The Care and Learn Model: a Practice and Research Model for Improving Healthcare Quality and Outcomes

Abstract

The Agency for Healthcare Research and Quality conducted internal work to formulate a model that could be used to analyze the Agency's research portfolio, identify gaps, develop and prioritize its research agenda, and evaluate its performance. Existing models described the structure and components of the healthcare system. Instead, we produced a model of two functions: caring and learning. Central to this model is the commitment to and participation of people-patients, communities, and health professionals-and the organization of systems to respond to people's problems using evidence. As a product of caring, the system produces evidence that is then used to adapt and continuously improve this response, closely integrating caring and learning. The Agency and the health services research and improvement communities can use this Care and Learn Model to frame an evidence-based understanding of vexing clinical, healthcare delivery, and population health problems and to identify targets for investment, innovation, and investigation.

Keywords: evidence-based medicine; health policy; health services research; healthcare delivery; quality improvement.

Figure 1

The Care and Learn Model. The two key functions of the system are to care and to learn. Caring starts in response to a problematic situation affecting people (a healthy or sick person or population). The healthcare system must gather information to assess the situation, identify appropriate evidence, and organize a response. The response, using evidence-based practice, entails organizing and mobilizing people, information, and processes, taking into account the community and social contexts. Learning is a continuous function of the system by which all responses are evaluated according to aims relevant to the situation and deemed important by key stakeholders. This evaluation produces practice-based evidence from which stakeholders must draw to adapt healthcare’s response to people’s problematic situations. The model hinges on the participation of people needing care and those responding with care, on the ongoing engagement in the functions of caring and learning, and on their commitment to achieving the aims of these functions.