Moving improvement research closer to practice: the Researcher-in-Residence model

Abstract

The traditional separation of the producers of research evidence in academia from the users of that evidence in healthcare organisations has not succeeded in closing the gap between what is known about the organisation and delivery of health services and what is actually done in practice. As a consequence, there is growing interest in alternative models of knowledge creation and mobilisation, ones which emphasise collaboration, active participation of all stakeholders, and a commitment to shared learning. Such models have robust historical, philosophical and methodological foundations but have not yet been embraced by many of the people working in the health sector. This paper presents an emerging model of participation, the Researcher-in-Residence. The model positions the researcher as a core member of a delivery team, actively negotiating a body of expertise which is different from, but complementary to, the expertise of managers and clinicians. Three examples of in-residence models are presented: an anthropologist working as a member of an executive team, operational researchers working in a front-line delivery team, and a Health Services Researcher working across an integrated care organisation. Each of these examples illustrates the contribution that an embedded researcher can make to a service-based team. They also highlight a number of unanswered questions about the model, including the required level of experience of the researcher and their areas of expertise, the institutional facilitators and barriers to embedding the model, and the risk that the independence of an embedded researcher might be compromised. The Researcher-in-Residence model has the potential to engage both academics and practitioners in the promotion of evidence-informed service improvement, but further evaluation is required before the model should be routinely used in practice.

Increasing the impact of health services research on service improvement: the researcher-in-residence model

“…The examples share three characteristics which define the model as an exemplar of co-production knowledge mobilisation principles. 11 First, the researcher(s) involved spend most of their time embedded in an operational team, rather than in an academic institution. As core members of the team, they share responsibility for delivering the team's objectives, working alongside managers, clinicians and service users.…”

“…12 The lessons from these examples 11,13 are being used to further develop the model in preparation for a comprehensive evaluation. Early learning suggests that the model is adding value to current approaches to both research and knowledge mobilisation, but is also highlighting some real challenges.…”

Development and implementation of a real time statistical control method to identify the start and end of the winter surge in demand for paediatric intensive care

“…The embedded research role held by the lead 25 author facilitated this engagement and seems a promising approach for implementing practical OR solutions within clinical settings (Marshall et al, 2014).…”

Researchers-in-Residence: a solution to the challenge of evidence-informed improvement?

“…One emerging approach is the Researcherin-Residence Model (Marshall et al, 2014). An in-residence researcher works as an integrated member of a service-based improvement team rather than as a dispassionate observer of improvement activities.…”

“…A number of different examples of the model are being developed (Marshall et al, 2014); an ethnographer working as an Anthropologistin-Residence in an executive team of a large teaching hospital helping to address problems with clinician engagement; an operational researcher working as a Modeller-in-Residence in a paediatric cardiac surgery team helping to find solutions to long operative waiting lists; a Health Service Researcher-in-Residence working in an integrated care organisation to improve the impact of a number of quality improvement programmes. Other examples are emerging, each of which will allow the model to be tested and further developed.…”