Conceptualising learning healthcare systems and organisations in the context of rehabilitation: a scoping review protocol

Background: Transformative system wide action is needed for healthcare systems to meet the needs of an increasing aging population and changing health needs. One idea is that health systems can become “learning organisations” (LO) or “learning healthcare systems” (LHS) that continuously generate and apply evidence, innovation, quality, and value to provide better care. This is of value to non-acute healthcare settings such as rehabilitation, which are complex, multi-dimensional and multi-disciplinary in nature. Little is known about how these frameworks have been applied to rehabilitation settings. Objective and inclusion criteria: The aim of this scoping review is to systematically map and summarise the literature conceptualising and operationalising LHS and LO in rehabilitation settings. Studies will be included which define a LO or LHS; or describe an operating LHS/LO; or include the translation of research evidence generated from LHS/LO data into healthcare improvement within a rehabilitation context will be included. Study designs such as quantitative, qualitative, mixed method studies, and case studies will be included. Methods: The guidelines from the Joanna Briggs institute methodology for scoping reviews will be used for this review. The literature search will be performed using a three-step search strategy: an initial limited search of two databases has been performed to identify relevant key words and index terms. The developed search string will be adapted and applied across the following databases: OVID MEDLINE, EMBASE, CINAHL Plus, APA PsycINFO and COCHRANE Database of Systematic Reviews. This will be followed by search of the reference lists of selected sources and relevant data-hubs. A draft data extraction framework will be used and updated iteratively to extract data. Frequency counts and qualitative content analysis will be employed to address the research question of how LHS and LO have been conceptualised and operationalised in the context of rehabilitation.