Impact of a health services innovation university program in a major public hospital and health service: a mixed methods evaluation

Abstract

Background While health services and their clinicians might seek to be innovative, finite budgets, increased demands on health services, and ineffective implementation strategies create challenges to sustaining innovation. These challenges can be addressed by building staff capacity to design cost-effective, evidence-based innovations, and selecting appropriate implementation strategies. A bespoke university award qualification and associated program of activities was developed to build the capacity of staff at Australia’s largest health service to implement and evaluate evidence-based practice (EBP): a Graduate Certificate in Health Science majoring in Health Services Innovation. The aim of this study was to establish the health service’s pre-program capacity to implement EBP and to identify preliminary changes in capacity that have occurred as a result of the Health Services Innovation program. Methods A mixed methods design underpinned by the Consolidated Framework for Implementation Research informed the research design, data collection, and analysis. Data about EBP implementation capacity aligned to the framework constructs were sought through qualitative interviews of university and health service executives, focus groups with students, and a quantitative survey of managers and students. The outcomes measured were knowledge of, attitudes towards, and use of EBP within the health service, as well as changes to practice which students identified had resulted from their participation in the program. Results The Health Services Innovation program has contributed to short-term changes in health service capacity to implement EBP. Participating students have not only increased their individual skills and knowledge, but also changed their EPB culture and practice which has ignited and sustained health service innovations and improvements in the first 18 months of the program. Capacity changes observed across wider sections of the organization include an increase in connections and networks, use of a shared language, and use of robust implementation science methods such as stakeholder analyses. Conclusion This is a unique study that assessed data from all stakeholders: university and health service executives, students, and their managers. By assembling multiple perspectives, we identified that developing the social capital of the organization through delivering a full suite of capacity-building initiatives was critical to the preliminary success of the program.

Models and approaches for building knowledge translation capacity and capability in health services: a scoping review

“…More than half of the programmes were described as using a combination of two or more strategies to build knowledge translation capability [ 6 , 11 , 26 , 27 , 30 , 32 , 33 , 36 – 42 , 46 , 47 , 49 , 52 , 55 – 58 ]. Programmes commonly involved targeted training and education for individuals and teams, delivered predominantly in the healthcare workplace, with few delivered in universities [ 31 , 51 , 59 , 60 ], or other settings (e.g. partnership organisations) [ 28 , 47 ].…”

“…Other initiatives included strategic research-practice partnerships, typically between a health service and academic institution [ 11 , 28 , 38 , 49 ], collaboratives (three or more research-interested organisations) [ 11 , 32 , 33 , 40 – 42 , 46 – 48 , 52 , 56 , 58 ], co-designed knowledge translation capacity-building programmes with health professionals or health programme managers [ 11 , 26 , 27 , 36 , 37 , 47 , 57 , 58 ], and dedicated funding for knowledge translation initiatives [ 33 , 39 ]. The programmes reporting isolated strategies utilised education [ 31 , 34 , 43 , 44 , 51 , 53 , 54 , 59 , 60 ], a support role [ 29 , 35 , 45 , 50 ] and research-practice partnerships [ 28 ].…”

“…Many programmes purposefully made time in the curriculum for group work to foster connections with peers and promote social learning [ 6 , 11 , 26 – 28 , 33 , 34 , 36 – 38 , 40 – 42 , 44 , 46 – 60 ]. Further, experiential learning or “learning by doing” whereby participants applied their new knowledge and skills to a real-world project or knowledge translation initiative [ 61 ] was commonly described as a core component of capability building programmes [ 6 , 26 – 28 , 30 , 31 , 34 , 36 – 40 , 43 , 44 , 46 , 47 , 49 – 51 , 53 – 57 , 59 ]. Passive learning through didactic teaching (e.g.…”

“…Passive learning through didactic teaching (e.g. via lectures, seminars or webinars) was a common feature of education strategies [ 6 , 31 , 39 , 43 , 44 , 46 , 49 , 51 – 56 , 58 – 60 ]. Many programmes also incorporated individual or team-based mentoring with a more experienced knowledge translation specialist or researcher [ 26 – 30 , 32 , 35 – 37 , 39 – 42 , 44 – 46 , 54 , 55 ].…”

Clinical research nursing pathways: The development and evaluation of a nursing research internship program using the RE-AIM framework

“…Data shows that access to support programs create lifelong researchers leading clinically relevant research ( Mickan and Coates, 2022 ; Carthon et al., 2017 ; Middlebrooks et al., 2016 ; Black et al., 2019 ; Eckert et al., 2022 ), who attract ongoing research funding and respected research outputs ( Middlebrooks et al., 2016 ; Eckert et al., 2022 ). Similar programs have contributed to changes in organisational culture and practice, increased connections and networks, and engagement in robust research methods ( Martin et al., 2022 ; Paterson and Strickland, 2023 ).…”