学习型健康系统对物理治疗师的相关性及其与实施科学的协同作用:一篇评论
Relevance of learning health systems to physiatrists and its synergy with implementation science: A commentary.
作者信息
Annaswamy Thiru M, Grover Prateek, Douglas Natalie F, Poploski Kathleen M, Anderson Catherine A, Clark Melissa A, Flores Ann Marie, Hafner Brian J, Hoffman Jeanne M, Kinney Adam R, Ressel Kristin, Sánchez Jennifer, Whitten Margarite J, Resnik Linda, McDonough Christine M
机构信息
Department of Physical Medicine & Rehabilitation, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Department of Communication Sciences and Disorders, The Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Mount Pleasant, Michigan, USA.
出版信息
PM R. 2024 Jul 5. doi: 10.1002/pmrj.13213.
As health care attempts to bridge the gap between evidence and practice, the concept of the learning health system (LHS) is becoming increasingly relevant. LHS integrates evidence with health systems data, driving health care quality and outcomes through updates in policy, practice, and care delivery. In addition, LHS research is becoming critically important as there are several initiatives underway to increase research capacity, expertise, and implementation, including attempts to stimulate increasing numbers of LHS researchers. Physical Medicine & Rehabilitation (PM&R) physicians (physiatrists), nurses, therapists (physical therapists, occupational therapists, speech therapists, clinical psychologists), and scientists are affiliated with LHSs. As LHS research expands in health care systems, better awareness and understanding of LHSs and LHS research competencies are key for rehabilitation professionals including physiatrists. To address this need, the Agency of Healthcare Research and Quality (AHRQ) identified 33 core competencies, grouped into eight domains, for training LHS researchers. The domains are: (1) Systems Science; (2) Research Questions and Standards of Scientific Evidence; (3) Research Methods; (4) Informatics; (5) Ethics of Research and Implementation in Health Systems; (6) Improvement and Implementation Science; (7) Engagement, Leadership, and Research Management; and the recently added (8) Health and Healthcare Equity and Justice. The purpose of this commentary is to define LHS and its relevance to physiatrists, present the role of implementation science (IS) in LHSs and application of IS principles to design LHSs, illustrate current LHS research in rehabilitation, and discuss potential solutions to improve awareness and to stimulate interest in LHS research and IS among physiatrists in LHSs.
随着医疗保健领域努力弥合证据与实践之间的差距,学习型健康系统(LHS)的概念变得越来越重要。LHS将证据与卫生系统数据相结合,通过政策、实践和护理服务的更新来推动医疗保健质量和成果。此外,LHS研究正变得至关重要,因为目前有多项举措致力于提高研究能力、专业知识和实施水平,包括试图激励越来越多的LHS研究人员。物理医学与康复(PM&R)医生(物理治疗师)、护士、治疗师(物理治疗师、职业治疗师、言语治疗师、临床心理学家)和科学家都与LHS相关联。随着LHS研究在医疗保健系统中的扩展,提高对LHS及其研究能力的认识和理解对于包括物理治疗师在内的康复专业人员来说至关重要。为满足这一需求,医疗保健研究与质量局(AHRQ)确定了33项核心能力,分为八个领域,用于培训LHS研究人员。这些领域包括:(1)系统科学;(2)研究问题和科学证据标准;(3)研究方法;(4)信息学;(5)卫生系统研究与实施的伦理;(6)改进与实施科学;(7)参与、领导力和研究管理;以及最近新增的(8)健康与医疗保健公平和正义。本评论的目的是定义LHS及其与物理治疗师的相关性,介绍实施科学(IS)在LHS中的作用以及IS原则在LHS设计中的应用,说明当前康复领域的LHS研究,并讨论提高认识以及激发LHS中物理治疗师对LHS研究和IS的兴趣的潜在解决方案。