Promoting learning health system feedback loops: Experience with a VA practice-based research network card study
| Autor: | Rachel E. Golden, Ruth Klap, Diane V. Carney, Elizabeth M. Yano, Alison B. Hamilton, Stephanie L. Taylor, Benjamin Kligler, Alison M. Whitehead, Fay Saechao, Yevgeniya Zaiko, Alyssa Pomernacki, Susan M. Frayne, Bevanne Bean-Mayberry, Sudha Bhoopalam, Kelly E. Buckholdt, Deborah DiNardo, Kathleen Bronson Dussán, Lisa Hardman, Elizabeth E. Hill, Tahira Juiris, Denise Koutrouba, Kristin Mattocks, Gina G. Rawson, Jeanette Rylander, Anne G. Sadler, Agnes Santiago-Cotto, Divya Singhal, Ishita Thakar |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Health Policy Debriefing MEDLINE Veterans Health Evidence-based medicine Learning Health System Representativeness heuristic United States Primary care clinic Practice-based research network Feedback Fiscal year United States Department of Veterans Affairs 03 medical and health sciences 0302 clinical medicine Family medicine medicine Humans Outpatient clinic Female 030212 general & internal medicine Psychology 030217 neurology & neurosurgery Veterans |
| Zdroj: | Healthcare. 8:100484 |
| ISSN: | 2213-0764 |
| DOI: | 10.1016/j.hjdsi.2020.100484 |
| Popis: | Background We tested the capacity of the 60-site VA Women's Health Practice-Based Research Network (WH-PBRN), embedded within VA, to employ a multisite card study to collect women Veterans' perspectives about Complementary and Integrative Health (CIH) and to rapidly return findings to participating sites and partnered national policy-makers in support of a Learning Health System (LHS) wherein evidence generation informs ongoing improvement. Methods VA primary care clinic clerks and nurses distributed anonymous surveys (patient feedback forms) at clinics for up to two weeks in fiscal year 2017, asking about CIH behavior and preferred delivery methods. We examined the project's feasibility, representativeness, acceptability, and impact via a tracking system, national administrative data, debriefing notes, and three surveys of WH-PBRN Site Leads. Results Twenty geographically diverse and largely representative VA Medical Centers and 11 Community-Based Outpatient Clinics volunteered to participate. Over six months, N = 1191 women Veterans responded (median 57; range 8–151 per site). In under three months, we returned local findings benchmarked against multisite findings to all participating sites and summary findings to national VA partners. Sites and partners disseminated results to clinical and leadership stakeholders, who then applied results as warranted. Conclusions VA effectively mobilized an embedded PBRN to implement a timely, representative, acceptable and impactful operations project. Implications Card studies by PBRNs within large, national healthcare systems can provide rapid feedback to participating sites and national leaders to guide policies, programs, and practices. Level of Evidence Self-selected respondents could have biased results. |
| Databáze: | OpenAIRE |
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