CLAHRC NWL Systematic Approach
Research type
Research Study
Full title
Evaluation of the NIHR CLAHRC NWL Systematic Approach to translating evidence-based research into practice in healthcare
IRAS ID
188851
Contact name
Becky Ward
Contact email
Duration of Study in the UK
4 years, 11 months, 21 days
Research summary
While peer-reviewed clinical evidence (such as journal articles, guidelines, toolkits) describe activities that healthcare providers can undertake to improve healthcare, they rarely come with a blueprint for how it can be embedded in routine practice.(Bate & Robert, 2002; Hoffmann et al., 2014; Kitson, Harvey, & McCormack, 1998; Shojania & Grimshaw, 2005)
The NIHR CLAHRC NWL programme has developed a systematic approach consisting of additional tools and methods to help with this process of embedding research into routine practice in healthcare. NIHR CLAHRC NWL funds and supports Quality Improvement Teams consisting of multidisciplinary staff (such as managers, doctors, nurses, pharmacists, and physiotherapists) and patients to use the systematic approach in projects lasting a fixed term e.g. 12 or 18 months.
The systematic approach includes activities which are proposed to provide benefits in the evidence translation process and are based on recommendations from existing research in this field.(Bate & Robert, 2002; Langley et al., 2009; Shojania & Grimshaw, 2005) The approach includes strategies to support the planning, conduct and evaluation of evidence-translation efforts, and provides guiding principles for teams to work towards including the strategic principles to act scientifically and pragmatically, embrace complexity, and to engage and empower those responsible for and effected by translation efforts including frontline healthcare staff and patients. In addition the approach specifies a number of tools and methods to guide team progress. For example, one activity is known as process mapping, whereby Quality Improvement Teams collaborate to produce a diagram depicting standard procedures of care delivery. This is hypothesized to help the team to better understand their system and opportunities for intervention, as well as providing an opportunity for patients and multi-disciplinary staff to interact in different ways and empathize with each other’s perspectives.(Langley et al., 2009)
The purpose of this research study is to thoroughly assess the strengths and weaknesses of the systematic approach and its component parts, and to better understand “what actually happens” during the process of evidence translation and improvement.
The research will be conducted through a series of 1:1 interviews and observations of group meetings and workshops with a diverse group of people involved in delivering and improving healthcare. This will include NHS doctors, managers, nurses, allied health professionals, data analysts, and commissioners, as well as academic researchers and members of the public. Documents produced in preparation for and as a result of these meetings will also be analysed. These methods will help to determine the strengths and weaknesses of the CLAHRC NWL approach to translate research into routine healthcare improvements.
The results of this research will be used to iteratively develop the approach and scale up improvements nationally and internationally.
While new clinical research is always necessary, much more needs to be done to apply existing research evidence more effectively in everyday practice. Therefore, this research project chooses to investigate the process of translating of research into healthcare practice.CLAHRC NWL has worked with partners to identify priority areas for improving care in Northwest London. The Delivery themes are targeted at areas of high morbidity with high health and care related costs that are recognised areas for improvement within Northwest London. These include Breathlessness, Early Years and Frailty as areas where local data suggest there is scope to significantly improve quality and value of care.
The Cross-cutting themes draw on existing literature and build on the CLAHRC NWL experience enriching understanding of the complexity of translation. To support successful and sustainable outcomes it is necessary to:
• Embed: Maximise knowledge of staff and patients to understand processes of care to help ‘fit’ research evidence. Test changes using an iterative approach to allow teams to react to obstacles and opportunities.
• Engage: Establish meaningful dialogue between patients and healthcare providers to ensure that changes to practice are aligned with patient needs and priorities.
• Consider the whole person: Focus on both mental and physical wellbeing to ensure patient centred care and high value service design.
• Utilise information: Identify key priorities to target research and resources. Provide regular feedback on implementation progress and impact on patient health.
• Collaborate: Engage staff, academics and patients to develop shared consensus on how to approach implementation, measure outcomes and build collective ownership and commitment to deliver improvements.The research priority is to thoroughly assess the strengths and weaknesses of the overall systematic approach and its component parts and use our findings to scale up and spread successful aspects of the work.
This research will be undertaken at project, theme and programme level using our academic partners’ expertise in clinical sciences, improvement science, epidemiology and social sciences. This work will be both formative, with frequent feedback of research to aid the development of programme activities, and summative, leading to dissemination through peer-reviewed publications and conferences.
REC name
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REC reference
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