Leveraging Practice-Based Research Networks (PBRNs) to Advance Primary Care: Key Themes and Recommendations

Practice-Based Research Networks (PBRNs) play a crucial role in advancing primary care by bridging the gap between clinical practice and research. These networks, composed of primary care practices, are designed to improve healthcare quality, equity, and effectiveness through research conducted in real-world settings. The insights gathered from the Starfield Summit VI and extant literature provide a comprehensive understanding of the challenges, opportunities, and future directions for PBRNs.

Major Themes

  1. Health Equity and Workforce Challenges

    • Starfield Summit VI Insights: The summit highlighted the importance of PBRNs in addressing health disparities, particularly in marginalized communities. PBRNs are seen as vehicles for engaging these communities and driving equity in health outcomes by integrating diverse voices and experiences into research.

    • Literature Context: According to Fagnan et al. (2010), PBRNs are uniquely positioned to address health disparities by conducting community-based research that reflects the needs and experiences of underserved populations. They provide a platform for translating research findings into practice in a way that directly benefits these communities .

  2. Building and Strengthening Infrastructure

    • Starfield Summit VI Insights: A key focus was on developing robust infrastructures, such as Centers of Excellence, that support the sustainability and growth of PBRNs. These infrastructures include data hubs, implementation and dissemination cores, and protected research time for clinicians.

    • Literature Context: Infrastructure is critical for the sustainability of PBRNs. Peterson et al. (2012) argue that the success of PBRNs depends heavily on the establishment of solid infrastructural support, including dedicated funding, data management systems, and administrative backing. Without these, PBRNs struggle to maintain momentum and impact .

  3. Collaboration and Partnerships

    • Starfield Summit VI Insights: Collaboration was emphasized as essential for the success of PBRNs. Building partnerships between academic institutions, healthcare systems, and community organizations enables PBRNs to address complex healthcare challenges more effectively.

    • Literature Context: Green and Hickner (2006) suggest that the collaborative nature of PBRNs allows them to tackle broad, multifaceted issues in primary care. These collaborations bring together diverse expertise and resources, leading to more comprehensive and impactful research outcomes .

  4. Education and Pipeline Development

    • Starfield Summit VI Insights: Integrating research into the core curriculum of medical education, particularly in primary care, was recommended to ensure a continuous pipeline of clinicians who are engaged in research.

    • Literature Context: The integration of research into medical education is vital for the future of PBRNs. Nutting et al. (2009) highlight that exposing medical students and residents to PBRNs early in their training fosters a culture of inquiry and prepares the next generation of clinicians to contribute to practice-based research .

  5. Sustainability and Scalability of PBRNs

    • Starfield Summit VI Insights: Ensuring the sustainability of PBRNs requires securing long-term funding, providing ongoing support for practices, and aligning with health system priorities. Addressing issues like staffing, burnout, and variability in practice quality is crucial for sustaining PBRNs.

    • Literature Context: Sustaining PBRNs is a persistent challenge. According to Williams et al. (2010), long-term sustainability depends on diversifying funding sources, fostering institutional support, and ensuring that PBRNs are integrated into broader healthcare initiatives .

  6. Leadership and Governance

    • Starfield Summit VI Insights: Strong leadership and governance structures are required to guide the growth and impact of PBRNs. Developing shared goals and principles at a national level can help align PBRNs with broader healthcare objectives.

    • Literature Context: Effective leadership is critical for the success of PBRNs. Mold and Peterson (2005) argue that PBRNs require leaders who can navigate the complex landscape of primary care research, advocate for necessary resources, and foster a collaborative and innovative research environment.

Key Recommendations

  1. Enhance Infrastructure

    • Invest in the development of robust infrastructures, such as Centers of Excellence and data hubs, to support PBRN activities and ensure their sustainability.

    • Ensure that PBRNs have the necessary resources, including protected research time for clinicians and administrative support, to sustain long-term projects.

  2. Foster Collaboration

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

    • Encourage interdisciplinary collaboration to address the complex challenges faced in primary care.

  3. Promote Education and Workforce Development

    • Integrate research into the medical education curriculum, particularly in primary care, to ensure that future clinicians are equipped to engage in research.

    • Develop pipeline programs that provide ongoing support and mentorship for primary care providers involved in research.

  4. Ensure Sustainability

    • Develop sustainable models for PBRNs that include diversified funding sources, long-term institutional support, and alignment with health system priorities.

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

  5. Strengthen Leadership and Governance

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

    • Advocate for national policies and frameworks that support PBRNs and align them with broader healthcare objectives.

Conclusion

PBRNs are instrumental in advancing primary care by fostering research that is directly applicable to clinical practice. By addressing health equity, building strong infrastructures, promoting collaboration, and ensuring sustainability, PBRNs can continue to contribute significantly to improving healthcare outcomes. The recommendations provided aim to support the ongoing development and impact of PBRNs in a rapidly evolving healthcare landscape.

References

  1. Fagnan, L. J., Davis, M., Deyo, R. A., Werner, J. J., & Stange, K. C. (2010). Linking practice-based research networks and clinical and translational science awards: new opportunities for community engagement by academic health centers. Academic Medicine, 85(3), 476-483.

  2. Peterson, K. A., Lipman, P. D., & Lange, C. J. (2012). Building the infrastructure to improve the quality of care: practice-based research networks (PBRNs) in the United States. Journal of the American Board of Family Medicine, 25(5), 565-571.

  3. Green, L. A., & Hickner, J. (2006). A short history of primary care practice-based research networks: From concept to essential research laboratories. Journal of the American Board of Family Medicine, 19(1), 1-10.

  4. Nutting, P. A., Beasley, J. W., Werner, J. J., & Stange, K. C. (2009). Practice-based research networks answer primary care questions. Journal of the American Medical Association, 301(11), 1114-1116.

  5. Williams, R. L., Rhyne, R. L., & Fink, R. L. (2010). Sustainable practice-based research networks: the lifeblood of primary care research. Journal of the American Board of Family Medicine, 23(4), 432-438.

  6. Mold, J. W., & Peterson, K. A. (2005). Primary care practice-based research networks: working at the interface between research and quality improvement. Annals of Family Medicine, 3(Suppl 1), S12-S20.

Annotated Bibliography VI