Dataset Information

Learning from the emergence of NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs): a systematic review of evaluations.

ABSTRACT:

Background

Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) were funded by NIHR in England in 2008 and 2014 as partnerships between universities and surrounding health service organisations, focused on improving the quality of healthcare through the conduct and application of applied health research. The aim of this review is to synthesise learning from evaluations of the CLAHRCs.

Methods

Fifteen databases including CINAHL, MEDLINE, EMBASE and PsycINFO were searched to identify any evaluations of CLAHRCs. Current and archived CLAHRC websites and the reference lists of retrieved articles were scanned to identify any additional evaluations. Searches were restricted to English language only. Any publications from evaluations of the CLAHRCs were eligible for inclusion if they fulfilled at least one of three pre-specified inclusion criteria. A narrative synthesis was undertaken.

Results

Twenty-six evaluations (reported in 37 papers) were deemed eligible for inclusion. Evaluations focused on describing and exploring the formative partnerships, vision, values, structures and processes of CLAHRCs; the nature and role of boundaries; the deployment of knowledge brokers and hybrid roles to support knowledge mobilisation; patient and public involvement; and capacity building. The relative lack of data about the early impact of CLAHRCs on health care provision or outcomes is notable.

Conclusions

Much of the evaluative focus on CLAHRCs has been on how they have been organised and on the development of theory around their emergent properties. Evidence is lacking on the impact of CLAHRCs particularly in relation to the knowledge mobilisation processes and practices adopted. Further evaluation of CLAHRCs and other similar research and practice partnerships is warranted and should focus on which knowledge mobilisation approaches work where, how and why.

Trial registration

PROSPERO (Registration number: CRD42016042945 ).

SUBMITTER: Kislov R

PROVIDER: S-EPMC6094566 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Publications

Learning from the emergence of NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs): a systematic review of evaluations.

Kislov Roman R Wilson Paul M PM Knowles Sarah S Boaden Ruth R

Implementation science : IS 20180815 1

<h4>Background</h4>Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) were funded by NIHR in England in 2008 and 2014 as partnerships between universities and surrounding health service organisations, focused on improving the quality of healthcare through the conduct and application of applied health research. The aim of this review is to synthesise learning from evaluations of the CLAHRCs.<h4>Methods</h4>Fifteen databases including CINAHL, MEDLINE, EMBASE and PsycINFO w ...[more]

PMID: 30111339

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Project description:BackgroundThe English National Health Service has made a major investment in nine partnerships between higher education institutions and local health services called Collaborations for Leadership in Applied Health Research and Care (CLAHRC). They have been funded to increase capacity and capability to produce and implement research through sustained interactions between academics and health services. CLAHRCs provide a natural 'test bed' for exploring questions about research implementation within a partnership model of delivery. This protocol describes an externally funded evaluation that focuses on implementation mechanisms and processes within three CLAHRCs. It seeks to uncover what works, for whom, how, and in what circumstances.Design and methodsThis study is a longitudinal three-phase, multi-method realistic evaluation, which deliberately aims to explore the boundaries around knowledge use in context. The evaluation funder wishes to see it conducted for the process of learning, not for judging performance. The study is underpinned by a conceptual framework that combines the Promoting Action on Research Implementation in Health Services and Knowledge to Action frameworks to reflect the complexities of implementation. Three participating CLARHCS will provide in-depth comparative case studies of research implementation using multiple data collection methods including interviews, observation, documents, and publicly available data to test and refine hypotheses over four rounds of data collection. We will test the wider applicability of emerging findings with a wider community using an interpretative forum.DiscussionThe idea that collaboration between academics and services might lead to more applicable health research that is actually used in practice is theoretically and intuitively appealing; however the evidence for it is limited. Our evaluation is designed to capture the processes and impacts of collaborative approaches for implementing research, and therefore should contribute to the evidence base about an increasingly popular (e.g., Mode two, integrated knowledge transfer, interactive research), but poorly understood approach to knowledge translation. Additionally we hope to develop approaches for evaluating implementation processes and impacts particularly with respect to integrated stakeholder involvement.

Project description:Scientometrics enables scholars to assess and visualize emerging research trends and hot-spots in the scientific literature from a quantitative standpoint. In the last decades, Africa has nearly doubled its absolute count of scholarly output, even though its share in global knowledge production has dramatically decreased. The still-ongoing COVID-19 pandemic has profoundly impacted the way scholarly research is conducted, published, and disseminated. However, the COVID-19-related research focus, the scientific productivity, and the research collaborative network of African researchers during the ongoing COVID-19 pandemic remain to be elucidated. This study aimed to clarify the COVID-19 research patterns among African researchers and estimate the strength of collaborations and partnerships between African researchers and scholars from the rest of the world during the COVID-19 pandemic, collecting data from electronic scholarly databases such as Web of Science (WoS), PubMed/MEDLINE and African Journals OnLine (AJOL), the largest and prominent platform of African-published scholarly journals. We found that COVID-19-related collaboration patterns varied among African regions. For instance, most of the scholarly partnerships occurred with formerly colonial countries (such as European or North-American countries). In other cases, scholarly ties of North African countries were above all with the Kingdom of Saudi Arabia. In terms of number of publications, South Africa and Egypt were among the most productive countries. Bibliometrics and, in particular, scientometrics can help scholars identify research areas of particular interest, as well as emerging topics, such as the COVID-19 pandemic. With a specific focus on the still-ongoing viral outbreak, they can assist decision- and policy-makers in allocating funding and economic-financial, logistic, organizational, and human resources, based on the specific gaps and needs of a given country or research area.

Project description:BACKGROUND:Leadership by point-of-care and senior managers is increasingly recognized as critical to the acceptance and use of research evidence in practice. The purpose of this systematic review was to identify the leadership behaviours of managers that are associated with research use by clinical staff in nursing and allied health professionals. METHODS:A mixed methods systematic review was performed. Eight electronic bibliographic databases were searched. Studies examining the association between leadership behaviours and nurses and allied health professionals' use of research were eligible for inclusion. Studies were excluded if leadership could not be clearly attributed to someone in a management position. Two reviewers independently screened abstracts, reviewed full-text articles, extracted data and performed quality assessments. Narrative synthesis was conducted. RESULTS:The search yielded 7019 unique titles and abstracts after duplicates were removed. Three hundred five full-text articles were reviewed, and 31 studies reported in 34 articles were included. Methods used were qualitative (n?=?19), cross-sectional survey (n?=?9), and mixed methods (n?=?3). All studies included nurses, and six also included allied health professionals. Twelve leadership behaviours were extracted from the data for point-of-care managers and ten for senior managers. Findings indicated that managers performed a diverse range of leadership behaviours that encompassed change-oriented, relation-oriented and task-oriented behaviours. The most commonly described behavior was support for the change, which involved demonstrating conceptual and operational commitment to research-based practices. CONCLUSIONS:This systematic review adds to the growing body of evidence that indicates that manager-staff dyads are influential in translating research evidence into action. Findings also reveal that leadership for research use involves change and task-oriented behaviours that influence the environmental milieu and the organisational infrastructure that supports clinical care. While findings explain how managers enact leadership for research use, we now require robust methodological studies to determine which behaviours are effective in enabling research use with nurses and allied health professionals for high-quality evidence-based care. TRIAL REGISTRATION:PROSPERO CRD42014007660.

Project description:ImportanceComputed tomographic (CT) scanning is the standard for the rapid diagnosis of intracranial injury, but it is costly and exposes patients to ionizing radiation. The Pediatric Emergency Care Applied Research Network (PECARN) rules for identifying children with minor head trauma who are at very low risk of clinically important traumatic brain injury (ciTBI) are widely used to triage CT imaging.ObjectiveTo examine whether optimal classification trees (OCTs), which are novel machine-learning classifiers, improve on PECARN rules' predictive accuracy.Design, setting, and participantsA secondary analysis of prospective, publicly available data on emergency department visits for head trauma used by the PECARN group to develop their tool was conducted to derive OCT-based prediction rules for ciTBI in a development cohort and compare their predictive performance vs the PECARN rules in a validation cohort among children who were younger than 2 years and 2 years or older. Data on 42 412 children with head trauma and without severely altered mental status who were examined between June 1, 2004, and September 30, 2006, were gathered from 25 emergency departments in North America participating in PECARN. Data analysis was conducted from September 15, 2016, to December 18, 2018.Main outcomes and measuresThe outcome was ciTBI, with predictive performance measured by estimating the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for the OCT and the PECARN rules. The OCT and PECARN rules' performance was compared by estimating ratios for each measure.ResultsOf the 42 412 children (15 996 [37.7%] girls) included in the analysis, 10 718 were younger than 2 years (25.3%; mean [SD] age, 11.6 [0.6] months) and 31 694 were 2 years or older (74.7%; age, 9.1 [4.9] years). Compared with PECARN rules, OCTs misclassified 0 vs 1 child with ciTBI in the younger and 10 vs 9 children with ciTBI in the older cohort, and correctly identified more children with very low risk of ciTBI in the younger (7605 vs 5701) and older (20 594 vs 18 134) cohorts. In the validation cohorts, compared with the PECARN rules, the OCTs had statistically significantly better specificity (in the younger cohort: 69.3%; 95% CI, 67.4%-71.2% vs 52.8%; 95% CI, 50.8%-54.9%; in the older cohort: 65.6%; 95% CI, 64.5%-66.8% vs 57.6%; 95% CI, 56.4%-58.8%), positive predictive value (odds ratios, 1.54; 95% CI, 1.36-1.74 and 1.23; 95% CI, 1.17-1.30, in younger and older children, respectively), and positive likelihood ratio (risk ratios, 1.54; 95% CI, 1.36-1.74 and 1.23; 95% CI, 1.17-1.30, in younger and older children, respectively). There were no statistically significant differences in the sensitivity, negative predictive value, and negative likelihood ratio between the 2 sets of rules.Conclusions and relevanceIf implemented, OCTs may help reduce the number of unnecessary CT scans, without missing more patients with ciTBI than the PECARN rules.

Dataset Information

Learning from the emergence of NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs): a systematic review of evaluations.

Background

Methods

Results

Conclusions

Trial registration

Publications

Learning from the emergence of NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs): a systematic review of evaluations.

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