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. 2024 May 6;9(1):e10424.
doi: 10.1002/lrh2.10424. eCollection 2025 Jan.

Creating pragmatic, rapid-cycle, evidence-based innovation: The Kaiser Permanente Northern California Delivery Science and Applied Research (DARE) program

Douglas A Corley  1   2 , Julie A Schmittdiel  1   3 , Smita Rouillard  2 , Yi-Fen Chen  2 , Tracy A Lieu  1   2
Affiliations

Creating pragmatic, rapid-cycle, evidence-based innovation: The Kaiser Permanente Northern California Delivery Science and Applied Research (DARE) program

Douglas A Corley et al. Learn Health Syst. .

Abstract

Introduction: Ongoing crises in the quality, affordability, sustainability, value, and equity of U.S. healthcare call for rapid, massive-scale innovations across multiple specialties. Physician groups and healthcare organizations commit significant monetary and personnel investments for innovation and improvement efforts, but most lack over-arching systems theory-supported conceptual frameworks for efficiently coordinating the timely, large-volume idea generation, refinement, prioritization, evidence development, implementation, and re-evaluation strategies needed for rapid-cycle improvements in health care delivery, outcomes, and value.

Methods: This article describes one large-scale, generalizable model: The Permanente Medical Group's (TPMG) Delivery Science and Applied Research (DARE) program within Kaiser Permanente Northern California. This organization-level initiative was designed to: (1) elicit clinical innovation and quality concerns across clinical specialties; (2) prioritize these questions for next-step evaluations; (3) create dedicated analytic, research, and clinical expertise to rapidly study the questions generated; (4) develop communities of clinician-researchers, embedded within their specialties' clinical operations, who gather ideas for evaluation, generate evidence, and facilitate implementation of research results (a.k.a. evidence-based innovators); and (5) broadly disseminate findings, to connect results with potential next-step implementation.

Results: The DARE program and its components rapidly led to more than 200 recently completed or ongoing projects, informed care changes, influenced national guidelines, developed communities of evidence-based clinician innovators in 15 specialties, and empowered new paths for career diversity and physician wellness. Key factors in the DARE program's success include explicitly defining high-impact ideas; engaging researchers with analysts experienced with large clinical data systems; developing several research funding mechanisms scaled to project size; prioritizing rapid and efficient project completion; supporting clinician-investigators embedded within their specialties; and structured organization-wide dissemination of findings for informing potential implementation.

Conclusions: High-volume, evidence-based innovation programs can be important, scale-able, reproducible models for different settings for increasing quality, affordability, sustainability, value, and equity in healthcare and furthering the difficult-to-achieve concept of developing sustainable learning healthcare systems.

Keywords: continuous quality improvement; delivery science; implementation; innovation; learning health systems; rapid analytics; research operations partnerships.

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Conflict of interest statement

Dr. Schmittdiel receives support from the DREAMS Center for Diabetes Translational Research (P30DK092924). The other authors report that they have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Key steps in evidence‐based innovation.
FIGURE 2
FIGURE 2
Core components of an evidence‐based innovation program.
FIGURE 3
FIGURE 3
Defining an impactful evidence‐based innovation idea: Four elements.
FIGURE 4
FIGURE 4
Effects of a home recovery after uncomplicated mastectomy program on the percent of patients with home recovery and on unexpected returns to care.
See this image and copyright information in PMC

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