Advancing the Delivery of Communication Sciences and Disorders Services Through Research: The Promise of Health Services Research

Abstract

Purpose: Traditional efficacy research, or research that studies interventions in controlled settings, can be difficult to translate to real-world clinical settings. In this article, we introduce the field of health services research (HSR) as 1 possible tool to aid this translation. HSR is a field of research that examines and intervenes in the use, cost, quality, delivery, organization, and outcomes of clinical interventions and services in the real-world setting. The complexity of the world outside the clinic walls is accounted for in HSR methods and data sources. As such, HSR often requires collaboration of stakeholders, including patients, caregivers, clinicians, and policy makers. These stakeholders are often engaged throughout the research process, from selecting research questions to disseminating results. HSR brings together researchers from multiple disciplines, including sociology, health economics, epidemiology, and implementation science, among others. The outcomes of HSR can inform policy changes both locally and nationally. To clarify the scope and impact of HSR, we present examples of HSR-based research on communication between patients with communication disorders and health care providers. Conclusions: HSR is a critical tool for clinicians and researchers in the discipline of communication sciences and disorders who are committed to improving the lives and health of persons with communication disorders. I n our rapidly changing health care landscape, traditional clinical efficacy research, or research that tests interventions in ideal settings, is insufficient to meaningfully impact the lives and health of patients who live in the real world. The discipline of communication sciences and disorders (CSD) has a substantial body of clinical research establishing the efficacy of CSD interventions in ideal settings. A paucity exists, however, in research that translates research findings into the context of day-today practice. Consequently, the uptake of evidence-based interventions in the clinic setting is poor, making the value of CSD services for improving patient outcomes difficult to demonstrate. Health services research (HSR) explores and provides evidence at this level of inquiry. The aims of this article are to (a) provide the definition and history of HSR, (b) describe typical HSR methods and study designs, and (c) provide an example of HSR in the discipline of CSD. Definition of HSR Framed within the National Institutes of Health (NIH) Translational T0-T4 Research Continuum, with T0 being basic research, T1 being translation to humans, T2 being translation to patients, T3 being translation to practice, and T4 being translation to communities, HSR