within the healthcare system. Although LHS is a widely accepted concept, there is little knowledge about evaluating an LHS. To explore the outputs and outcomes of an LHS model, we evaluated the COVID-19 Evidence Support Team (CEST) in Saskatchewan, Canada, an initiative to rapidly review scientific evidence about COVID-19 for decision-making. By evaluating this program during its formation, we explored how and to what extent the CEST initiative was used by stakeholders. An additional study aim was to understand how CEST could be applied as a functional LHS and the value of similar knowledge-to-action cycles.
Using a formative evaluation design, we conducted qualitative interviews with key informants (KIs) who were involved with COVID-19 response strategies in Saskatchewan. Transcripts were analyzed using reflexive thematic analysis to identify key themes. A program logic model was created to represent the inputs, activities, outputs, and outcomes of the CEST initiative.
Interview data from 11 KIs were collated under three overarching categories: (1) outputs, (2) short-term outcomes, and (3) long-term outcomes from the CEST initiative. Overall, participants found the CEST initiative improved speed and access to reliable information, supported and influenced decision-making and public health strategies, leveraged partnerships, increased confidence and reassurance, and challenged misinformation. Themes relating to the long-term outcomes of the initiative included improving coordination, awareness, and using good judgment and planning to integrate CEST sustainably into the health system.
This formative evaluation demonstrated that CEST was a valued program and a promising LHS model for Saskatchewan. The future direction involves addressing program recommendations to implement this model as a functional LHS in Saskatchewan.
对学习型健康系统（LHS）进行评估有助于促进医疗系统的持续改进与协作。尽管LHS是一个被广泛接受的概念，但对于评估LHS的了解却很少。为了探索LHS模型的产出和结果，我们对加拿大萨斯喀彻温省的COVID-19证据支持团队（CEST）进行了评估，这是一项旨在快速审查有关COVID-19的科学证据以供决策的倡议。通过在该项目形成期间对其进行评估，我们探索了利益相关者如何以及在多大程度上使用了CEST倡议。另一个研究目标是了解CEST如何作为一个功能性的LHS加以应用以及类似的知识转化为行动循环的价值。
采用形成性评估设计，我们对参与萨斯喀彻温省COVID-19应对策略的关键信息提供者（KI）进行了定性访谈。使用反思性主题分析法对访谈记录进行分析以确定关键主题。创建了一个项目逻辑模型来展示CEST倡议的投入、活动、产出和结果。
来自11名KI的访谈数据被整理为三个总体类别：（1）产出，（2）短期结果，以及（3）CEST倡议的长期结果。总体而言，参与者发现CEST倡议提高了获取可靠信息的速度和便利性，支持并影响了决策和公共卫生策略，利用了伙伴关系，增强了信心并消除了疑虑，还对错误信息提出了挑战。与该倡议长期结果相关的主题包括改善协调、提高认识，以及运用良好判断力和规划将CEST可持续地融入卫生系统。
这项形成性评估表明，CEST是一个有价值的项目，也是萨斯喀彻温省一个有前景的LHS模型。未来的方向包括落实项目建议，以便在萨斯喀彻温省将该模型作为一个功能性的LHS加以实施。
