Abstract
Background: Embedded research is emerging as a key strategy to advance learning health systems and evidence-informed integrated care transformation. Embedded research aims to align research with the evidence needs of health system organizations and is intended to help inform organizational decision-making. To build the embedded research workforce and enhance capacity within health system organizations to engage with and draw value from embedded research, embedded research training programs have emerged. This study examines two of the largest embedded research training programs in Canada - the CIHR Health System Impact (HSI) Program and the Ontario Health Team (OHT) Impact Fellows Program - to distill key outcomes, impacts and promising practices for individuals seeking to maximize their value and contribution as an embedded researcher and for organizations seeking to harness embedded research as a strategy for evidence-informed integrated care transformation.
Approach: A mixed-methods study design with multiple sources of data and grounded in the Canadian Health Services and Policy Research Alliance Informing Decision-Making Impact Framework was used to assess outcomes and impacts. Data from program documents and website review were used to describe and compare the two programs. Data from program reporting, including fellow and mentor reports and impact narratives, were used to examine outcomes and impacts. The program teams collaborated to review the outcomes and impacts and, from these, co-design a suite of promising practices for individuals and organizations to maximize the value of embedded research towards integrated care transformation. The draft promising practices were shared with integrated care-focused fellows, alum, and mentors in the programs for review and refinement. Their input was incorporated to finalize the promising practices.
Results: The CIHR HSI Program and the OHT Impact Fellows Program share similar objectives and core design elements. The programs differ in several key factors, including geographic scope, eligibility criteria for the fellow and the embedding health system organization, duration of the embedded fellowship, prioritized focus areas, and size of cohort. Positive outcomes and impacts are observed in both programs at the level of the fellow (i.e., competency development), the mentor (i.e., expanded academic and system relationships, commitment to research, growth as a mentor), and the embedding health system organization (i.e., increased capacity for embedded research, evidence-informed projects). Several promising practices were identified that focus on developing key core competencies, ensuring a strong start to embedded research relationships, building a supportive culture for embedded research, and co-creating shared vision and goals for success between academic and health system organizations.
Implications: The emerging evidence from the CIHR HSI and the OHT Impact Fellows programs suggests that embedded research is a promising tool to help advance evidence-informed integrated care. By co-creating embedded research promising practices with the programs participants, this study generates practical tips and considerations that can help other individuals and organizations optimize their embedded research impacts. This study also contributes to advancing several of the nine pillars of integrated care, including workforce capacity and capability (#5), system leadership (#6), and transparency of progress, results impact (#9).