As residents at BWH during a pivotal time for health care redesign and reform, Amol Navathe, MD, PhD, and Sachin Jain, MD, MBA, noticed a gap in available literature on “delivery science,” which refers to the scientific study of the systems, processes, management, and information technology used to improve the quality and safety of care.
While many journals published the occasional article on care redesign or related topics, there wasn’t a dedicated place for health care professionals to share critical ideas and knowledge about health care delivery.
After more than two years of planning and hard work, Navathe and Jain launched a journal dedicated to these topics. Healthcare: The Journal of Delivery Science and Innovation, published by Elsevier Press, released its first issue on June 24 in print and online.
“The purpose of the journal is to disseminate best practices and connect academic ideas with implementation,” said Navathe, now a clinical fellow at BWH. “Ideas are a dime a dozen; the question everyone needs answered is—where is the evidence to support that idea?”
Jain, who is now the chief medical information and innovation officer at Merck and an attending physician at the Boston VA Medical Center, pinpointed what makes this publication stand apart from others. “In the medical world, publishing results is often the end of the journey. With this journal, we see that as the beginning—what comes next is how to translate the best ideas into practice,” he said.
The journal, which will be published quarterly, promotes cutting-edge research on innovation in health care delivery. Featured topics include care redesign, applied health information technology, payment innovation, managerial innovation, quality improvement research, new training and education models and comparative delivery innovation.
“We hope that decision-makers will find the evidence, strategies and methods needed to support translation of first-rate ideas into broader practice,” the co-editors wrote in an introductory piece for the first issue. “We will highlight the successes and challenges of care delivery innovation and work to close the knowledge gaps that exist between academics, front-line practitioners, industry and policy-makers.”
The journal’s target audience is all health care professionals, as every discipline plays a role in care redesign. “We want to engage not only those who think about delivery science on a day-to-day basis, but also those folks on the front lines whose work is affected by it. Everyone’s input is critical in improving how we care for patients,” said Navathe.
Navathe stressed that BWH has many stories to share in this journal. “At BWH, we have this ethos of data-driven care,” he said. “This hospital has connected the research enterprise with patient care, and we need to spread the word on how that’s done effectively so other academic medical centers can benefit.”
The journal boasts an impressive editorial board, and the first issue features some of the biggest names in health care as contributors, including Don Berwick, MD, former administrator of the Centers for Medicare and Medicaid Services, and former BWH Global Health Equity Chief Jim Yong Kim, MD, PhD, now president of the World Bank.
“Failure to incorporate multidisciplinary perspectives into health care delivery has hampered progress towards the goals that we all want to reach: better health outcomes and reduced health care costs,” Kim wrote. “The work in these pages brings the early seeds of leadership and transformation that we so urgently need: in health care delivery and across the social goals that define our highest aspirations for human progress.”
Feedback on the first issue has been very positive, said Jain. “We received a tremendous reception from stakeholders about the types of articles we published,” he said.
A Team Effort
Navathe and Jain are quick to credit the long list of people who supported their idea and helped to propel it forward.
“It’s amazing how people have pitched in their time and energy for this project, helping us to push it forward from the start,” said Navathe. “To us, their involvement also speaks to the need for this journal—people need a vehicle to discuss these issues.”
They are grateful for the support of many BWH leaders, including Joel Katz, MD, director of the Internal Medicine Residency program, Bill Taylor, director of the DPM/HVMA primary care residency program, Joseph Loscalzo, MD, PhD, chair of the Department of Medicine, and Joseph Frolkis, MD, vice chair for Primary Care.
While it was not easy as a resident to take on this challenge, the support of Katz and Taylor played a major role.
“It’s people like Joel and Bill who say that residents can have an impact,” said Navathe. “It’s why a lot of us come to BWH for our training.”
Jain added, “I don’t think there’s another residency program in the country where two residents could get together and do this kind of thing during training. The support at the Brigham is incredible.”