Could 5R Research Help Achieve the Triple Aim?

Creating the Evidence through Comparative Effectiveness Research for Interprofessional Education and Collaborative Practice by Deploying a National Intervention Network and a National Data Repository

“…In the US, healthcare reform initiated by the Affordable Care Act [ 3 ], has accelerated the pressure [ 23 ] for implementable knowledge generated by, among other efforts, intervention research to answer questions about specific actions that will improve healthcare provision (safety, quality), for specific groups or populations, that will be cost effective [ 23 ]. While answering these questions is essential, quickly influencing practice (at multiple levels) is even more essential [ 23 , 24 , 25 ].…”

“…This concern with quickly moving significant research findings into practice is one focus of not only CER but also of other articulated endeavors such as 5R research (which is an example of CER) [ 25 , 26 ]. One recent editorial [ 24 ] has connected the dots between 5R research as an approach that could advance the Triple Aim. The knowledge creation strategies of the National Center are aligned with the efforts of 5R research, recognizing the importance of quick practice implementation whenever possible.…”

“…Well-designed observational studies or quasi-experimental interventions (such as the ones undertaken by the Nexus incubators) frequently produce valuable evidence that can and should inform action [ 19 , 20 , 21 , 22 ]. Others [ 23 , 24 , 25 ] have made a similar case suggesting that what they refer to as the 5Rs is a bold standard for conducting relevant research in a changing world [ 23 ]. Proponents of the 5Rs offer that the changing paradigm of healthcare research needs to (1) be relevant to stakeholders, (2) be rapid and recursive, (3) redefine rigor while maintaining scientific integrity, (4) report on required resources needed to implement interventions, and (5) be replicable [ 23 , 24 , 25 ].…”

Reflections From the Intersection of Health Professions Education and Clinical Practice: The State of the Science of Interprofessional Education and Collaborative Practice

“…Moreover, a changing paradigm for health care research, such as the 5R perspective or the framework of critical realism, 3 will be needed for this work. The 5R perspective [36][37][38] advocates that intervention-based health care research should (1) be relevant to stakeholders, (2) be rapid and recursive, (3) redefine rigor while maintaining scientific integrity, (4) report on required resources needed to implement interventions, and (5) be replicable. 28 Critical realism, 3 which is compatible with the 5R perspective, [36][37][38] prioritizes empirical observation with the goal of finding regularities from those observations that can be generalized.…”

In This Issue: Raise the Gaze

“…• the medical to the social determinants of health 1 • the policies and particulars of case management programs, to their effects on people and populations 2,3 • caring for disadvantaged, disenfranchised individuals, to helping people participate in the political process 4 • designing portals to enable patients to access personal health records, to assessing how this technology can be implemented in small and medium sized practices 5 • referring to advising 6 • rigor to relevance in research 7,8 • bemoaning reductions in the contribution of family physicians to the child health workforce, to knowing some of the factors that underlie recent changes 9 • lamenting that so many people die in the hospital, to understanding how family physicians can deftly take on different roles to help terminally ill patients spend their last days in familiar surroundings 10 • depersonalized, inflexible, unsustainably expensive care in one health care system, to patient-centered, transparent, and affordable care in another system 11 • literal to meaningful translation and communication 12 • the personal turmoil of being the target of legal action, to the transcendent effects of helping another person 13 Ian McWhinney observed that a uniquely important (and often unsupported and undervalued) facet of family medicine is "an acquaintance with the particulars." 14 The articles in this issue incite the notion that personal knowledge is vital to the effectiveness of primary care.…”