Collaborations for Leadership in Applied Health Research and Care: lessons from the theory of communities of practice

Abstract

BackgroundThe paper combines the analytical and instrumental perspectives on communities of practice (CoPs) to reflect on potential challenges that may arise in the process of interprofessional and inter-organisational joint working within the Collaborations for Leaderships in Applied Health Research and Care (CLAHRCs)--partnerships between the universities and National Health Service (NHS) Trusts aimed at conducting applied health research and translating its findings into day-to-day clinical practice.DiscussionThe paper discusses seminal theoretical literature on CoPs as well as previous empirical research on the role of these communities in healthcare collaboration, which is organised around the following three themes: knowledge sharing within and across CoPs, CoP formation and manageability, and identity building in CoPs. It argues that the multiprofessional and multi-agency nature of the CLAHRCs operating in the traditionally demarcated organisational landscape of the NHS may present formidable obstacles to knowledge sharing between various professional groupings, formation of a shared 'collaborative' identity, and the development of new communities within the CLAHRCs. To cross multiple boundaries between various professional and organisational communities and hence enable the flow of knowledge, the CLAHRCs will have to create an effective system of 'bridges' involving knowledge brokers, boundary objects, and cross-disciplinary interactions as well as address a number of issues related to professional and organisational identification.SummaryThe CoP approach can complement traditional 'stage-of-change' theories used in the field of implementation research and provide a basis for designing theory-informed interventions and evaluations. It can help to illuminate multiple boundaries that exist between professional and organisational groups within the CLAHRCs and suggest ways of crossing those boundaries to enable knowledge transfer and organisational learning. Achieving the aims of the CLAHRCs and producing a sustainable change in the ways applied health research is conducted and implemented may be influenced by how effectively these organisations can navigate through the multiple CoPs involved and promote the development of new multiprofessional and multi-organisational communities united by shared practice and a shared sense of belonging--an assumption that needs to be explored by further empirical research.

Getting the most out of knowledge and innovation transfer agents in health care: a qualitative study

“…[39][40][41][42][43][44][45][46] The reports to date highlight similarities and differences between structural and content features of the CLAHRCs and point to early successes and challenges. For example, successes include strengthened networks and relationships; 39,44,47 new organisational roles that 'make sense to professionals'; collective action to improve practices; 48 and creating a culture of reflection and learning.…”

“…Baumbusch et al 91 explain how project meetings were used to feed back emerging findings for practitioners to action, and for practitioners to provide context that would assist interpretation of the findings. Kislov et al 40 describe such events and artefacts as 'boundary objects'. Others also write of the importance of colocating the partners, which facilitates not only formal face-to-face meetings but also informal discussion 'at the water cooler'.…”

Not just a talking shop: practitioner perspectives on how communities of practice work to improve outcomes for people experiencing multiple exclusion homelessness

“…It has been suggested that theory is not sufficiently utilised in the context of implementation research (Kislov et al, 2011). With regard to communities of practice, the literature surfaces two distinct theoretical propositions about the instrumental use of communities of practice and how their cultivation might improve collaborative responses in such a way as to impact on service user outcomes.…”

“…In the healthcare sector, they have mostly been developed as unprofessional entities. Here, there is evidence that can play a role in the generation of social, human, organisational, professional and patient capital thus being useful for enhancing care, providing learning opportunities, analysing practice, problem solving, sharing knowledge and generating ideas (Kislov et al 2011). Much less is known about the development of interdisciplinary communities of practice (Kilbride et al, 2011).…”

Exploring a “community of practice” methodology as a regional platform for large-scale collaboration in cancer surgery—the Ottawa approach

“…It has also been increasingly used as a theoretical approach to analyze and compare large-scale health care collaborations 1,5,8 . Additionally, a number of recent research findings have suggested that features of cop might be beneficial in addressing the challenges of multi-professional, multi-organizational collaborations [9][10][11] .The present paper attempts to close the gap between cop conceptualization and its application in health care settings by describing a working model that was used in the implementation of regional cops in cancer surgery. In addition, we explore the nature of peer networks within health care organizations and the opportunity for integrating existing networks from independent hospitals within a region into a manageable community.…”