Learning Health System study designs for the evaluation of workforce interventions to cultivate eudaimonia (flourishing)

Abstract

Background

The Learning Health System (LHS) framework is designed to enhance healthcare by systematically integrating internal data and external evidence to promote quality, safety, and efficiency, aligning science, informatics, incentives, and culture for continuous improvement, innovation, and equity.

Methods

The Agency for Healthcare Research and Quality (AHRQ) also outlined key LHS learning goals structured around four interconnected approaches: (1) evidence generation to create new knowledge, (2) evidence adoption to translate findings into practice, (3) evidence dissemination to share best practices across systems, and (4) evidence management to integrate internal and external insights using technology and informatics. We propose this model can also enhance workforce well-being (also termed “flourishing” or eudaimonia by Aristotle) through system-level changes informed by rigorously collected local data.

Findings

Healthcare workers who flourish realize their purpose, improve patient health, and align themselves through daily decisions and actions toward this end. However, excessive workload, documentation burden, and unsupported caregiving responsibilities can detract from this goal. A wide range of LHS methods can be applied to address healthcare worker well-being and result in LHS cycles of learning and improvement. We present four examples demonstrating how LHS-concordant research methods align with AHRQ's learning goals to transition from mitigating burnout to actively promoting flourishing.

Contribution

Together, the application of the AHRQ learning goals forms a continuous feedback loop that facilitates mutual enhancement between healthcare delivery and research, advancing clinician well-being and system-wide improvement. This change in focus offers a new method for the design and evaluation of workforce well-being interventions, can restore excellence in patient care, and contributes to creating sustainable, human-centered healthcare systems.