Learning Health System Embedded Scientist Training and Research Center - ABSTRACT – UCSF E-STaR OVERALL The aspirations of an integrated Learning Health System (LHS) are to deliver care that is of the highest quality, is safe, and is optimally efficient. These goals guide all UCSF-affiliated health systems, including UCSF Health, SF Health Network/Zuckerberg SF General and the SF Veterans Affairs Medical Center. The diversity of patient populations and delivery systems represented by UCSF-affiliated health systems, along with their evolution as integrated LHS, is a ripe, natural training environment for developing LHS scientists. To achieve greater impact, UCSF needs a larger workforce of LHS scientists from diverse backgrounds, working in teams with clinical operators, data stewards and informaticians, and engaged with multiple stakeholders (patients, caregivers, clinicians, institutional leadership) to co-produce real-time improvements in practice patterns, patient-centered outcomes, and health system performance. As an AHRQ/PCORI-sponsored LHS K12 Career Development Program and LHS Center of Excellence, UCSF has designed an outstanding research training and career development program for 8 individuals who have already demonstrated an impact. This UCSF E- STaR Center proposal will create and scale up LHS-specific training and research infrastructure: Aim 1. To establish multidisciplinary Cores that share resources and facilities with healthcare systems to support research and training for LHS scientists, particularly in areas of embedded research training, patient and stakeholder engagement, informatics, and outcome evaluation. The Administrative Core (AC) will provide overarching Center leadership, stakeholder engagement and coordination, recruitment, program evaluation, and internal and external communications. The Research Education Core (REC) will implement the Scholar training program; the Research and Data Analysis Core (RDAC) will provide consultation and services for study design and analysis, facilitating data access and dedicated IT support; Aim 2. To enroll Scholars from diverse backgrounds, and provide them with the research, engagement, and leadership skills necessary to pursue successful careers as LHS scientists. The AC and REC will coordinate recruitment, training, and retention activities. Performance and outcomes will be captured in the Program Evaluation; Aim 3. To enable embedded research that advances and continuously improves healthcare quality, equity, and patient-centered outcomes, and to disseminate results locally and nationally. RDAC will implement processes to systematically ensure patient-centered outcomes are measured, captured, and aggregated across embedded research projects. Expected Outcomes: At end of 5 years, the UCSF LHS E-STaR Center will have trained >60 Scholars across at least 6 unique health systems, and provided consultative LHS support to >100 additional scientists. Their research projects will increase the quality and health outcomes for patients of all backgrounds, with results disseminated through local health systems, publications in the medical literature, and presentations at national meetings.