Integrating Research into Health Care Systems: Executives' Views

Abstract

BOX 1 Definition Used in Survey A continuous learning healthcare system is one where knowledge is derived from practice and used to drive the cycle of continuous improvement. Knowledge generation can include data analysis for process and quality improvement as well as a range of research activities, for example:  An observational study using data from different organizations to compare stroke rates among patients treated with either dabigatran or warfarin therapy for atrial fibrillation  A cluster randomized trial where hospitals are randomized to either routine care or chlorhexidine bathing and nasal decolonization to assess if this reduces hospital-associated infections.

What allows a health care system to become a learning health care system: Results from interviews with health system leaders

“…Respondents emphasized institutional leaders set the vision for change, contribute financial and personnel resource investments, and sustain personal engagement; they similarly attributed organizational culture as the biggest barrier to transformation. These themes are consistent with management literature highlighting the role of transformational leaders in changing organizational culture, and with reports within the LHCS context and continuous quality improvement efforts on the importance of culture and leadership . Elsewhere, health system CEOs with commitments to high‐value health care labeled “visible and determined leadership by CEO and board” as the “key ingredient to achieving high‐value care.”…”

A Multisite Health System Survey to Assess Organizational Context to Support Evidence‐Based Practice

“…To be a high‐reliability organization, a culture of EBP and a spirit of inquiry are needed (Frankel, Haraden, Federico, & Lenoci‐Edwards, ). High‐reliability organizations establish a learning healthcare system, which utilizes EBP and research resulting in new evidence to support high‐quality, safe, and efficient health care and is used to drive continuous improvement (Johnson et al., ).…”

“…Within a learning healthcare system, nursing leadership's influence on organizational culture, context, nursing practice environment, and organizational resources is key to developing and enhancing a culture of EBP within organizations. Nursing leaders must consider the value and challenges of integrating EBP and research to guide quality improvement and patient care outcomes in order to support integration of EBP into nursing processes (Johnson et al., ). Implementation and sustainability of a culture of EBP require a systematic approach, which should begin with an organizational assessment of readiness for EBP (Melnyk, ).…”

Funding the Training of Future Health Services Researchers

“…Similarly, a recent PCORI/NAM survey of senior executives from health systems found the speed and focus of current research “out of synch” with fast‐paced changes in the delivery system (Johnson et al. ).…”