Evolution of an Approach to Rapidly Synthesizing Evidence About Pressing Health-System Issues

Article type
Authors
Wilson M1, Lavis J1, Waddell K2, Gauvin F2, Moat K1
1Department of Health Evidence & Impact, McMaster University; McMaster Health Forum
2McMaster Health Forum
Abstract
Background: Rapidly synthesizing evidence is critical for supporting evidence-informed policymaking about health systems. Since 2013 we have developed, implemented and iteratively refined a rapid-response program at the McMaster Health Forum that has (in days or weeks) identified and synthesized evidence for Canadian policymakers and stakeholders about more than 50 pressing health-system issues.

Objectives: Our objective was to document the evolution of this program to provide insights for others interested in rapidly synthesizing evidence.

Methods: We used a multi-method approach to document how and why our rapid-response program has evolved and to identify current and future challenges faced in efforts to provide robust yet rapidly synthesized evidence to inform pressing health-system issues. This included a detailed internal program review that was based on internal documentation and interviews with staff, a documentary analysis of products produced through the program and a focus group with those involved in the administration and scientific aspects of running the rapid-response program.

Results: Our experience with conducting rapid syntheses has evolved to: 1) incorporate longer timelines (e.g., 60- or 90-day requests); 2) address both health- and social-system issues; 3) better accommodate the types of complex questions often asked by policymakers (e.g., that synthesize evidence about policy problems, options, implementation considerations, and monitoring and evaluation plans); 4) expand the types of evidence and insights synthesized (e.g., by drawing on systematic reviews and primary studies, as well as from policy documents and key informant interviews); and 5) conduct and integrate multiple types of analyses such as policy, systems and political analysis.

Conclusions: While our approach to conducting rapid syntheses remains underpinned by a commitment to being systematic and transparent in identifying and synthesizing evidence and insights for health- and social-system leaders it has evolved in a way that allows us to go farther, faster in responding to urgent requests.

Patient or healthcare consumer involvement: Topics addressed in rapid syntheses are driven by requests from health-system policymakers and stakeholders, which can include consumer-driven groups. Moreover, when rapid syntheses are conducted for governments or other stakeholders, they are often generated through internal engagement processes within those organizations and generate findings that are relevant to patients and consumers (e.g., how to empower caregivers in home-based restorative care processes) and/or prioritize the need for patient/consumer engagement (e.g., through rapid-learning health systems that are anchored on patient needs, perspectives and aspirations, and focused on improving their
care experiences and health at manageable per capita costs and with positive provider experiences).