Health research, development and innovation in England from 1988 to 2013: from research production to knowledge mobilization

Walshe, Kieran; Davies, H. T. O.

doi:10.1177/1355819613502011

Cited by 54 publications

(60 citation statements)

References 25 publications

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“…It also leaves somewhat sidelined any analysis of the research infrastructure and its fitness for purpose. 198 In addition, broader political concerns and the role of the media are, similarly, not fully visible in the archetypes.…”

Section: Discussionmentioning

confidence: 99%

Mobilising knowledge to improve UK health care: learning from other countries and other sectors – a multimethod mapping study

Davies

Powell

Nutley

2015

Health Services and Delivery Research

Self Cite

114

176

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BackgroundThe past two decades have seen rich conceptual development and a wide variety of practical initiatives around research use or ‘knowledge mobilisation’, but so far there has been little systematic effort to map, conceptualise and learn from these initiatives, or to investigate the degree to which they are underpinned by contemporary thinking as set out in the literature. This gap is particularly apparent when looking at knowledge mobilisation at the ‘macro’ level, that is the strategies and activities of major research funders, major research producers and key research ‘intermediaries’.Aims and objectivesThe study had three key objectives with associated research questions: to map the knowledge mobilisation landscape in health care (in the UK and internationally) and in social care and education within the UK; to understand the models, theories and frameworks that underpin the approaches to knowledge mobilisation; and to learn from the success or otherwise of the strategies and approaches in use.MethodsThe study was multimethod and multiphased, with considerable interactivity between the different strands. Data were collected through a review of 71 published reviews on knowledge mobilisation; website review of the knowledge mobilisation activities of 186 agencies; in-depth interviews (n = 52) with key individuals in agencies; a web survey (response rate 57%;n = 106); and two stakeholder workshops (at months 6 and 16).FindingsWe identified a wide range of models, theories and frameworks used to describe knowledge mobilisation and created a conceptual map that highlights six domains of thinking and debate in the literature. The interview and survey data showed three broad, overlapping roles undertaken by agencies: developing and sharing research-based products; emphasising brokering; and focusing on implementation. The knowledge mobilisation approaches in use had been shaped by many factors but there was only limited use of the models, theories and frameworks from the literature. Participants saw formal evaluation of knowledge mobilisation activities as important but highly challenging. Rich formative experience was described but formal evaluation was relatively rare. Few agencies involved service users or members of the public in knowledge mobilisation activities. Working inductively from the study data we derived eight key archetypes or ‘bundles of knowledge mobilisation activities’ that could be used by agencies to explore their knowledge mobilisation activities, future strategies and stakeholder perspectives.ConclusionsKnowledge mobilisation could be enhanced by providing support to enable cross-sector and interagency learning, reflection on the conceptual basis of approaches and increased evaluation of knowledge mobilisation activities. Further research is needed to evaluate approaches to assessing research use and impact, on systems approaches to knowledge mobilisation, on sustaining and scaling-up approaches, and on applying a wider range of literatures to knowledge mobilisation. Further research would also be useful on the knowledge mobilisation archetypes and how they can work in complementary ways.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Discussionmentioning

confidence: 99%

Mobilising knowledge to improve UK health care: learning from other countries and other sectors – a multimethod mapping study

Davies

Powell

Nutley

2015

Health Services and Delivery Research

Self Cite

114

176

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“…22 It has been argued that, although there has been a huge investment in developing an infrastructure to fund and deliver high-quality health-related research in the UK, this has been achieved, in part, by splitting research production from the delivery of health-care services. 23 The impact of this has been an exacerbation of the boundary between research and practice, and a call for a change of paradigm.…”

Section: Reconceptualising the Challengementioning

confidence: 99%

Collective action for knowledge mobilisation: a realist evaluation of the Collaborations for Leadership in Applied Health Research and Care

Rycroft‐Malone

Burton

Wilkinson

et al. 2015

Health Serv Deliv Res

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BackgroundThe establishment of the Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) was the culmination of a number of policy initiatives to bridge the gap between evidence and practice. CLAHRCs were created and funded to facilitate development of partnerships and connect the worlds of academia and practice in an effort to improve patient outcomes through the conduct and application of applied health research.ObjectivesOur starting point was to test the theory that bringing higher education institutions and health-care organisations closer together catalyses knowledge mobilisation. The overall purpose was to develop explanatory theory regarding implementation through CLAHRCs and answer the question ‘what works, for whom, why and in what circumstances?’. The study objectives focused on identifying and tracking implementation mechanisms and processes over time; determining what influences whether or not and how research is used in CLAHRCs; investigating the role played by boundary objects in the success or failure of implementation; and determining whether or not and how CLAHRCs develop and sustain interactions and communities of practice.MethodsThis study was a longitudinal realist evaluation using multiple qualitative case studies, incorporating stakeholder engagement and formative feedback. Three CLAHRCs were studied in depth over four rounds of data collection through a process of hypothesis generation, refining, testing and programme theory specification. Data collection included interviews, observation, documents, feedback sessions and an interpretive forum.FindingsKnowledge mobilisation in CLAHRCs was a function of a number of interconnected issues that provided more or less conducive conditions for collective action. The potential of CLAHRCs to close the metaphorical ‘know–do’ gap was dependent on historical regional relationships, their approach to engaging different communities, their architectures, what priorities were set and how, and providing additional resources for implementation, including investment in roles and activities to bridge and broker boundaries. Additionally, we observed a balance towards conducting research rather than implementing it. Key mechanisms of interpretations of collaborative action, opportunities for connectivity, facilitation, motivation, review and reflection, and unlocking barriers/releasing potential were important to the processes and outcomes of CLAHRCs. These mechanisms operated in different contexts including stakeholders’ positioning, or ‘where they were coming from’, governance arrangements, availability of resources, competing drivers, receptiveness to learning and evaluation, and alignment of structures, positions and resources. Preceding conditions influenced the course and journey of the CLAHRCs in a path-dependent way. We observed them evolving over time and their development led to the accumulation of different types of impacts, from those that were conceptual to, later in their life cycle, those that were more direct.ConclusionsMost studies of implementation focus on researching one-off projects, so a strength of this study was in researching a systems approach to knowledge mobilisation over time. Although CLAHRC-like approaches show promise, realising their full potential will require a longer and more sustained focus on relationship building, resource allocation and, in some cases, culture change. This reinforces the point that research implementation within a CLAHRC model is a long-term investment and one that is set within a life cycle of organisational collaboration.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…21 Some argue that research output is dominated by a biomedical focus on drugs, tests and devices. Instead, Walshe and Davies 22 suggest that the current 'predominant concerns' relate to 'pathway and process redesign, safety and quality; organizational issues like coordination, integration and networking; workforce issues like training and skill mix; and patient issues like experience, education and empowerment'. Addressing these concerns may require alternative models of knowledge creation in order to close the knowledge-practice gap.…”

Section: Knowledge Mobilisationmentioning

confidence: 99%

“…28 Like their predecessors, Academic Health Science Collaborations (AHSCs), the central aim of these collaborations is 'knowledge mobilisation, rather than research production'. 22 As designated in 'Innovation Health and Wealth' 27 and the 'Strategy for UK Life Sciences', 29 AHSNs are a systematic delivery mechanism for the adoption and spread of innovation at pace and scale through the NHS. The networks are designed to foster collaborations between academia, industry and health service, and shared aims include diffusing innovation, putting research into practice, and promoting economic growth.…”

Section: Academic Health Science Collaborations Partnerships and Netmentioning

confidence: 99%

Getting the most out of knowledge and innovation transfer agents in health care: a qualitative study

Bullock

Barnes

Morris³

et al. 2016

Health Serv Deliv Res

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BackgroundKnowledge and innovation transfer (KIT) is recognised internationally as a complex, dynamic process that is difficult to embed in organisations. There is growing use of health service–academic–industry collaborations in the UK, with knowledge brokers linking producers with the users of knowledge and innovation.AimFocusing on KIT ‘agent’ roles within Academic Health Science Networks in England and Partnerships in Wales, we show how individual dispositions, processes and content contribute to desired outcomes.MethodsWe studied the KIT intentions of all Academic Health Science Networks in England, and the South East Wales Academic Health Science Partnership. Using a qualitative case study design, we studied the work of 13 KIT agents purposively sampled from five networks, by collecting data from observation of meetings, documentation, KIT agent audio-diaries, and semistructured interviews with KIT agents, their line managers and those they supported (‘Links’). We also used a consensus method in a meeting of experts (nominal group technique) to discuss the measurement of outcomes of KIT agent activity.FindingsThe case study KIT agents were predominantly from a clinical background with differing levels of experience and expertise, with the shared aim of improving services and patient care. Although outside of recognised career structures, the flexibility afforded to KIT agents to define their role was an enabler of success. Other helpful factors included (1) time and resources to devote to KIT activity; (2) line manager support and a team to assist in the work; and (3) access and the means to use data for improvement projects. The organisational and political context could be challenging. KIT agents not only tackled local barriers such as siloed working, but also navigated shifting regional and national policies. Board-level support for knowledge mobilisation together with a culture of reflection (listening to front-line staff), openness to challenges and receptivity to research all enabled KIT agents to achieve desired outcomes. Nominal group findings underscored the importance of relating measures to specific intended outcomes. However, the case studies highlighted that few measures were employed by KIT agents and their managers. Using social marketing theory helped to show linkages between processes, outcomes and impact, and drew attention to how KIT agents developed insight into their clients’ needs and tailored work accordingly.LimitationsLevel of KIT agent participation varied; line managers and Links were interviewed only once; and outcomes were self-reported.ConclusionsSocial marketing theory provided a framework for analysing KIT agent activity. The preparatory work KIT agents do in listening, understanding local context and building relationships enabled them to develop ‘insight’ and adapt their ‘offer’ to clients to achieve desired outcomes.Future workThe complexity of the role and the environment in which it is played out justifies more research on KIT agents. Suggestions include (1) longitudinal study of career pathways; (2) how roles are negotiated within teams and how competing priorities are managed; (3) how success is measured; (4) the place of improvement methodologies within KIT work; (5) the application of social marketing theory to comparative study of similar roles; and (6) patients as KIT agents.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Health research, development and innovation in England from 1988 to 2013: from research production to knowledge mobilization

Cited by 54 publications

References 25 publications

Mobilising knowledge to improve UK health care: learning from other countries and other sectors – a multimethod mapping study

Mobilising knowledge to improve UK health care: learning from other countries and other sectors – a multimethod mapping study

Collective action for knowledge mobilisation: a realist evaluation of the Collaborations for Leadership in Applied Health Research and Care

Getting the most out of knowledge and innovation transfer agents in health care: a qualitative study

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