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学习型健康系统中实施科学的伙伴关系构建考量:以加拿大艾伯塔省实施科学协作组织为例

Partnership-building considerations for implementation science in learning health systems: a case study of the Implementation Science Collaborative in Alberta, Canada.

作者信息

Brooks Stephanie P, Alba Cody, Thomson Denise, Davison Sara N, Storey Kate

机构信息

Learning Health System Team, Alberta SPOR SUPPORT Unit, Department of Medicine, University of Alberta, Edmonton, AB, Canada.

School of Public Health, University of Alberta, Edmonton, AB, Canada.

出版信息

Front Health Serv. 2024 Feb 16;4:1327395. doi: 10.3389/frhs.2024.1327395. eCollection 2024.

Abstract

INTRODUCTION

Implementation of health innovations is inherently collaborative, requiring trans-sectoral partnerships between implementation researchers, innovation teams, and implementation practitioners. Implementation science has been shown to improve implementation successes; however, challenges that hinder partnerships to advance implementation science continue to persist. Using a whole-system approach to assess and respond to implementation science partnership barriers may shed light on effective responses.

METHODS

We conducted a case study of Alberta's learning health system, using semi-structured group and individual interviews to create a nuanced understanding of the considerations required for implementation research collaborations. We interviewed 53 participants representing 21 offices in the health system, academia, professional associations, and government who regularly plan, evaluate, and/or study health system implementation initiatives in Alberta. Using the Partnership Model for Research Capacity Building, we identified current facilitators and challenges for partnerships for conducting and using implementation science, at different levels of Alberta's health-research ecosystem.

RESULTS

Alberta's healthcare system is well set up to readily embed intervention effectiveness and efficacy research. Infrastructure was also in place to strengthen implementation practice. However, weaknesses around exchanging knowledge and skills, providing feedback and mentoring, and accommodating diversity affected the ability of both individuals and teams to build implementation science capacity. Without this capacity, teams could not participate in embedded implementation research collaborations. We report the response of the Alberta Strategy for Patient-Oriented Research SUPPORT Unit to these barriers to provide practical guidance on various program options to strengthen individual- and organization-level implementation science capacity.

DISCUSSION

This study applied a whole-system approach to assess factors across Alberta's health-research ecosystem, which affect partnerships to advance implementation science. Our findings illustrated that partnership considerations go beyond interpersonal factors and include system-wide considerations. With the results, health organization leaders have (1) a method for assessing organizational capability to readily embed implementation research and (2) a catalog of potential responses to create conditions to readily engage with implementation science in their day-to-day implementation processes.

摘要

引言

健康创新的实施本质上具有协作性,需要实施研究人员、创新团队和实施从业者之间建立跨部门伙伴关系。实施科学已被证明能提高实施成功率;然而,阻碍推进实施科学的伙伴关系的挑战依然存在。采用全系统方法来评估和应对实施科学伙伴关系障碍可能会为有效应对措施提供启示。

方法

我们对艾伯塔省的学习型健康系统进行了案例研究,通过半结构化小组访谈和个人访谈,以深入了解实施研究合作所需考虑的因素。我们采访了53名参与者,他们代表了卫生系统、学术界、专业协会和政府的21个办公室,这些人员经常在艾伯塔省规划、评估和/或研究卫生系统实施举措。使用研究能力建设伙伴关系模型,我们确定了在艾伯塔省卫生研究生态系统的不同层面开展和应用实施科学的伙伴关系当前的促进因素和挑战。

结果

艾伯塔省的医疗保健系统已做好充分准备,能够轻松融入干预效果和效能研究。同时也具备加强实施实践的基础设施。然而,在知识和技能交流、提供反馈和指导以及包容多样性方面的薄弱环节影响了个人和团队建立实施科学能力的能力。没有这种能力,团队就无法参与嵌入式实施研究合作。我们报告了艾伯塔省以患者为导向的研究支持战略股对这些障碍的应对措施,以提供关于各种项目选项的实用指南,以加强个人和组织层面的实施科学能力。

讨论

本研究采用全系统方法来评估艾伯塔省卫生研究生态系统中影响推进实施科学伙伴关系的因素。我们的研究结果表明,伙伴关系考虑因素不仅包括人际因素,还包括全系统因素。基于这些结果,卫生组织领导人有(1)一种评估组织轻松融入实施研究能力的方法,以及(2)一系列潜在应对措施的目录,以便在日常实施过程中创造条件,轻松参与实施科学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8fd/10904619/c46f5bd7b4e6/frhs-04-1327395-g001.jpg

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