期刊
BMJ OPEN
卷 11, 期 2, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2020-040749
关键词
impact assessment; indigenous primary healthcare; continuous quality improvement; capacity strengthening
资金
- competitive Australian National Health and Medical Research Council Centre (NHMRC) Centre of Research Excellence Grant [1078927]
- NHMRC [1148660, 1062377]
The study applied the Framework to Assess the Impact from Translational health research (FAIT) to Lessons from the Best to Better the rest (LFTB), reporting impacts from LFTB and assessing the feasibility and outcomes from a retrospective application of FAIT. LFTB contributed to knowledge advancement in Indigenous PHC service delivery, enhanced capacity of health centre staff, researchers, and health service users, and leveraged funding for the subsequent LEAP Project. Future impact assessments should consider the limitation of capturing impact when final outcomes have not yet been realized.
Objectives To (1) apply the Framework to Assess the Impact from Translational health research (FAIT) to Lessons from the Best to Better the Rest (LFTB), (2) report on impacts from LFTB and (3) assess the feasibility and outcomes from a retrospective application of FAIT. Setting Three Indigenous primary healthcare (PHC) centres in the Northern Territory, Australia; project coordinating centre distributed between Townsville, Darwin and Cairns and the broader LFTB learning community across Australia. Participants LFTB research team and one representative from each PHC centre. Primary and secondary outcome measures Impact reported as (1) quantitative metrics within domains of benefit using a modified Payback Framework, (2) a cost-consequence analysis given a return on investment was not appropriate and (3) a narrative incorporating qualitative evidence of impact. Data were gathered through in-depth stakeholder interviews and a review of project documentation, outputs and relevant websites. Results LFTB contributed to knowledge advancement in Indigenous PHC service delivery; enhanced existing capacity of health centre staff, researchers and health service users; enhanced supportive networks for quality improvement; and used a strengths-based approach highly valued by health centres. LFTB also leveraged between $A1.4 and $A1.6 million for the subsequent Leveraging Effective Ambulatory Practice (LEAP) Project to apply LFTB learnings to resource development and creation of a learning community to empower striving PHC centres. Conclusion Retrospective application of FAIT to LFTB, although not ideal, was feasible. Prospective application would have allowed Indigenous community perspectives to be included. Greater appreciation of the full benefit of LFTB including a measure of return on investment will be possible when LEAP is complete. Future assessments of impact need to account for the limitations of fully capturing impact when intermediate/final impacts have not yet been realised and captured.
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