CLAHRCs in practice: combined knowledge transfer and exchange strategies,cultural change,and experimentation

Abstract

Objectives

The nine NIHR CLAHRCs are collaborations between universities and local NHS organizations that seek to improve patient outcomes through the conduct and application of applied health research. The theoretical and practical context within which the CLAHRCs were set up was characterized by a considerable degree of uncertainty, and the CLAHRCs were established as a natural experiment.

Methods

We adopted a formative and emergent evaluation approach. Drawing on in-depth, multi-method case studies of two CLAHRCs we explored how they pursued their remit by supporting efforts to increase the relevance and use of health research, and building relationships.

Results

Both CLAHRCs: strengthened local networks and relationships; built capacity in their local academic and NHS communities to undertake and use research that meets the needs of the service; developed research and implementation methodologies; and added to understanding of the complex relation between research and implementation. There was evidence of impact of CLAHRC projects on health and social care services. Informed by the literature on implementing collaborative research initiatives, knowledge transfer and exchange and cultural change, some key lessons can be drawn.

Conclusion

The CLAHRCs pursued a strategy that can be categorized as one of flexible comprehensiveness; i.e. their programmes have been flexible and responsive and they have used a range of approaches that seek to match the diverse aspects of the complex issues they face. Key features include their work on combining a range of knowledge transfer and exchange strategies, their efforts to promote cultural change, and the freedom to experiment, learn and adapt. Although the CLAHRCs do not, by themselves, have the remit or resources to bring about wholesale service improvement in health care, they do have features that would allow them to play a key role in some of the wider initiatives that encourage innovation.

Keywords

R&D evaluation health care research policy

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References

Denis

J-L

Lomas

. Convergent evolution: the academic and policy roots of collaborative research. J Health Serv Res Policy 2003; 8(Suppl. 2): 1–6.

Lomas

. Using ‘Linkage and Exchange’ to move research into policy at a Canadian Foundation. Health Aff 2000; 19: 236–240.

Brazil

Ozer

Cloutier

. From theory to practice: improving the impact of health services research. BMC Health Serv Res 2005; 5: 1–1.

Kogan

Henkel

. Government and research: the Rothschild experiment in a government department, London: Heinemann, 1983.

Denis

Lehoux

Hivon

. Creating a new articulation between research and practice through policy? The views and experiences of researchers and practitioners. J Health Serv Res Policy 2003; 8(Suppl 2): 44–50.

Stetler

Ritchie

Rycroft-Malone

. Improving quality of care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change. Implement Sci 2007; 2: 3–3.

Kogan

Henkel

Hanney

. Government and research: thirty years of evolution, Dordrecht: Springer, 2006.

Soper

Buxton

Hanney

. Developing the protocol for the evaluation of The Health Foundation's ‘Engaging with Quality' initiative: an emergent approach. Implement Sci 2008; 3: 46–46.

Ling

Soper

Marjanovic

. Delivering the aims of the CLAHRCs: evaluating CLAHRCs’ strategies and contributions. Interim report: phase 1, Cambridge: RAND Europe, 2011.

10.

Graham

Tetroe

. Learning from the U.S. Department of Veterans Affairs Quality Enhancement Research Initiative: QUERI Series. Implement Sci 2009; 4: 13–13.

11.

Bowen

Martens

. The need to know team. Demystifying knowledge translation: learning from the community. J Health Serv Res Policy 2005; 10: 203–211.

12.

NIHR Health Services and Delivery Research Programme. HS&DR project portfolio – CLAHRCs, http://www.netscc.ac.uk/hsdr/projlisting.php?srtid=31 (2013, accessed April 2013).

13.

May

Harrison

Finch

. Understanding the normalization of telemedicine services through qualitative evaluation. J Am Med Inform Assoc 2003; 10: 596–604.

14.

Hanney

Kuruvilla

Soper

. Who needs what from a national health research system: lessons from reforms to the English Health Department’s R&D system. Health Res Policy Syst 2010; 8: 11–11.

15.

NIHR Cambridge and Peterborough CLAHRC. Collaborators, http://www.clahrc-cp.nihr.ac.uk/partner-organisations (2013, accessed April 2013).

16.

East of England Evidence Adoption Centre. Home, http://www.eac.cpft.nhs.uk/ (2013, accessed October 2012).

17.

NIHR Cambridge and Peterborough CLAHRC. With the people, for the people: applying mental health research, http://www.cam.ac.uk/research/news/with-the-people-for-the-people-applying-mental-health-research (2013, accessed April 2013).

18.

NIHR Cambridge and Peterborough CLAHRC. Key performance indicators, http://www.clahrc-cp.nihr.ac.uk/about-us/clahrc-board/key-performance-indicators (2013, accessed April 2013).

19.

NIHR Cambridge and Peterborough CLAHRC. Improving access to psychological therapies. Briefing paper 2. http://www.clahrc-cp.nihr.ac.uk/wp-content/uploads/2012/11/CLAHRC-IAPT-briefing_CH-Nov19.pdf (2012, accessed April 2013).

20.

Hammond

Croudace

Radhakrishnan

. Comparative effectiveness of cognitive therapies delivered face-to-face or over the telephone: an observational study using propensity methods. PLoS ONE 2012; 7: e42916–e42916.

21.

Department of Health. Report of the high level group on clinical effectiveness, London: Department of Health, 2007.

22.

The NIHR CLAHRC for the South West Peninsula. The NIHR CLAHRC for the South West Peninsula. Proposal, http://clahrc-peninsula.nihr.ac.uk/includes/site/files/files/PenCLARHC%20executive%20summary%20version%20for%20directors.pdf (2008, accessed April 2013).

23.

Folk-us. Folk.us Homepage, http://www.folkus.org.uk/ (2013, accessed March 2013).

24.

The NIHR CLAHRC for the South West Peninsula. PenCHORD, http://clahrc-peninsula.nihr.ac.uk/penchord.php (2013, accessed March 2013).

25.

Goodwin

Jones-Hughes

Thompson-Coon

. Implementing the evidence for preventing falls among community-dwelling older people: a systematic review. J Safety Res 2011; 42: 443–451.

26.

The NIHR CLAHRC for the South West Peninsula. CLAHRC BITE: Bringing tranexamic acid (TXA) into practice safely, quickly and efficiently, http://clahrc-peninsula.nihr.ac.uk/includes/site/files/files/Bites/BITE%2001%20-%20Tranexamic%20Acid.pdf (2012, accessed March 2013).

27.

Peninsula Health Technology Commissioning Group. The annual report of the Peninsula Health Technology Commissioning Group 2011–2012, http://www.devonpct.nhs.uk/Library/SWPHTCG/PHTCG_Annual%20_Report_2011_12_final.pdf (2012, accessed April 2013).

28.

The NIHR CLAHRC for the South West Peninsula. NICE Disinvestment project protocol, http://clahrc-peninsula.nihr.ac.uk/includes/site/files/files/NICE%20Disinvestment%20project%20Protocol.pdf (2012, accessed April 2013).

29.

National Institute for Health Research. Collaborations for leadership in Applied Health Research and Care. Progress Report for Second Award Year. The NIHR CLAHRC for the South West Peninsula (Peninsula CLAHRC). 2011 [Unpublished].

30.

Soper B, Hinrichs S, Drabble S, et al. Delivering the aims of the CLAHRCs: evaluating CLAHRCs' strategies and contributions. Health Ser and Deliv Res. Epub ahead of print 2013.

31.

Francis

Perlin

. Improving performance through knowledge translation in the Veterans Health Administration. J Contin Educ Health Prof 2006; 26: 63–71.

32.

Oliver

. The Veterans Health Administration: an American success story? Milbank Q 2007; 85: 5–35.

33.

Best

Holmes

. Systems thinking, knowledge and action: towards better models and methods. Evidence Policy 2010; 6: 145–159.

34.

Lavis

Ross

McLeod

. Measuring the impact of health research. J Health Serv Res Policy 2003; 8: 165–170.

35.

Mitton

Adair

McKenzie

. Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q 2007; 85: 729–768.

36.

Bartunek

Trullen

Bonet

. Sharing and expanding academic and practitioner knowledge in health care. J Health Serv Res Policy 2003; 8(Suppl): 62–68.

37.

Lomas

. The in-between world of knowledge brokering. BMJ 2007; 334: 129–132.

38.

Cohen

Levinthal

. Absorptive capacity: a new perspective on learning and innovation. Adm Sci Q 1990; 35: 128–128.

39.

Callon

Bowker

. Is science a public good? Fifth Mullins Lecture, Virginia Polytechnic Institute, 23 March 1993. Sci Technol Human Values 1994; 19: 395–424.

40.

Mannion R, Davies H, Harrison S, et al. Changing management cultures and organisational performance in the NHS, http://www.netscc.ac.uk/hsdr/files/project/SDO_FR_08-1501-94_V02.pdf (2010, accessed June 2013).

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