背景:尽管人们对学习卫生系统(LHS)的兴趣增加,缺乏评估LHS实施情况的指导和工具。为了解决这个问题,我们的目标是对现有工具进行范围审查,并评估LHS实施的范例。
方法:我们对Scopus内的同行评审研究进行了范围审查,EMBASE,MEDLINE,和MEDLINE过程中描述(1)评估操作LHS的实施或(2)开发框架或工具以促进此评估。阿尼玛,基础研究,摘要,非英语语言文章,2018年之前的出版物被排除在外。考虑了所有研究设计。
结果:从最初确定的1300项研究中,4有资格,用九个实施评估例子揭示了三个工具。确定的工具共享了经过评估的结构,包括:利益相关者,数据,研究证据,实施,和社会技术基础设施。然而,评价方法存在分歧。工具包括用于过程成熟度的五点数字评级系统,以及称为网络成熟度网格(NMG)的雷达图;KaiserPermanenteWashington(KPWA)LHS逻辑模型,它提供了与LHS运营相关的结构和样本度量的广泛列表;最后是LADDERS,一个简单的工具或基于表单的模板,旨在随着时间的推移进行一致的评估。NMG工具在适应和采用方面是最成熟的。值得注意的是,三个工具中有两个(NMG和KPWALHS逻辑模型)将LHS概念化为一套流程,而设计的工具是链接这些构造的流程。
■对LHS实施的评估仍然是一个正在探索的调查领域,因为本次范围界定审查仅发现了三种用于LHS实施评估的工具。我们的研究结果表明,需要在这一领域进行进一步的实证研究,并建议在评估过程中需要考虑的结构的早期共识。
BACKGROUND: Despite increased interest in learning health systems (LHS), a paucity of guidance and tools for evaluating LHS implementation exists. To address this, we aim to undertake a scoping review on existing tools and evaluation of exemplars of LHS implementation.
METHODS: We conducted a scoping review of peer-reviewed studies within Scopus, EMBASE, MEDLINE, and MEDLINE in-process that described (1) the evaluation of the implementation of an operating LHS or (2) the development of a framework or tool to facilitate this evaluation. Anima, basic research, abstracts, non-English language articles, and publications before 2018 were excluded. All study designs were considered.
RESULTS: From 1300 studies initially identified, 4 were eligible, revealing three tools with nine implementation evaluation examples. The identified tools shared constructs which were evaluated, including: Stakeholders, Data, Research Evidence, Implementation, and Sociotechnical Infrastructure. However, there was divergence in evaluation methodology. Tools ranged from a five-point numerical rating system for process maturity with a radar chart called the Network Maturity Grid (NMG); the Kaiser Permanente Washington (KPWA) LHS Logic Model, which provides a broad list of constructs and sample measures relevant to LHS operations; and finally LADDERS, a simple tool or form-based template designed for consistent evaluation over time. The NMG tool was the most mature in terms of adaptation and adoption. Notably, two (NMG and the KPWA LHS Logic Model) out of three tools conceptualized the LHS as a suite of processes and devised tools were processes that linked these constructs.
UNASSIGNED: The evaluation of LHS implementation remains an under explored area of investigation, as this scoping review found only three tools for LHS implementation evaluation. Our findings indicate a need for further empirical research in this area and suggest early consensus in constructs that need to be considered during evaluation.