Assessing impact on health, health care, and public support: The evolution of a CTSA hub’s evaluation and continuous improvement program

Clinical and Translational Science Award (CTSA) hubs are charged with supporting high-quality, community-engaged clinical research; improving the effectiveness and efficiency of research; and facilitating dissemination and implementation of findings into practice, leading to improved clinical outcomes and public health. Traditional academic outcomes, such as publications, subsequent grant funding, and innovative research methods, have often been cited as evidence of hubs' impacts. This article describes one CTSA's approach to extending beyond traditional research outcomes to operationalizing and measuring impacts on health, health care, and public support of research. The approach replaces logic models with key driver diagrams, shifts responsibility for performance indicators to individual programs, consolidates and standardizes impact measures across programs, and adapts existing measures, such as the Translational Science Benefits Model. Measurement challenges include the extended time from supporting a study to its impact, reliance on investigators and partners to provide information, gaining access to organization-wide data, limited validated tools for this purpose, and the limits to documenting breadth of impact. Early lessons learned include the need to embrace various and often imperfect methods and measures, strategically engage partners for mutual benefit, support programs to adopt a continuous improvement mindset, and collaborate with leadership to prioritize and support change.