Dissemination of trial results to scientific audiences will necessarily focus on a small number of outcomes specified in advance. As discussed in Sections 1 and 2 of this chapter, dissemination to health system audiences, including either partners in a specific trial or leaders of other health systems, should typically consider a wider range of outcomes including resource use or cost, effects on patient or member satisfaction, effects on staff engagement or satisfaction, and effects on “report card” quality measures.

In some cases, health system leaders and frontline staff may focus on metrics or terminology different from those familiar to clinical or health services researchers. For example, when evaluating economic impact, researchers and research audiences may focus on incremental cost, incremental cost-effectiveness ratios, or graphical representation in cost-effectiveness planes. In contrast, health system leaders typically consider economic impact in terms of return on investment or changes in per-member-per-month expenditures.

The relative importance of different outcomes may vary across health systems or within health systems over time. For example, the relative importance of any specific quality metric may vary depending on a health system’s relative performance for that metric or the clinical areas identified as organizational priorities. Different health systems may vary in specific priorities regarding improving or maintaining staff satisfaction or engagement. Priority of specific outcomes may vary with changes in regulatory requirements, public reporting expectations, or financial incentives.

Investigators should understand the structure and business models of partner health systems. Scientific presentations of incremental cost or cost-effectiveness typically consider broader perspectives, such as total health services costs or overall societal costs. Health system decision-makers, however, typically consider a more local perspective. For example, a telephone-based care management program that reduces inpatient care could produce net gains for a health insurer but net losses for a hospital system providing care to those insured.

See also the Dissemination Approaches for Different Audiences chapter of the Living Textbook.