After meeting in person at the 2019 AcademyHealth Annual Research Meeting in Washington, DC, our cohort of fellows started meeting each month to share our Delivery System Science Fellowship (DSSF) experience and explore the next steps in our professional careers. As we reflect on the last year, we wanted to share our top reasons why students should consider applying to the DSSF and why operational partners should consider hosting a fellow.

Delivery System Science Fellows have the opportunity to apply their knowledge and learn new skills in real-world settings.

To deliver high-value care in the continually changing US health care landscape, the next generation of researchers must develop new skills and pragmatically apply them. Delivery System Science Fellows collaborate with clinicians, patients, health system leaders, community organizations, and other stakeholders, and develop new ideas to rapidly advance clinical practice and health policy. Embedded researchers gain exposure to the complex processes and workflows at each health system host site and intimate knowledge of care delivery practices, challenges, and opportunities from clinical experts. Application of this knowledge is required to engage in continuous quality improvement and/or funded research to improve health outcomes.

Delivery System Science Fellows are the bridge between research and practice that is required to improve care delivery in a learning health system.

As partners in the process to achieve the Quadruple Aim, health services researchers and health systems work together to address operationally relevant research questions and disseminate new knowledge for the health care workforce and research community. In the absence of this partnership, the effectiveness, context, and reproducibility of an intervention or process improvement may be at risk for over or underestimation, may fail to be disseminated with the wider community, or may remain a missed opportunity to test a change. Fellows learn firsthand how to structure research to meet the demands of health systems and funders, adjust to budget constraints, and implement strategies to effectively communicate with a range of stakeholders, including operations. Health systems embracing a “culture of learning” approach to rigorous quality improvement and research provides common ground for partnership.

Delivery System Science Fellows work with the end users of the embedded research they conduct.

Our interventions and tests of change are only as good as the level of engagement from the leaders, clinicians, and other stakeholders participating in them. Those clinical and administrative staff performing the work know the pain points or opportunities where change is essential to support high-value care, eliminate waste and variation in practice, and achieve the Quadruple Aim. Quality improvement projects facilitate active involvement of frontline staff and their voice in clinical practice changes and creates an environment for tests of change. There are classic challenges such as staff resistance, hierarchical relationships, and staff burnout/moral injury to consider in this work. Through the DSSF, we have learned ways to navigate those challenges.

We hope this information inspires the next cohort of Delivery System Science Fellows to apply their skills to real-world problems as partners in the quest to rapidly, and continuously change healthcare for the better.

AcademyHealth is currently accepting applications for the Delivery System Science Fellowship. To learn more about the program, view the 2020 host sites, and submit an application, visit

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