Title: Getting research into health care practice: General lessons and the case of genetics Sue Dopson Sad
1Getting research into health care practice
General lessons and the case of geneticsSue
DopsonSaïd Business SchoolTempleton College
2Virtuous Circle
RD
inform/ shape
synthesise
Practice
Evidence
implement
3Research 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
4Key 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?
5Process 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
6Issues 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
7Common 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
8Common Core Themes
- Professional networks shape behaviour
- Professional boundaries inhibit knowledge
diffusion - Context as an influence on diffusion
- Opinion leaders as change facilitators and
inhibitors
9Policy 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
10Policy 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
11Barriers 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?
12Recent 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
13Data 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
14Expectations of GKP
- A range of views. Extremes.
-
- bringing things together
- -
- not much in practical terms
15Barriers 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
16Barriers 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
17Commercialisation
- Range of views e.g.
- markets are quite small, there is little money
to make - to
- the commercial spin outs cover a wide spectrum
18Issues
- 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
19I need help . . . . . please
- Significant research questions?