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Baxter H, Bearne L, Stone T, Thomas C, Denholm R, Redwood S, Purdy S, Huntley AL. The effectiveness of knowledge-sharing techniques and approaches in research funded by the National Institute for Health and Care Research (NIHR): a systematic review. Health Res Policy Syst 2024; 22:41. [PMID: 38566127 PMCID: PMC10988883 DOI: 10.1186/s12961-024-01127-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The National Institute of Health and Care Research (NIHR), funds, enables and delivers world-leading health and social care research to improve people's health and wellbeing. To achieve this aim, effective knowledge sharing (two-way knowledge sharing between researchers and stakeholders to create new knowledge and enable change in policy and practice) is needed. To date, it is not known which knowledge sharing techniques and approaches are used or how effective these are in creating new knowledge that can lead to changes in policy and practice in NIHR funded studies. METHODS In this restricted systematic review, electronic databases [MEDLINE, The Health Management Information Consortium (including the Department of Health's Library and Information Services and King's Fund Information and Library Services)] were searched for published NIHR funded studies that described knowledge sharing between researchers and other stakeholders. One researcher performed title and abstract, full paper screening and quality assessment (Critical Appraisal Skills Programme qualitative checklist) with a 20% sample independently screened by a second reviewer. A narrative synthesis was adopted. RESULTS In total 9897 records were identified. After screening, 17 studies were included. Five explicit forms of knowledge sharing studies were identified: embedded models, knowledge brokering, stakeholder engagement and involvement of non-researchers in the research or service design process and organisational collaborative partnerships between universities and healthcare organisations. Collectively, the techniques and approaches included five types of stakeholders and worked with them at all stages of the research cycle, except the stage of formation of the research design and preparation of funding application. Seven studies (using four of the approaches) gave examples of new knowledge creation, but only one study (using an embedded model approach) gave an example of a resulting change in practice. The use of a theory, model or framework to explain the knowledge sharing process was identified in six studies. CONCLUSIONS Five knowledge sharing techniques and approaches were reported in the included NIHR funded studies, and seven studies identified the creation of new knowledge. However, there was little investigation of the effectiveness of these approaches in influencing change in practice or policy.
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Affiliation(s)
- Helen Baxter
- Evidence and Dissemination, National Institute for Health and Care Research, Twickenham, United Kingdom.
- National Institute for Health and Care Research, Applied Research Collaboration West (NIHR ARC WEST), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom.
| | - Lindsay Bearne
- Evidence and Dissemination, National Institute for Health and Care Research, Twickenham, United Kingdom
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Tracey Stone
- National Institute for Health and Care Research, Applied Research Collaboration West (NIHR ARC WEST), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Clare Thomas
- National Institute for Health and Care Research, Applied Research Collaboration West (NIHR ARC WEST), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- National Institute for Health and Care Research, Health Protection Research Unit in Behaviour Science and Evaluation (NIHR HPRU BSE), University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Rachel Denholm
- National Institute for Health and Care Research, Bristol Biomedical Research Centre (NIHR BRC), University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sabi Redwood
- National Institute for Health and Care Research, Applied Research Collaboration West (NIHR ARC WEST), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sarah Purdy
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alyson Louise Huntley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Sharp CA, Bresnen M, Austin L, McCarthy J, Dixon WG, Sanders C. Implementing disruptive technological change in UK healthcare: exploring development of a smart phone app for remote patient monitoring as a boundary object using qualitative methods. J Health Organ Manag 2020; ahead-of-print. [PMID: 33277889 DOI: 10.1108/jhom-07-2020-0295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Developing technological innovations in healthcare is made complex and difficult due to effects upon the practices of professional, managerial and other stakeholders. Drawing upon the concept of boundary object, this paper explores the challenges of achieving effective collaboration in the development and use of a novel healthcare innovation in the English healthcare system. DESIGN/METHODOLOGY/APPROACH A case study is presented of the development and implementation of a smart phone application (app) for use by rheumatoid arthritis patients. Over a two-year period (2015-2017), qualitative data from recorded clinical consultations (n = 17), semi-structured interviews (n = 63) and two focus groups (n = 13) were obtained from participants involved in the app's development and use (clinicians, patients, researchers, practitioners, IT specialists and managers). FINDINGS The case focuses on the use of the app and its outputs as a system of inter-connected boundary objects. The analysis highlights the challenges overcome in the innovation's development and how knowledge sharing between patients and clinicians was enhanced, altering the nature of the clinical consultation. It also shows how conditions surrounding the innovation both enabled its development and inhibited its wider scale-up. ORIGINALITY/VALUE By recognizing that technological artefacts can simultaneously enable and inhibit collaboration, this paper highlights the need to overcome tensions between the transformative capability of such healthcare innovations and the inhibiting effects simultaneously created on change at a wider system level.
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Affiliation(s)
- Charlotte A Sharp
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, Manchester, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, The University of Manchester, Manchester, UK
- National Institute for Health Research School for Primary Care Research, The University of Manchester, Manchester, UK
- Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Mike Bresnen
- Faculty of Business and Law, Manchester Metropolitan University, Manchester, UK
| | - Lynn Austin
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, Manchester, UK
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
| | - Jillian McCarthy
- Alliance Manchester Business School, The University of Manchester, Manchester, UK
| | - William G Dixon
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, Manchester, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, The University of Manchester, Manchester, UK
- Rheumatology Department, Salford Royal NHS Foundation Trust, Manchester, UK
| | - Caroline Sanders
- National Institute for Health Research School for Primary Care Research, The University of Manchester, Manchester, UK
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
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Barber S, French C, Matthews R, Lovett D, Rollinson T, Husson F, Turley M, Reed J. The role of patients and carers in diffusing a health-care innovation: A case study of "My Medication Passport". Health Expect 2019; 22:676-687. [PMID: 31131523 PMCID: PMC6737838 DOI: 10.1111/hex.12893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/12/2019] [Accepted: 03/24/2019] [Indexed: 11/30/2022] Open
Abstract
Background Patients are increasingly recognized as playing important roles in improving health services. Little is known about the mechanisms by which patients develop and diffuse local innovations in a complex health‐care system. Objective To ascertain how diffusion of an innovation, My Medication Passport, occurred and roles played by patients in it. Design Case study: quantitative mapping of innovation's diffusion and analysis of the routes and occupations of those through whom the innovation spread; documentary analysis; reflective assessment of patient's roles. Setting and participants NHS Trusts, third sector organizations, patients and health‐care professionals. Interventions studied Co‐produced action to raise awareness and influence use of the innovation; order database which enabled ease of access to the innovation. Main outcome measures Geographical spread of innovation; occupations of individuals; types of organizations using the innovation. Results The innovation spread from initial development and use in Northwest London across the UK and beyond. Key roles played by patients were as follows: co‐producer; advocate; relationship builder; relationship broker; planner; presenter; awareness raiser; trainer; networker. Patients identified and introduced potential audiences and users to MMP, using social, organizational, sectoral, lay and professional networks to do so. They organized a range of awareness‐raising and communication activities, monitored feedback, evaluated the impact and responded to new interest. Discussion and conclusions The roles of patients in diffusing innovations are under‐recognized. Collaborative working between patients, carers and health‐care professionals in planning and progressing the use and supporting diffusion of the innovation was important. Principles described in this study are relevant to progressing other patient‐led ideas for innovative changes relating to health service development.
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Affiliation(s)
- Susan Barber
- NIHR Collaboration for Leadership in Applied Health Care and Research (CLAHRC) Northwest London, Chelsea & Westminster Hospital NHS Foundation Trust, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Catherine French
- NIHR Collaboration for Leadership in Applied Health Care and Research (CLAHRC) Northwest London, Chelsea & Westminster Hospital NHS Foundation Trust, Department of Primary Care and Public Health, Imperial College London, London, UK.,Guy's and Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK
| | - Rachel Matthews
- NIHR Collaboration for Leadership in Applied Health Care and Research (CLAHRC) Northwest London, Chelsea & Westminster Hospital NHS Foundation Trust, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Derryn Lovett
- NIHR Collaboration for Leadership in Applied Health Care and Research (CLAHRC) Northwest London, Chelsea & Westminster Hospital NHS Foundation Trust, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Tom Rollinson
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Fran Husson
- NIHR Collaboration for Leadership in Applied Health Care and Research (CLAHRC) Northwest London, Chelsea & Westminster Hospital NHS Foundation Trust, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Margaret Turley
- NIHR Collaboration for Leadership in Applied Health Care and Research (CLAHRC) Northwest London, Chelsea & Westminster Hospital NHS Foundation Trust, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Julie Reed
- NIHR Collaboration for Leadership in Applied Health Care and Research (CLAHRC) Northwest London, Chelsea & Westminster Hospital NHS Foundation Trust, Department of Primary Care and Public Health, Imperial College London, London, UK
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van der Graaf P, Shucksmith J, Rushmer R, Rhodes A, Welford M. Performing collaborative research: a dramaturgical reflection on an institutional knowledge brokering service in the North East of England. Health Res Policy Syst 2019; 17:49. [PMID: 31068186 PMCID: PMC6507129 DOI: 10.1186/s12961-019-0449-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 04/02/2019] [Indexed: 11/30/2022] Open
Abstract
Background To increase the uptake of research evidence in practice, responsive research services have been developed within universities that broker access to academic expertise for practitioners and decision-makers. However, there has been little examination of the process of knowledge brokering within these services. This paper reflects on this process within the AskFuse service, which was launched in June 2013 by Fuse, the Centre for Translational Research in Public Health, in North East England. The paper outlines the challenges and opportunities faced by both academics and health practitioners collaborating through the service. Methods The authors reflected on conversations between the AskFuse Research Manager and policy and practice partners accessing the service between June 2013 and March 2017. Summary notes of these conversations, including emails and documents relating to over 240 enquiries, have been analysed using an auto-ethnographic approach. Findings We identified five challenges to knowledge brokering in an institutional service, namely length of brokerage time required, limits to collaboration, lack of resources, brokering research in a changing system, and multiple types of knowledge. Conclusions To understand and overcome some of the identified challenges, we employ Goffman’s dramaturgical perspective and argue for making better use of the distinction between front and back stages in the knowledge brokering process. We emphasise the importance of back stages for defusing destructive information that could discredit collaborative performances.
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Affiliation(s)
- Peter van der Graaf
- Teesside University, School of Health and Social Care, Constantine Building, Middlesbrough, TS1 3BA, United Kingdom.
| | - Janet Shucksmith
- Teesside University, School of Health and Social Care, Constantine Building, Middlesbrough, TS1 3BA, United Kingdom
| | - Rosemary Rushmer
- Teesside University, School of Health and Social Care, Constantine Building, Middlesbrough, TS1 3BA, United Kingdom
| | - Avril Rhodes
- Teesside University, School of Health and Social Care, Constantine Building, Middlesbrough, TS1 3BA, United Kingdom
| | - Mark Welford
- Teesside University, School of Health and Social Care, Constantine Building, Middlesbrough, TS1 3BA, United Kingdom
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Abstract
Purpose The purpose of this paper is to examine how knowledge exchange between academics and clinicians in Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) is influenced by their social position based on their symbolic and social capitals, that is, their personal professional status and connections to high-status professional peers, knowledge brokers, and unfamiliar professional peers. Design/methodology/approach Using an online survey, the author triangulates the cross-sectional measurement of the effects of academic and clinicians' social position in the initial and later phases of CLAHRCs with the longitudinal measurement of these effects over a two-year period. Findings First, academics and clinicians with a higher personal professional status are more likely to develop joint networks and decision making both in the early and later phases of a CLAHRC. Second, academics and clinicians who are more connected to higher status occupational peers are more likely to develop joint networks in the early phase of a knowledge exchange partnership but are less likely to become engaged in joint networks over time. Third, involvement of knowledge brokers in the networks of academics and clinicians is likely to facilitate their inter-professional networking only in the later partnership phase. Practical implications Academics and clinicians' capitals have a distinctive influence on knowledge exchange in the early and later phases of CLAHRCs and on a change in knowledge exchange over a two-year period. Originality/value Prior research on CLAHRCs has examined how knowledge exchange between academics and clinicians can be encouraged by the creation of shared governance mechanisms. The author advances this research by highlighting the role of their social position in facilitating knowledge exchange.
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Affiliation(s)
- Girts Racko
- Warwick Business School, University of Warwick , Coventry, UK
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Ii SS, Fitzgerald L, Morys-Carter MM, Davie NL, Barker R. Knowledge translation in tri-sectoral collaborations: An exploration of perceptions of academia, industry and healthcare collaborations in innovation adoption. Health Policy 2017; 122:175-183. [PMID: 29191387 DOI: 10.1016/j.healthpol.2017.11.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 01/19/2023]
Abstract
With the aging population and increase in chronic disease conditions, innovation to transform treatment pathways and service delivery will be necessary. The innovation adoption process however, can take 15 years before widespread adoption occurs in most healthcare systems. Current UK government policies to increase the facilitation of innovation adoption are under way. The aim of this study is to explore perceptions of tri-sectoral collaborations in the healthcare sector. The data in the study are drawn from a cross-sectional survey conducted in 2015 of professionals in academia, industry and the healthcare sectors in England, focusing on Diabetes care. Academia and healthcare respondents had the least work experience outside of their sectors compared to the industry respondents. Healthcare and academia respondents rated the industry sector less trustworthy, unethical, having different goals and less understanding of the other sectors. Industry respondents had a more positive perspective towards potential collaborators. The results from the study demonstrate greater potential challenges to tri-sectoral collaborations and the government's knowledge translation policy, due to pre-conceived notions and lack of understanding of other sectors. The purely structural approach of establishing government mandated translational networks may be insufficient without active attempts to improve collaborative relationships. Mechanisms to facilitate trust building and collaboration are proposed.
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Affiliation(s)
- Suzanne Sayuri Ii
- Oxford-UCL Centre for the Advancement of Sustainable Medical Innovation (CASMI), Radcliffe Department of Medicine, University of Oxford, United Kingdom.
| | | | | | - Natasha L Davie
- Oxford-UCL Centre for the Advancement of Sustainable Medical Innovation (CASMI), Radcliffe Department of Medicine, University of Oxford, United Kingdom; Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, United Kingdom.
| | - Richard Barker
- Oxford-UCL Centre for the Advancement of Sustainable Medical Innovation (CASMI), Radcliffe Department of Medicine, University of Oxford, United Kingdom.
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