Experience of Health Leadership in Partnering With University-Based Researchers in Canada – A Call to “Re-imagine” Research

Document Type : Original Article

Authors

1 Applied Research and Evaluation Consultant, Centreville, NS, Canada

2 Department of Community Health Sciences, University of Manitoba Winnipeg, Winnipeg, MB, Canada

3 Ottawa Research Institute, University of Ottawa, Ottawa, ON, Canada

4 School of Nursing, University of Northern British Columbia, Prince George, BC, Canada

5 Universite de Saint-Boniface, Winnipeg, MB, Canada

6 University of Winnipeg, Winnipeg, MB, Canada

7 Hôpital Montfort, University of Ottawa, Ottawa, ON, Canada

8 Northern Health, Prince George, BC, Canada

9 University of Northern British Columbia, Prince George, BC, Canada

10 Nova Scotia Health Authority, Halifax, NS, Canada

Abstract

Background
Emerging evidence that meaningful relationships with knowledge users are a key predictor of research use has led to promotion of partnership approaches to health research. However, little is known about health system experiences of collaborations with university-based researchers, particularly with research partnerships in the area of health system design and health service organization. The purpose of the study was to explore the experience and perspectives of senior health managers in health service organizations, with health organization-university research partnerships.
 
Methods
In-depth, semi-structured interviews (n = 25) were conducted with senior health personnel across Canada to explore their perspectives on health system research; experiences with health organization-university research partnerships; challenges to partnership research; and suggested actions for improving engagement with knowledge users and promoting research utilization. Participants, recruited from organizations with regional responsibilities, were responsible for system-wide planning and support functions.
 
Results
Research is often experienced as unhelpful or irrelevant to decision-making by many within the system. Research, quality improvement (QI) and evaluation are often viewed as separate activities and coordinated by different responsibility areas. Perspectives of senior managers on barriers to partnership differed from those identified in the literature: organizational stress and restructuring, and limitations in readiness of researchers to work in the fast-paced healthcare environment, were identified as major barriers. Although the need for strong executive leadership was emphasized, “multi-system action” is needed for effective partnerships.
 
Conclusion
Common approaches to research and knowledge translation are often not appropriate for addressing issues of health service design and health services organization. Nor is the research community providing expertise to many important activities that the healthcare system is taking to improve health services. A radical rethinking of how we prepare health service researchers; position research within the health system; and fund research activities and infrastructure is needed if the potential benefits of research are to be achieved. Lack of response to health system needs may contribute to research and ‘evidence-informed’ practice being further marginalized from healthcare operations. Interventions to address barriers must respond to the perspectives and experience of health leadership.

Highlights

Supplementary File 1 (Download)

 

Commentaries Published on this Paper

 

  • Bridging the ‘Two Cultures’ of Research and Service: Can Complexity Theory Help?; Comment on “Experience of Health Leadership in Partnering With University-Based Researchers in Canada – A Call to ‘Re-imagine’ Research”

          Abstract | PDF

 

  • When Coproduction Is Unproductive; Comment on “Experience of Health Leadership in Partnering with University-Based Researchers in Canada: A Call to ‘Re-Imagine’ Research”

          Abstract | PDF

 

  • Re-imagining Research: A Bold Call, but Bold Enough?; Comment on “Experience of Health Leadership in Partnering with University-Based Researchers in Canada: A Call to ‘Re-Imagine’ Research”

          Abstract | PDF

 

  •  Reimagining Researchers in Health Research; Comment on “Experience of Health Leadership in Partnering With University-Based Researchers in Canada: A Call to ‘Re-Imagine’ Research”

          Abstract | PDF

 

  • Building Research Capacity for Impact in Applied Health Services Research Partnerships; Comment on “Experience of Health Leadership in Partnering With University-Based Researchers in Canada – A Call to “Re-imagine” Research”

           Abstract | PDF

 

  • What Can Health Services Researchers Offer Health Systems? Developing Meaningful Partnerships Between Academics and Health System Workers; Comment on “Experience of Health Leadership in Partnering with University-Based Researchers in Canada - A Call to ‘Re-imagine’ Research”

          Abstract | PDF

 

  •  Advancing Health Services Collaborative and Partnership Research; Comment on “Experience of Health Leadership in Partnering with University-Based Researchers in Canada – A Call to ‘Re-imagine’ Research”

          Abstract | PDF

 

  • Promising Points for Intervention in Re-Imagining Partnered Research in Health Services; Comment on “Experience of Health Leadership in Partnering with University-Based Researchers in Canada – A Call to ‘Re-imagine’ Research”

          Abstract | PDF

 

  • Cultivating Value Co-Creation in Health System Research; Comment on “Experience of Health Leadership in Partnering with University-Based Researchers in Canada – A Call to Re-imagine Research”

         Abstract | PDF

 

  • Can We Re-Imagine Research So It Is Timely, Relevant and Responsive?; Comment on “Experience of Health Leadership in Partnering with University-Based Researchers in Canada: A Call to ‘Re-Imagine’ Research”

          Abstract | PDF

 

Authors' Response to the Commentaries

 

  • Re-imagining Health Research Partnership in a Post-COVID World: A Response to Recent Commentaries

          Abstract | PDF

 

Watch the Video Summary here.

 

Keywords

Main Subjects

References

  1. Glasser M, Holt N, Hall K, et al. Meeting the needs of rural populations through interdisciplinary partnerships. Fam Community Health. 2003;26(3):230-245.
  2. Padgett SM, Bekemeier B, Berkowitz B. Collaborative partnerships at the state level: promoting systems changes in public health infrastructure. J Public Health Man. 2004;10(3):251-257.
  3. Johnson KE, Tachibana C, Coronado GD, et al. A guide to research partnerships for pragmatic clinical trials. BMJ Brit Med J. 2014;349:g6826. doi:10.1136/bmj.g6826
  4. Mafuta EM, Dieleman MA, Essink L, et al. Participatory approach to design social accountability interventions to improve maternal health services: a case study from the Democratic Republic of the Congo. Glob Health Res Pol. 2017;2(1):4. doi:10.1186/s41256-017-0024-0
  5. Schmittdiel JA, Grumbach K, Selby JV. System-based participatory research in health care: An approach for sustainable translational research and quality improvement. Ann Fam Med. 2010;8(3):256-259. doi:10.1370/afm.1117
  6. Bailie R, Matthews V, Brands J, Schierhout G. A systems-based partnership learning model for strengthening primary healthcare. Implement Sci. 2013;8(1):143. doi:10.1186/1748-5908-8-143
  7. Balbale SN, Locatelli SM, LaVela SL. Through their eyes: Lessons learned using participatory methods in health care quality improvement projects. Qual Health Res. 2016;26(10):1382-1392. doi:10.1177/1049732315618386
  8. Canadian Academy of Health Sciences. Academic recognition of team science: How to optimize the Canadian Academic System.  Ottawa, ON: The Expert Panel on Academic Recognition of Team Science in Canada, CAHS; 2017.
  9. Ovretveit J, Hempel S, Magnabosco L, Mittman BS, Rubenstein LV, Ganz DA. Guidance for research-practice partnerships (R-PPs) and collaborative research. J Health Org Man. 2014;28(1):115-126. doi:10.1108/JHOM-08-2013-0164
  10. Bowen S. The relationship between engaged scholarship, knowledge translation and participatory research. In: Higginbottom G, Liamputtong P, eds. Using participatory research methods in qualitative research. Sage Publications; 2015.
  11. Allen ML, Culhane‐Pera KA, Pergament S, Call KT. A capacity building program to promote CBPR partnerships between academic researchers and community members. Clin Transl Sci. 2011;4(6):428-433. doi:10.1111/j.1752-8062.2011.00362.x
  12. Kothari A, Wathen CN. A critical second look at integrated knowledge translation. Health Policy. 2013;109(2):187-191. doi:10.1016/j.healthpol.2012.11.004
  13. 13            Harlos K, Tetroe J, Graham I, Bird M, Robinson N. Mining the management literature for insights into implementing evidence-based change in healthcare. Healthc Policy. 2012;8(1):33-48.
  14. Kiefer L, Frank J, Di Ruggiero E, et al. Fostering evidence-based decision-making in Canada. C J Public Health. 2005;96(3):I1-I19
  15. Wathen N, Watson G, Jack S, Caldwell S, Lewis N. From big to small: A process for developing policy-relevant research summaries. Healthcare Policy. 2008;4(1):60-69.
  16. Lavis J, Roberston D, Woodside C, McLeod CB, Abelson J. How can research organizations more effectively transfer research knowledge to decision makers? Milbank Q. 2003;81(2):221-248.
  17. Zardo P, Barnett AG, Suzor N, Cahill T. Does engagement predict research use? An analysis of The Conversation Annual Survey 2016. PLoS One. 2018;13(2): e0192290. doi:10.1371/journal.pone.0192290
  18. Gollust SE, Seymour JW, Pany MJ, Goss A, Meisel ZF, Grande D. Mutual distrust: Perspectives from researchers and policy makers on the research to policy gap in 2013 and recommendations for the future. Inquiry. 2017;1(54):46958017705465. doi:10.1177/0046958017705465
  19. Oliver K, Innvar S, Lorenc T, Woodman J, Thomas J. A systematic review of barriers to and facilitators of the use of evidence by policymakers. BMC Health Serv Res. 2014;4:2. doi:10.1186/1472-6963-14-2
  20. Ellen ME, Léon G, Bouchard G, Ouimet M, Grimshaw JM, Lavis JN. Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study. Implement Sci. 2014;9:179. doi:10.1186 s13012-014-0179-8
  21. Hanney S, Boaz A, Jones T, Soper B. Engagement in research: an innovative three-stage review of the benefits for health-care performance. NIHR J Library. 2013;1;8. doi:10.3310/hsdr01080
  22. Boaz A, Hanney S, Jones T, Soper B. Does the engagement of clinicians and organisations in research improve healthcare performance: a three-stage review. BMJ Open. 2015;5(12):e009415. doi:10.1136/bmjopen-2015-009415
  23. Rycroft-Malone J, Burton CR, Wilkinson J, et al. Collective action for implementation: a realist evaluation of organisational collaboration in healthcare. Implement Sci. 2016;11:17. doi:10.1186/s13012-016-0380-z
  24. Gagliardi AR, Kothari A, Graham ID. Research agenda for integrated knowledge translation (IKT) in healthcare: what we know and do not yet know. J Epidemiol Community Health. 2017;71(2):105-106. doi:10.1136/jech-2016-207743
  25. Boaz A, Hanney S, Borst R, O'Shea A, Kok M. How to engage stakeholders in research: design principles to support improvement. Health Res Policy Syst. 2018;16(1):60. doi:10.1186/s12961-018-0337-6
  26. Esmail L, Moore E, Rein A. Evaluating patient and stakeholder engagement in research: moving from theory to practice. J Comp Eff Res. 2015;4(2):133-145. doi:10.2217/cer.14.79
  27. Wildridge V, Childs S, Cawthra L, Madge B. How to create successful partnerships-a review of the literature. Health Info Libr J. 2004;21(suppl 1):3-19. doi:10.1111/j 1740-3324.2004.00497.x
  28. Walter I, Davies H, Nutley S. Increasing research impact through partnerships: evidence from outside health care. J Health Serv Res Policy. 2003;8(suppl 2):58-61. doi:10.1258/135581903322405180
  29. Jagosh J, Macaulay AC, Pluye P, et al. Uncovering the benefits of participatory research: Implications of a realist review for health research and practice. Milbank Q. 2012;90(2):311-346. doi:10.1111/j.1468-0009.2012.00665.x
  30. Sibbald SL, Tetroe J, Graham ID. Research funder required research partnerships: A qualitative inquiry. Implement Sci. 2014;9:176. doi:10.1186/s13012-014-0176-y
  31. Brazil K, Ozer E, Cloutier MM, Levine R, Stryer D. From theory to practice: Improving the impact of health services research. BMC Health Serv Res. 2005;5:1. doi:10.1186/1472-6963-5-1
  32. Kitson A, Brook A, Harvey G, et al. Using complexity and network concepts to inform healthcare knowledge translation. Int J Health Policy Manag. 2017;7(3):231-243. doi:10.15171/ijhpm.2017.79
  33. Greenhalgh T, Wieringa S. Is it time to drop the 'knowledge translation’ metaphor? A critical literature review. J R Soc Med. 2011;104(12):501-509. doi:10.1258/jrsm.2011.110285
  34. Rycroft-Malone J, Burton CR, Bucknall T, Graham ID, Hutchinson AM, Stacey D. Collaboration and co-production of knowledge in healthcare: Opportunities and challenges. Int J Health Policy Manag. 2016;5(4):221-223. doi:10.15171/ijhpm.2016.08
  35. Wehrens R. Beyond two communities - from research utilization and knowledge translation to co-production? Public Health. 2014;128(6):545-551. doi:10.1016/j.puhe.2014.02.004
  36. Fox DM. History matters for understanding knowledge exchange. Milbank Q. 2010;88(4):484-491. doi:10.1111/j.1468-0009.2010.00609.x
  37. Greenhalgh T, Raftery J, Hanney S, Glover M. Research impact: a narrative review. BMC Med. 2016;14:78. doi:10.1186/s12916-016-0620-8
  38. Traynor R, Dobbins M, DeCorby K. Challenges of partnership research: Insights from a collaborative partnership in evidence-informed public health decision making. Evid Policy. 2015;11(1):99-109. doi:10.1332/174426414X14043807774174
  39. Smits PA, Denis JL. How research funding agencies support science integration into policy and practice: an international overview. Implement Sci. 2014;9:28. doi:10.1186/1748-5908-9-28
  40. Tetroe JM, Graham ID, Foy R, et al. Health research funding agencies’ support and promotion of knowledge translation: an international study. Milbank Q. 2008;86(1):125-155. doi:10.1111/ j.1468-0009.2007.00515.x
  41. McLean RKD, Graham ID, Tetroe JM, Volmink JA. Translating research into action: an international study of the role of research funders. Health Res Policy Syst. 2018;16(1):44. doi:10.1186/s12961-018-0316-y
  42. Hoffmeyer A, Scott C, Lagendyk L. Researcher-decision-maker partnerships in health services research: Practical challenges, guiding principles. BMC Health Serv Res. 2012;12:280. doi:10.1186/1472-6963-12-280
  43. Hoekstra F, Martin Ginis KA, Allan V, Kothari A, Gainforth HL. Evaluating the impact of a network of research partnerships: a longitudinal multiple case study protocol. Health Res Policy Syst. 2018;16(1):107. doi:10.1186/s12961-018-0377-y
  44. Bowen S, Botting I, Graham ID, Huebner, LA. Beyond “two cultures”: Guidance for establishing effective researcher/health system partnerships. Int J Health Policy Manag. 2017;6(1):27-42. doi:10.15171/IJHPM.2016.71
  45. Greenhalgh T, Jackson C, Shaw S, Janamian T. Achieving research impact through co-creation in community-based health services: Literature review and case study. Milbank Q. 2016;94(2):392-429. doi:10.1111/1468-0009.12197
  46. Heaton J, Day J, Britten N. Collaborative research and the co-production of knowledge for practice: an illustrative case study. Implement Sci. 2016;11:20. doi:10.1186/s13012-016-0383-9
  47. Bornstein S, Baker R, Navrarro P, Mackey Speed D, Sullivan M. Putting research in place: An innovative approach to providing contextualized evidence synthesis for decision makers. Syst Rev. 2017;6(218):1-13. doi:10.1186/s13643-017-0606-4
  48. Lehmann U, Gilson L. Action learning for health system governance: the reward and challenge of co-production. Health Policy Plann. 2015;30(8):957-963. doi:10.1093/heapol/czu097
  49. Bartunek JM, Rynes SL. Academics and practitioners are alike and unlike: The paradoxes of academic-practitioner relationships. J Manage. 2014;40(5):1181-1201. doi:10.1177/0149206314529160
  50. Nyström ME, Karltun J, Keller C, Andersson Gäre B. Collaborative and partnership research for improvement of health and social services: researcher's experiences from 20 projects. Health Res Policy Syst. 2018;16(1):46. doi:10.1186/s12961-018-0322-0
  51. Ellen ME, Lavis JN, Horowitz E, Berglas R. How is the use of research evidence in health policy perceived? A comparison between the reporting of researchers and policy-makers. Health Res Policy Syst. 2018;16(1):64. doi:10.1186/s12961-018-0345-6
  52. Campbell DM, Redman S, Jorm L, Cooke M, Zwi AB, Rychetnik L. Increasing the use of evidence in health policy: practice and views of policy makers and researchers. Aust New Zealand Health Policy. 2009;6:21. doi:10.1186/1743-8462-6-21
  53. Haynes A, Rowbotham SJ, Redman S, Brennan S, Williamson A, Moore G. What can we learn from interventions that aim to increase policy-makers' capacity to use research? A realist scoping review. Health Res Policy Syst. 2018;16(1):31. doi:10.1186/s12961-018-0277-1
  54. Jessani NS, Siddiqi SM, Babcock C, Davey-Rothwell M, Ho S, Holtgrave DR. Factors affecting engagement between academic faculty and decision-makers: learnings and priorities for a school of public health. Health Res Policy Syst. 2018;16(1):65. doi:10.1186/s12961-018-0342-9
  55. Wehrens R, Bekker M, Bal R. The construction of evidence-based local health policy through partnerships: Research infrastructure, process, and context in the Rotterdam 'Healthy in the City' programme. J Public Health Policy. 2010;31(4):447-460. doi:10.1057/jphp.2010.33
  56. Talbot C, Talbot C. Bridging the academic - policy-making gap: Practice and policy issues. Public Money Manage. 2015;35(3):187-194. doi:10.1080/09540962.2015.1027491
  57. Best A, Greenhalgh T, Lewis S, Saul JE, Carroll S, Bitz J. Large-system transformation in health care: a realist review. Milbank Q. 2012;90(3):421-56. doi:10.1111/1468-0009.2012.00670.x
  58. Canada’s Health Care System. Government of Canada website.   https://www.canada.ca/en/health-canada/services/canada-health-care-system.html. Updated August 22, 2016. Accessed May 17, 2019.
  59. Latest Update: Structural Profile of Public Health in Canada. National Collaborating Centre for Healthy Public Policy website. http://www.ncchpp.ca/710/Structural_Profile_of_Public_Health_in_Canada.ccnpps. Updated in 2018. Accessed May 17, 2019.
  60. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-1288. do:10.1177/1049732305276687
  61. Patton, MJ. Qualitative Research and Evaluation Methods. 3rd ed.  Thousand Oaks: Sage Publications; 2002.
  62. Marshall M, Pagel C, French C, et al. Moving improvement research closer to practice: the Researcher-in-Residence model. BMJ Qual Saf. 2014;23(10):801-805. doi:10.1136/bmjqs-2013-002779
  63. Hirschhorn LR, Ramaswamy R, Devnani M, Wandersman A, Simpson LA, Garcia-Elorrio E. Research versus practice in quality improvement? Understanding how we can bridge the gap. Int J Qual Health Care. 2018;30(suppl 1):24-28. doi:10.1093/intqhc/mzy018
  64. Vindrola-Padros C, Pape T, Utley M, Fulop NJ. The role of embedded research in quality improvement: a narrative review. BMJ Qual Saf. 2017;26(1):70-80. doi:10.1136/bmjqs-2015-004877
  65. Cooke J, Ariss S, Smith C, Read J. On-going collaborative priority-setting for research activity: a method of capacity building to reduce the research-practice translational gap. Health Res Policy Syst. 2015;13-25. doi:10.1186/s12961-015-0014-y
  66. Bowen S. A Guide to Evaluation in Health Research. Ottawa: Canadian Institutes of Health Research;  2012. http://www.cihr-irsc.gc.ca/e/documents/kt_lm_guide_evhr-en.pdf.
  67. Bryson JM, Crosby BC, Middleton Stone M. Designing and Implementing Cross‐Sector Collaborations: Needed and Challenging. Public Adm Rev. 2015;75(5):647-663.
  68. Kickbusch I, Gleicher D. Governance for health in the 21st century. World Health Organization; 2012. http://www.euro.who.int/__data/assets/pdf_file/0019/171334/RC62BD01-Governance-for-Health-Web.pdf.  
  69. Kislov R, Wilson PM, Knowles S, Boaden R. Learning from the emergence of NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs): a systematic review of evaluations. Implement Sci. 2018;13:111. doi:10.1186/s13012-018-0805-y
  70. Bornstein S. Modernizing our doctoral and postdoctoral training programs: Bold new initiatives. Healthcare Papers. 2016;16(16):55-58. doi:10.12927/hcpap.2016.24727
  71. Luyckx VA, Biller-Andorno N, Saxena A, Tran NT. Health policy and systems research: towards a better understanding and review of ethical issues. BMJ Glob Health. 2017;2(2):e000314. doi:10.1136/bmjgh-2017-000314
  72. Pratt B, Paul A, Hyder AA, Ali J. Ethics of health policy and systems research: a scoping review of the literature. Health Policy Plan. 2017;32(6):890-910. doi:10.1093/heapol/czx003
  73. Marshall MN. Bridging the ivory towers and the swampy lowlands; increasing the impact of health services research on quality improvement. Int J Qual Health Care. 2014;26(1):1-5. doi:10.1093/intqhc/mzt076
  74. Goodyear-Smith F, Jackson C, Greenhalgh T. Co-design and implementation research: challenges and solutions for ethics committees. BMC Med Ethics. 2015;16:78. doi:10.1186/s12910-015-0072-2
  75. Bowen S, Martens P, Need to Know Team. Demystifying knowledge translation: learning from the community. J Health Serv Res Policy. 2005;10(4):203-211. doi:10.1258/135581905774414213
  76. Van de Van AH, Johnson PE. Knowledge for theory and practice. Acad Manage Rev. 2006;31(4):802-821. doi:10.2307/20159252
  77. Gifford WA, Squires JE, Angus DE, et al. Managerial leadership for research use in nursing and allied health care professions: a systematic review. Implement Sci. 2018;13(1):127. doi:10.1186/s13012-018-0817-7
  78. Wolfenden L, Yoong SL, Williams CM, et al. Embedding researchers in health service organizations improves research translation and health system performance: The Australian Hunter New England Population Health example. J Clin Epidemiol. 2017;85:3-11. doi:10.1016/j.jclinepi.2017.03.007
  79. Long JC, Cunningham FC, Braithwaite J. Bridges, brokers and boundary spanners in collaborative networks: a systematic review. BMC Health Serv Res. 2013;13:158. doi:10.1186/1472-6963-13-158
  80. Franzen SR, Chandler C, Lang T. Health research capacity development in low and middle income countries: reality or rhetoric? A systematic meta-narrative review of the qualitative literature. BMJ Open. 2017;7(1):e012332. doi:10.1136/bmjopen-2016-012332
International Journal of Health Policy and Management
Volume 8, Issue 12
December 2019
Pages 684-699

Files

History

  • Receive Date: 01 February 2019
  • Revise Date: 27 July 2019
  • Accept Date: 28 July 2019
  • First Publish Date: 01 December 2019

Share

How to cite

Statistics