Implementation, Trust and the Provision of Health Care

Lead Research Organisation: MRC Health Services Resrch Collaboration

Abstract

This programme will make a substantial contribution to the field of knowledge translation and implementation research. Drawing on case studies from a range of different clinical settings involving acute and chronic illnesses, it will examine how implementation strategies affect the way research evidence is translated into changes in policy and practitioner behaviour in different social and organisational contexts.

Technical Summary

We are working on two related research questions: 1) Trust relations in health care, and how they impact on service delivery. 2) Implementation, and how research evidence is translated into practice. We have developed an agenda for further research based on a systematic review, an international workshop exploring the major theoretical and methodological questions in trust research, and empirical research using both survey (including an international comparison) and qualitative methods to explore some of the key questions on our research agenda . A key question relates to the salience of trust relations in the implementation process. A cross unit appointment funded by the MRC PHSRN has been set up (in collaboration with the MRC Social and Public Health Unit and the GPRF), the researcher will conduct a scoping review of the implementation literature, identifying areas that require further research into the translation, dissemination and implementation of research into policy and practice. We will hold a workshop to disseminate the findings of this review and for its conclusions to inform an empirical study into how evidence emerging from MRC funded research is disseminated and implemented, using both prospective and retrospective case studies. Given the political salience of the effectiveness of institutions such as NICE, a study has been initiated which is using a prospective design and qualitative methods to explore the implementation of NICE guidelines in different clinical and organisational settings. We are also examining the contexts in which clinical practice changes through links with two HTA Trials (sickle screening in primary care, SHIFT and management of depression through exercise, TREAD), using qualitative methods.

Publications

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