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Partnered research involves activities where researchers and practitioners work together, with different roles, to use research both to solve practical problems and to contribute to science.1 Researchers partner with healthcare teams and systems to increase the relevance and impact of research to operational imperatives and care delivery. The learning health care system calls for close participation in the research and development process by researchers with organizational leadership and on-the-ground clinicians, as well as patients and caregivers, to enhance the adoption of innovative discoveries.
VA is a leader in partnered research and HSR contributes to partnered research within VA through many of its activities, such as by offering advanced fellowships in research and through the Researchers and Evaluators in Residence program; supporting a Career Development Program; collaborating with program offices and operational partners in developing research priorities; conducting state-of-the-art expert conferences; and funding Consortia of Research (COREs) and the Research to Impact for Veterans (RIVRs) initiative. Partnered research is advanced, as well, through implementation science conducted by the Quality Enhancement Research Initiative (QUERI).
In an effort to improve the impact of these activities and contribute to a Learning Healthcare System at VA, HSR is collaborating in three areas. HSR and the Office of Academic Affiliations are fostering improvements to the HSR advanced fellowship guidelines and processes. HSR is contributing to a partnered research training and certification program undertaken by the Society for General Internal Medicine (SGIM). HSR also participates in efforts to promote embedded research.
1 Ovretveit J, Hempel S, Magnabosco JL, Mittman BS, Rubenstein LV, Ganz DA.Guidance for research-practice partnerships (R-PPs) and collaborative research. J Health Organ Manag. 2014;28(1):115–126.
Purpose: To provide early-stage investigators--or investigators new to the field of partnered research--with approaches, skills, and practical experience in developing partnered research with operational leaders at the medical center, regional, and national levels.
Goals:
Training Overview and Structure: VA Partnered Research Program Training Overview
Session 1: Learning Health Systems take Partnership
Session 2: Implementation in Partnership with Operations
Session 3: Partnering for Impact
Session 4: Communicating with Partners
Session 5: The Intersection of Research and Operations
Session 6: Making an Elevator Pitch
Embedded Research consists of in-house health services research conducted by investigators employed by that health system. Optimal research-operations collaborations result in studies that produce timely, relevant, practical and readily implemented answers to key management problems, in addition to valuable contributions to scientific knowledge. VA emerged as an early leader in health services and embedded research and has been conducting embedded research in its efforts to improve the health of Veterans.
HSR&D has supported embedded research within VHA and, collaborating with external research partners, has sought to understand the environment for embedded research and practices that will foster its growth. To this end, HSR&D supports an AcademyHealth special interest group of embedded researchers, participated in a conference on embedded research, chartered a whitepaper on embedded research, and fostered a supplement on embedded research to further this work in VA and beyond.
Journal Supplement on Embedded Research
Healthcare Supplement Features HSR&D Articles on the Importance of Embedded Research. 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. Healthcare: The Journal of Delivery Science and Innovation. June 2021;8(1).
Key Informant Whitepaper on Embedded Research Practices
Embedded Research: Applications for the Veteran’s Health Administration, October 2019, AcademyHealth. As private delivery systems innovate their own research enterprises, the VA is exploring opportunities to learn from their progress and successes. This whitepaper provides recommendations based on the results of key informant interviews and a survey as part of a project to learn about the practice of embedded research, with an emphasis on two issues of particular importance to the VA: 1) how health systems determine which health services research questions to pursue, and 2) how health systems incentivize researchers to address questions of interest to their own organization.
Accelerating the Development of Learning Healthcare Systems through Embedded Research
AHRQ/PCORI/VA/Kaiser Permanente Southern California hosted a research conference, “Accelerating the Development of Learning Healthcare Systems through Embedded Research”, February 19-21, 2019. The Conference recommended the following activities to accelerate embedded research:
What follows are the presentations of the findings of 5 workgroups that participated in this state-of-the-art conference.
Workgroup A: Organizational Arrangements: Governance, Staffing, Funding
Workgroup B: Research Support for Management Decisions
Workgroup C: Data Resources and Analytics
Workgroup D: Strengthening the Embedded Research Community
Workgroup E: Accelerating Implementation of Embedded Research Output