Getting research into health care practice: General lessons and the case of genetics Sue Dopson Sad - PowerPoint PPT Presentation

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Getting research into health care practice: General lessons and the case of genetics Sue Dopson Sad

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Title: Getting research into health care practice: General lessons and the case of genetics Sue Dopson Sad


1
Getting research into health care practice
General lessons and the case of geneticsSue
DopsonSaïd Business SchoolTempleton College
2
Virtuous Circle
RD
inform/ shape
synthesise
Practice
Evidence
implement
3
Research Aims
  • Interested in what makes new knowledge credible
    and therefore utilised? Why do actors decide to
    use new knowledge? What is the significance of
    the social context in which the innovation is to
    be embedded?
  • Research has explored the complexities of
    implementing EBM. Undertook an overview of 49
    cases involving 1400 interviews in healthcare
    organisations with colleagues
  • Qualitative methodology potential contribution
    to organisational studies

4
Key questions of the work together
  • Would it be additive to scale up or aggregate
    analysis by taking an overview across a suite of
    seven related studies of the diffusion of
    innovation?
  • If so, what are the rules of method to be
    adopted?
  • In what ways are the rules different from those
    apparent within the conventional systematic
    review paradigm?

5
Process adopted
  • What constituted the databases, transcripts,
    final reports
  • Reread of all final project reports
  • Summaries of key points/themes
  • Draft coding structure to examine reports
  • Collective discussion/simultaneous analysis

6
Issues arising
  • The varying theoretical approaches and values of
    researchers
  • The varied interpretation of key terms in
    research design, methods and data analysis
  • The importance of trust (structures/incentives)
    amongst researchers if sharing of knowledge is to
    occur

7
Common Core Themes
  • Robust evidence is not sufficient to facilitate
    diffusion
  • The interpretation of evidence is socially
    constructed
  • Evidence is differentially available for
    different professions
  • Hierarchies of evidence exist
  • Other sources of evidence are important e.g.
    tacit and experimental

8
Common Core Themes
  • Professional networks shape behaviour
  • Professional boundaries inhibit knowledge
    diffusion
  • Context as an influence on diffusion
  • Opinion leaders as change facilitators and
    inhibitors

9
Policy and Managerial Implications
  • No magic bullets
  • No magic targets
  • Receptive context for change includes
  • A favourable history of relationships between
    professionals and managerial groups and between
    professional groups
  • Sustained political and managerial support and
    pressure for change at a local level

10
Policy and Managerial Implications
  • A supportive organisational culture, clear goals
    for change
  • Effective and good quality relationships within
    and between local groups
  • Access to opportunities to share information and
    ideas within the local context
  • The introduction of organisational innovations to
    foster improved and effective interchanges
    between groups

11
Barriers to Knowledge Flows - Questions
  • People Can the relatively poor exchange of
    information between groups working within
    healthcare be improved?
  • People Why are the complex ways in which
    clinical practice is influenced ignored?
  • Organisations Are organisations structured to
    facilitate the sharing of fragmented information
    flows?
  • Institutions Are we yet to put in place the
    right frameworks for todays knowledge flows?

12
Recent research Scoping Exercise
Genetics knowledge Parks Bids put in to D of H
and DTI 6 parks funded Each park gets
approximately 5 million over 5 years
13
Data collected in the first stage
  • Expectations of Genetics Knowledge Park
  • Views on the two key objectives of the funding
  • To ensure results of research translate to the
    NHS
  • Commercialisation

14
Expectations of GKP
  • A range of views. Extremes.
  • bringing things together
  • -
  • not much in practical terms

15
Barriers to translationSome emerging themes
  • The history of genetics research in Oxford
  • The speed of the production of scientific
    knowledge
  • The state of the Oxford Trust
  • The role of the media
  • Ethical issues
  • Public understanding
  • Clinical groups understanding

16
Barriers to translationSome emerging themes
  • The capacity of the NHS to fund and deliver the
    results of the research
  • The impact on roles, educational training
  • The non awareness of purchasers
  • Background, career paths, incentives
  • The organisation and management of genetic
    services
  • Physical location of the actors involved
  • What is NHS RD

17
Commercialisation
  • Range of views e.g.
  • markets are quite small, there is little money
    to make
  • to
  • the commercial spin outs cover a wide spectrum

18
Issues
  • Implementation, what thinking is being done on
    this.
  • Knowledge intermediaries
  • Education and training
  • How will this all impact on patients
  • Other GKPs, how will the six GKPs learn from
    each other
  • The role of funding bodies

19
I need help . . . . . please
  • Significant research questions?
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