Networked innovation in the health sector: comparative qualitative study of the role of Collaborations for Leadership in Applied Health Research and Care in translating research into practice

Abstract

BackgroundCollaborations for Leadership in Applied Health Research and Care (CLAHRCs) were an initiative of the National Institute for Health Research in response to a new research and development strategy in the NHS: ‘Best Research for Best Health’. They were designed to address the ‘second gap in translation’ identified by the Cooksey review; namely, the need to improve health care in the UK by translating clinical research into practice more effectively. Nine CLAHRCs, each encompassing a university in partnership with local NHS bodies, were funded over the period 2008–13.AimsThe aim of this report is to provide an independent and theory-based evaluation of CLAHRCs as a new form of networked innovation in the health sector. This evaluation is based on an intensive research study involving three CLAHRCs in the UK and three international organisations (one in the USA and two in Canada). This study was carried out over two overlapping time phases so as to capture changes in the CLAHRCs over time. Networked innovation in the health sector is conceptualised as involving the translation of knowledge via informal social networks.MethodsA mix of research methods was used to help ensure the validity and generalisability of the study. These methods addressed the development of each CLAHRC over time, over multiple levels of analysis, and with particular reference to the translation of knowledge across the groups involved, and the quality of the informal underpinning network ties that supported such translation. Research methods, therefore, included a qualitative enquiry based on case studies and case analysis, cognitive mapping methods, and social network analysis.FindingsThrough our study, we found that each one of our samples of CLAHRCs appropriated the CLAHRC idea in a particular way, depending on their different interpretations or ‘visions’ of the CLAHRC’s role in knowledge translation (KT), and different operating models of how such visions could be achieved. These helped to shape the development of social networks (centralised vs. decentralised) and each CLAHRC’s approach to KT activity (‘bridging’ vs. ‘blurring’ the boundaries between professional groups). Through a comparative analysis, we develop an analytical model of the resultant capabilities which each case, including our international sites, developed for undertaking innovation, encompassing a combination of both ‘integrative capability’ (the ability to move back and forth between scientific evidence and practical application) and ‘relational capability’ (the ability of groups and organisations to work together). This extends previous models of KT by highlighting the effects of leadership and management, and the emergence of social network structures. We further highlight the implications of this analysis for policy and practice by discussing how network structures and boundary-spanning roles and activities can be tailored to different KT objectives.ConclusionsDifferent interpretations and enactments of the CLAHRC mission ultimately led to differing capabilities for KT among our studied initiatives. Further research could usefully explore how these different capabilities are produced, and how they may be more or less appropriate for particular national health-care settings, with a view to improving the design blueprint for future KT initiatives.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Building capacity to use and undertake research in health organisations: a survey of training needs and priorities among staff

“…15 Funded by the National Institute for Health Research (NIHR), the first round of five CLAHRCs was established in 2009. Evaluation demonstrated that the first wave had differing capabilities with respect to reducing the ‘know-do’ gap, partly because of differing interpretations and enactments of their mission 16. However, success in this area will inevitably require a long-term, sustained focus on relationship building, resource allocation and, in some cases, culture change 17.…”

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

“…This study is timely because of the increasing use of KIT roles by AHSNs and partnerships, 60 and the relative lack of evidence for their effectiveness, 94 although the literature on knowledge brokers has grown significantly in the last few years with the publication of evaluations of CLAHRCs 39,42,44,60,245,250,251 and other initiatives. 90 The complexity of the role and the environment in which it is played out justifies the need for more research on knowledge brokers.…”

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“…Such linkages can also support knowledge mobilisation and coproduction if conducted in a meaningful manner. 7 CLAHRCs have demonstrated an increase in social networks, partnerships and 'relational capability' enabled by leadership, 15 and our experience is that these networks support successful funding applications.…”

“…It can also be made possible through 'matched funding' arrangements where all types of collaborating organizations offer resource such as time, facilities or fee waivers into the collaboration free of charge to the research partnership. The relatively long-term funding period of the CLAHRC (5 years for each term) has provided an on-going academic and practice infrastructure 15 and opportunities for iterative learning embedded in special interest groups, steering and advisory groups 2 and CoPs.…”