Scholarship cites health care managers (HCMs) as not using research evidence in their management practice. The purpose of this review was to evaluate the effectiveness of interventions to enhance HCMs use of research evidence in practice.
Methods
We carried out a systematic review and focus groups to validate the review findings. We searched 10 electronic databases for studies reporting on interventions for HCMs to enhance research utilization in their practice. Qualitative studies were analysed using Hoon’s approach to meta-synthesis.
Results
Seven, primarily qualitative, studies of varying quality (reported in 11 articles) met our inclusion criteria. Interventions to enhance research use by HCMs included: informal and formal training, computer-based application, executive-level knowledge translation activities and residency programmes. Studies did not report efficacy of interventions or impacts of increasing managers’ use of research on staff or patient outcomes. Meta-synthesis yielded four contextual factors influencing the perceived effectiveness of interventions to enhance research use by HCMs: organizational culture, competing priorities, time as a resource and capacity building. Included studies differed in how they defined research and demonstrated varying understandings of research among HCMs, limiting the generalizability of work in this field.
Conclusions
Healthcare managers are increasingly called upon to make evidence-based decisions in practice, but the small number of studies and diverse strategies employed hinder our ability to identify any intervention to increase use of evidence as superior. Future studies in this area should clearly articulate the definition of research evidence they base their decisions on.
RousseauD.Is there such a thing as evidence-based management?AMR2006;
31: 256–269.
2.
CascioWF.Evidence-based management and the marketplace for ideas. AMJ2007;
50: 1009–1012.
3.
KovnerARundallT.Evidence-based management reconsidered. Front Health Serv Manage2006;
22: 3–22.
4.
BirkenSDiMartinoLKirkMet al.
Elaborating on theory with middle managers' experience implementing healthcare innovations in practice. Implement Sci2016;
11: 1–5.
5.
BirkenSLeeS-YDWeinerB.Uncovering middle managers’ role in healthcare innovation implementation. Implement Sci2012;
7: 28–39.
6.
GuoRBerkshireSDFultonLVet al.
Use of evidence-based management in healthcare administration decision-making. Leadersh Health Serv2017;
30: 330–342.
7.
VarsiCEkstedtMGammonDet al.
Middle managers' experiences and role in implementing an interactive tailored patient assessment eHealth intervention in clinical practice. Comput Inform Nurs2015;
33: 249–257.
8.
CimiottiJPAikenLHSloaneDMet al.
Nurse staffing, burnout, and health care-associated infection. Am J Infect Control2012;
40: 486–490.
9.
CummingsGGTateKLeeSet al.
Leadership styles and outcome patterns for the nursing workforce and work environment: a systematic review. Int J Nursing Stud2018;
85: 19–60.
10.
AikenLHSloaneDMBruyneelLet al.
Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet2014;
383: 1824–1830.
11.
CummingsGMidodziWWongCet al.
The contribution of hospital nursing leadership styles to 30-day patient mortality. Nurs Res2010;
59: 331–339.
12.
VerschuerenMKipsJEuwemaM.A review on leadership of head nurses and patient safety and quality of care. Adv Health Care Manage2013;
14: 3–34.
13.
WongCCummingsGDucharmeL.The relationship between nursing leadership and patient outcomes: a systematic review update. J Nurs Manage2013;
21: 709–724.
14.
Foundation CHSR. Evidence-based decision-making.
Ontario:
Canadian Health Services Foundation, 2000.
15.
LavisJNHuwTDaviesRet al.
Working within and beyond the Cochrane Collaboration to make systematic reviews more useful to healthcare managers and policy makers. Healthcare Policy/Politiques De Santé2006;
1: 21–33.
16.
LavisJNRobertsonDWoodsideJet al.
How can research organizations more effectively transfer research knowledge to decision makers?Millbank Q2003;
81: 221–248.
17.
FoxD.Evidence of evidence-based health policy: the politics of systematic reviews in coverage decision. Health Aff2005;
24: 114–122.
18.
PfefferJSuttonRI.Hard facts, dangerous half-truths, and total nonsense.
Boston:
Harvard Business Review, 2006.
19.
ChampionWLeachA.Variables related to research utilization in nursing: an empirical investigation. J Adv Nurs1989;
14: 705–710.
20.
WalsheKRundallTG.Evidence-based management: from theory to practice in health care. Milbank Q2001;
79: 429–457.
21.
MoherDLiberatiATetzlaffJet al.
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med2009;
6: e1000097.
22.
AvokaJNaabFOfeiaA.Leadership styles in nursing management: implications for staff outcomes. JHSCI2016;
6: 23–36.
23.
EstabrooksCRutakumwaWO'LearyKAet al.
Sources of practice knowledge among nurses. Qual Health Res2005;
15: 460–476.
24.
EstabrooksCWallinLMilnerM.Measuring knowledge utilization in health care. Int J Policy Anal Eval2003;
1: 3–36.
25.
MoldJWPetersonKA.Primary care practice-based research networks: working at the interface between research and quality improvement. Ann Fam Med2005;
6: S12–S20.
LettsLWilkinsSLawMet al. Critical review form – qualitative studies (Version 2.0).
Occupational Therapy Evidence-Based Practice Research Group, 2007.
28.
CummingsGLeeHMacgregorTet al.
Factors contributing to nursing leadership: a systematic review. J Health Serv Res Policy2008;
13: 240–248.
29.
HoonC.Meta-synthesis of qualitative case studies: an approach to theory building. Organiz Res Meth2013;
16: 522–556.
30.
MilesMBHubermanAM.Qualitative data analysis: an expanded sourcebook. 2nd ed.
Thousand Oaks, CA:
Sage, 1994.
31.
HainesTGrossABurnieSet al.
Patient education for neck pain with or without radiculopathy. Cochrane Database Syst Rev2009;
1: CD005106.
32.
Schick-MakaroffKMacDonaldMPlummerMet al.
What synthesis methodology should I use? A review and analysis of approaches to research synthesis. AIMS Public Health2016;
3: 172–215.
33.
ReganSWongCLaschingerHet al.
Starting out: qualitative perspectives on new graduate nurses and nurse leaders on transition to practice. J Nurs Manage2017;
25: 246–255.
34.
BullockAMorrisZSAtwellC (eds) The personal touch: exchanging knowledge through manager placements in research teams. In: Proceedings of the European conference on knowledge management. Academic Conferences & Publishing International Ltd. Sonning Common, UK 2012; 1: 144–151.
35.
BullockAMorrisZSAtwellC.Exchanging knowledge through healthcare manager placements in research teams. Serv Ind J2013;
33: 1363–1380.
36.
BullockAMorrisZSAtwellC.Collaboration between health services managers and researchers: making a difference?J Health Serv Res Policy2012;
17: 2–10.
37.
MorrisZSBullockAAtwellC.Developing engagement, linkage and exchange between health services managers and researchers: experience from the UK. J Health Serv Res Policy2013;
18: 23–29.
38.
Lavoie-TremblayMAndersonM.Nurse Executives’ Perceptions of the Executive Training for Research Application (EXTRA) program. Worldviews Evid Based Nurs2012;
9: 186–192.
39.
Lavoie-TremblayMAndersonM.The executive training for research application (EXTRA) program: perceptions of the first cohort of fellows. Healthc Manage Forum2007;
20: 8–19.
40.
AldrichRBonevskiBWilsonA.A case study on determining and responding to health managers' priorities for research to assist health service decision making. Aust Health Review2006;
30: 435–441.
41.
ChampagneFLemiex-CharlesLDuranceauMet al.
Organizational impact of evidence-informed decision making training initiatives: a case study comparison of two approaches. Implement Sci2014;
9: 53.
42.
AtakLGignacPAndersonM.Getting the right information to the table: using technology to support evidence-based decision making. Healthc Manage Forum2010;
23: 164–168.
43.
JacobsJDugganKErwinPet al.
Capacity building for evidence-based decision making in local health departments: scaling up an effective training approach. Implement Sci2014;
9: 124.
44.
MittonCPattenS.Evidence-based priority setting: what do the decision-makers think. J Health Serv Res Policy2004;
9: 146–152.
45.
TourishD. ‘
Evidence Based Management’, or ‘Evidence Oriented Organizing’? A critical realist perspective. Organization2012;
20(2): 173–192.
46.
PendergastML.Issues in defining and applying evidence-based practices criteria for treatment of criminal-justice involved clients. J Psychoactive Drugs2011;
43: 10–18.
47.
Hagen-ZankerJMallettRSlaterR.The benefits and challenges of using systematic reviews in international development research. J Develop Effectiv2012;
4: 445–455.
48.
McCaugheyDBruningNS.Rationality versus realty: the challenges of evidence-based decision making for health policy makers. Implement Sci2010;
5: 39–51.
49.
ChecklandKSnowSMcDermottIet al. Management practice in primary care organisations: the roles and behaviours of middle managers and GPs. Final report. National Institutes of Health Research Programme NSDaO, Manchester, UK, 2011.
50.
HoltonJAGrandyG.Voiced inner dialogue as relational reflection-on-action: the case of middle managers in health care. Manage Learn2016;
47: 369–390.
51.
National Institute for Health Research. New evidence on management and Leadership. Programme HSaDR, 2013, Manchester. UK.
52.
VerschuerenMKipsJEuwemaM.A review on leadership of head nurses and patient safety and quality of care. Adv Healthc Manage2013;
14: 3–34.
53.
KothariAMacLeanLEdwardsN.Increasing capacity for knowledge translation: understanding how some researchers engage policy makers. Evid Policy2009;
5: 33–51.
54.
WyeLBranganECameronAet al.
Evidence based policy making and the 'art' of commissioning – how English healthcare commissioners access and use information and academic research in 'real life' decision-making: an empirical qualitative study. BMC Health Serv Res2015;
15: 12.
55.
PerrierLMrklasKLavisJNet al.
Interventions encouraging the use of systematic reviews by health policymakers and managers: a systematic review. Implement Sci2011;
6: 43
56.
LaRoccaRYostJDobbinsMet al.
The effectiveness of knowledge translation strategies used in public health: a systematic review. BMC Public Health2012;
12: 751.
57.
DemberLArchdeaconPKrishnanMet al.
Pragmatic trials in maintenance dialysis: perspectives from the Kidney Health Initiative. J Am Soc Nephrol2016;
27: 2955–2963.
BrennanSMcKenzieJTurnerTet al.
Development and validation of SEER (Seeking, Engaging with and Evaluating Research): a measure of policymakers’ capacity to engage with and use research. Health Res Policy Syst2017;
15: 1.
KastnerMTriccoASoobiahCet al.
What is the most appropriate knowledge synthesis method to conduct a review? Protocol for a scoping review. BMC Med Res Methodol2012;
12: 114–124.
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