Dr. Barbara Starfield's work demonstrated that countries with primary care-oriented health systems have better population health outcomes, higher quality care, greater health equity, and lower costs. 

The Starfield Summit is an ongoing series of meetings that provide an opportunity for conversation among a diverse group of leaders in primary care research and policy. The Summits are intended to galvanize participants, generate important discussion, and enable research and policy agenda-setting in support of primary care function as an essential catalyst in health system reform.

Speakers:
Drs. Wilson Pace, Warren Newton, Kurt Strange, and Kevin Peterson

Activities:
Appreciative inquiry, group activity envisioned PBRNs addressing health, equity, and primary care workforce issues, small groups taking the emerging visions of PBRNs to create a design plan.

Principal Sponsor:
American Diabetes Association

Gold Sponsors:
American Board of Family Medicine and the American Academy of Family Physicians

Silver Sponsors:
NAPCRG

Partners:
Association of Departments of Family Medicine
Joseph LeMaster, MD
Wilson D. Pace, MD

On Sunday, June 16, 2024, 49 people attended the Starfield VI Summit from 34 different organizations/practices and three countries. There were seven different sponsors for the event.

Kickoff Appreciative Inquiry - Small group sharing

• Why I’m not a keynote speaker:  personal history, challenges, current opportunity for PBRNs (20 min)

• Discovery: paired reflect & share on peak experience re PBRN impact on new knowledge for health & equity. (12 min)

• Shout-out and set up of small group Dream activity (3 min)

Sharing the dream

• Groups of 6-8 use posterboard, crayons, creative materials to envision, at the level of metaphor & story: PBRNs in this moment of opportunity to address, health, equity & primary care workforce

• What would PBRNs look and feel like if they were about those peak experiences we just shared?

Shared ideas and research questions

• Designed together with people and budget in mind. Sometimes all the people are within primary care, while other times primary care teams are collaborating with specialty care and specialty care researchers.

• When successful PBRNs are more than just one individual project and greater than just one idea. They bring together many different people. In medical practices this includes clinicians, staff, nurses, administrators, patients and the community.  In academics it includes investigators of all sorts. 

Creating meaning (asthma study)

• The "meaning" found within PBRNs came up multiple times. This is the bigger context in which a study may sit. For example, while an asthma project is important for the individual patients and practices, in the larger context the approaches to asthma in primary care research are part of state and national research efforts and possible training or policy initiatives.

• When things go well (Asthma Toolkits and Community AIR project)

  • Involved patients, community members, practices, clinicians, schools, organizations.

  • Newspapers in an entire geographic region of a state.   

  • The asthma project combined evidence and story. Over 1000 people were engaged in the rollout of the project in communities and practices.  The study improved asthma treatment in practices and resulted in decreased ER and hospitalization for asthma exacerbation.

Major Themes

1. Practice-Based Research Networks (PBRNs) and Health Equity:

• Emphasized the role of PBRNs in addressing health equity and workforce challenges in primary care.

• Discussions focused on how PBRNs can leverage their networks to improve care delivery, engage with communities, and foster equitable health outcomes.

• The concept of "bridges" was highlighted as a metaphor for connecting research with clinical practice, communities, and various stakeholders.

2. Infrastructure and Collaboration:

• The need for robust infrastructure was a recurring theme, including the creation of Centers of Excellence in Primary Care Research.

• Emphasis on building partnerships, leveraging existing infrastructures, and ensuring the sustainability of research initiatives through diversified funding and strategic collaborations.

• Discussions on developing data hubs, cores for implementation and dissemination, and pathways for clinician engagement in research were central to these sessions.

3. Education and Workforce Development:

• Identified the importance of integrating research into medical education and training for primary care providers.

• Proposed new pipeline programs to ensure that research is a core component of primary care practice, similar to other specialties like oncology.

• The necessity of cultivating a "culture of inquiry" within primary care to drive ongoing research and innovation was underscored.

4. Sustainability and Scalability of PBRNs:

• Addressed the need for sustainable models that support continuous research efforts beyond individual projects.

• Emphasized the importance of securing funding, providing protected research time for clinicians, and aligning with health system priorities to ensure PBRNs can thrive.

• Highlighted challenges related to staffing, burnout, and the variability in practice quality, and proposed strategies to address these through systemic support and infrastructure development.

5. Leadership and Governance:

• The summit discussed the need for strong leadership and governance structures to guide the growth and impact of PBRNs.

• Encouraged the development of shared goals and principles at a national level to align PBRNs with broader healthcare objectives.

• Explored the role of leadership in fostering trust, collaboration, and effective communication across PBRNs and with external stakeholders.

Recommendations

1. Enhancing Infrastructure:

• Invest in developing and maintaining robust infrastructures such as data hubs and Centers of Excellence to support PBRN activities.

• Create sustainable models that include ongoing support for practices, staff, and researchers, not just project-based funding.

2. Fostering Collaboration:

• Strengthen partnerships between academia, healthcare systems, and community organizations to enhance the reach and impact of PBRNs.

• Encourage interdisciplinary collaboration and engagement with diverse stakeholders to address complex healthcare challenges.

3. Promoting Education and Workforce Development:

• Integrate research into the core curriculum of medical education, particularly in primary care disciplines.

• Develop pipeline programs that prepare and encourage primary care providers to participate in research, with adequate support and resources.

4. Sustaining PBRNs:

• Develop strategies to secure long-term funding, including negotiating for research-specific revenue streams within healthcare systems.

• Address workforce issues by ensuring adequate staffing, reducing burnout, and improving the quality of care through continuous professional development and support.

5. Strengthening Leadership:

• Establish clear leadership structures within PBRNs that promote shared vision, accountability, and the translation of research into practice.

• Advocate for national policies and frameworks that support PBRNs and align them with healthcare system priorities.

This summary encapsulates the key discussions, themes, and recommendations from the Starfield VI Summit, focusing on how PBRNs can be leveraged to advance primary care, address health equity, and build a sustainable research ecosystem.