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Healthcare Supplement Features HSR&D Articles on the Importance of Embedded Research


BACKGROUND:

Sponsored by VA’s Health Services Research and Development (HSR&D) Service, this supplemental issue of the journal Healthcare: The Journal of Delivery Science and Innovation considers the impact of embedded research on solving the disconnect between healthcare organizations and health services researchers. In this way, funders can capitalize on embedded frameworks to enhance the translation of research findings into changes in healthcare delivery. With this goal in mind, in November 2019, a national meeting was organized by a trio of Federal funders – VA, the Agency for Healthcare Research and Quality (AHRQ), and the Patient-Centered Outcomes Research Institute (PCORI) – in collaboration with AcademyHealth and Kaiser Permanente. Approximately 100 participants from various academic and health systems were invited and worked in workgroups focused on the following themes:

  • Organizational arrangements, including governance, staffing, and funding;
  • Research support for management decisions;
  • Data resources and use;
  • Strengthening the embedded research community; and
  • Accelerating implementation of embedded research output.

The articles in this Supplement reflect the work that began during this national meeting, and include:

  • Elwy and colleagues describe how their research into how physicians disclose medical errors helped them develop and implement an evidence-based national program for disclosing large-scale adverse events.
  • Isaacson and Simpson summarize the conclusions of the national meeting workgroup on governance and funding, noting the value of a formal governance committee and a portfolio of short- and long-term projects supported by a mix of health systems and external funding.
  • Taylor and colleagues describe the work of the Center for Outcomes Research and Evaluation at Atrium Health – one of the largest public not-for-profit US hospital systems, which conducts “clinically integrated research” using rapid-cycle evaluations to answer key operational questions and create paths for additional extramural funding.
  • Tuzzio and colleagues use case studies from the NIH Collaboratory Demonstration embedded pragmatic clinical trials to offer methodologic approaches that researchers can employ to account for concurrent quality improvement activities that occur alongside embedded research.
  • Vashi and colleagues discuss an embedded evaluation of the VA Innovators Network – an operational program that seeks to catalyze workplace innovation by frontline VA employees.

Guest Editors for this supplement were David Atkins, MD, MPH, HSR&D Director, Washington, DC; Jeffrey Kullgren, MD, MS, MPH, HSR&D’s Center for Clinical Management Research (CCMR), Ann Arbor, MI; and Lisa Simpson, MB, BCh, MPH, FAAP, AcademyHealth CEO, Washington, DC.

In the editorial entitled “Enhancing the Role of Research in a Learning Health Care System” by Drs. Atkins, Kullgren, and Simpson, they provide an overview of the supplement, and discuss the importance of training early career researchers in how to successfully conduct embedded research. They also emphasize the need to accelerate the growth and impact of embedded research as a key strategy in improving healthcare.


Healthcare: The Journal of Delivery Science and Innovation. June 2021;8(1).

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.


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