empirical investigation qualitative research

• Skip to main content
• Skip to primary sidebar
• Skip to footer
• QuestionPro

• Solutions Industries Gaming Automotive Sports and events Education Government Travel & Hospitality Financial Services Healthcare Cannabis Technology Use Case NPS+ Communities Audience Contactless surveys Mobile LivePolls Member Experience GDPR Positive People Science 360 Feedback Surveys
• Resources Blog eBooks Survey Templates Case Studies Training Help center

Home Market Research

Empirical Research: Definition, Methods, Types and Examples

Content Index

Empirical research: Definition

Empirical research: origin, quantitative research methods, qualitative research methods, steps for conducting empirical research, empirical research methodology cycle, advantages of empirical research, disadvantages of empirical research, why is there a need for empirical research.

Empirical research is defined as any research where conclusions of the study is strictly drawn from concretely empirical evidence, and therefore “verifiable” evidence.

This empirical evidence can be gathered using quantitative market research and  qualitative market research  methods.

For example: A research is being conducted to find out if listening to happy music in the workplace while working may promote creativity? An experiment is conducted by using a music website survey on a set of audience who are exposed to happy music and another set who are not listening to music at all, and the subjects are then observed. The results derived from such a research will give empirical evidence if it does promote creativity or not.

LEARN ABOUT: Behavioral Research

You must have heard the quote” I will not believe it unless I see it”. This came from the ancient empiricists, a fundamental understanding that powered the emergence of medieval science during the renaissance period and laid the foundation of modern science, as we know it today. The word itself has its roots in greek. It is derived from the greek word empeirikos which means “experienced”.

In today’s world, the word empirical refers to collection of data using evidence that is collected through observation or experience or by using calibrated scientific instruments. All of the above origins have one thing in common which is dependence of observation and experiments to collect data and test them to come up with conclusions.

LEARN ABOUT: Causal Research

Types and methodologies of empirical research

Empirical research can be conducted and analysed using qualitative or quantitative methods.

• Quantitative research : Quantitative research methods are used to gather information through numerical data. It is used to quantify opinions, behaviors or other defined variables . These are predetermined and are in a more structured format. Some of the commonly used methods are survey, longitudinal studies, polls, etc
• Qualitative research:   Qualitative research methods are used to gather non numerical data.  It is used to find meanings, opinions, or the underlying reasons from its subjects. These methods are unstructured or semi structured. The sample size for such a research is usually small and it is a conversational type of method to provide more insight or in-depth information about the problem Some of the most popular forms of methods are focus groups, experiments, interviews, etc.

Data collected from these will need to be analysed. Empirical evidence can also be analysed either quantitatively and qualitatively. Using this, the researcher can answer empirical questions which have to be clearly defined and answerable with the findings he has got. The type of research design used will vary depending on the field in which it is going to be used. Many of them might choose to do a collective research involving quantitative and qualitative method to better answer questions which cannot be studied in a laboratory setting.

LEARN ABOUT: Qualitative Research Questions and Questionnaires

Quantitative research methods aid in analyzing the empirical evidence gathered. By using these a researcher can find out if his hypothesis is supported or not.

• Survey research: Survey research generally involves a large audience to collect a large amount of data. This is a quantitative method having a predetermined set of closed questions which are pretty easy to answer. Because of the simplicity of such a method, high responses are achieved. It is one of the most commonly used methods for all kinds of research in today’s world.

Previously, surveys were taken face to face only with maybe a recorder. However, with advancement in technology and for ease, new mediums such as emails , or social media have emerged.

For example: Depletion of energy resources is a growing concern and hence there is a need for awareness about renewable energy. According to recent studies, fossil fuels still account for around 80% of energy consumption in the United States. Even though there is a rise in the use of green energy every year, there are certain parameters because of which the general population is still not opting for green energy. In order to understand why, a survey can be conducted to gather opinions of the general population about green energy and the factors that influence their choice of switching to renewable energy. Such a survey can help institutions or governing bodies to promote appropriate awareness and incentive schemes to push the use of greener energy.

Learn more: Renewable Energy Survey Template Descriptive Research vs Correlational Research

• Experimental research: In experimental research , an experiment is set up and a hypothesis is tested by creating a situation in which one of the variable is manipulated. This is also used to check cause and effect. It is tested to see what happens to the independent variable if the other one is removed or altered. The process for such a method is usually proposing a hypothesis, experimenting on it, analyzing the findings and reporting the findings to understand if it supports the theory or not.

For example: A particular product company is trying to find what is the reason for them to not be able to capture the market. So the organisation makes changes in each one of the processes like manufacturing, marketing, sales and operations. Through the experiment they understand that sales training directly impacts the market coverage for their product. If the person is trained well, then the product will have better coverage.

• Correlational research: Correlational research is used to find relation between two set of variables . Regression analysis is generally used to predict outcomes of such a method. It can be positive, negative or neutral correlation.

LEARN ABOUT: Level of Analysis

For example: Higher educated individuals will get higher paying jobs. This means higher education enables the individual to high paying job and less education will lead to lower paying jobs.

• Longitudinal study: Longitudinal study is used to understand the traits or behavior of a subject under observation after repeatedly testing the subject over a period of time. Data collected from such a method can be qualitative or quantitative in nature.

For example: A research to find out benefits of exercise. The target is asked to exercise everyday for a particular period of time and the results show higher endurance, stamina, and muscle growth. This supports the fact that exercise benefits an individual body.

• Cross sectional: Cross sectional study is an observational type of method, in which a set of audience is observed at a given point in time. In this type, the set of people are chosen in a fashion which depicts similarity in all the variables except the one which is being researched. This type does not enable the researcher to establish a cause and effect relationship as it is not observed for a continuous time period. It is majorly used by healthcare sector or the retail industry.

For example: A medical study to find the prevalence of under-nutrition disorders in kids of a given population. This will involve looking at a wide range of parameters like age, ethnicity, location, incomes  and social backgrounds. If a significant number of kids coming from poor families show under-nutrition disorders, the researcher can further investigate into it. Usually a cross sectional study is followed by a longitudinal study to find out the exact reason.

• Causal-Comparative research : This method is based on comparison. It is mainly used to find out cause-effect relationship between two variables or even multiple variables.

For example: A researcher measured the productivity of employees in a company which gave breaks to the employees during work and compared that to the employees of the company which did not give breaks at all.

LEARN ABOUT: Action Research

Some research questions need to be analysed qualitatively, as quantitative methods are not applicable there. In many cases, in-depth information is needed or a researcher may need to observe a target audience behavior, hence the results needed are in a descriptive analysis form. Qualitative research results will be descriptive rather than predictive. It enables the researcher to build or support theories for future potential quantitative research. In such a situation qualitative research methods are used to derive a conclusion to support the theory or hypothesis being studied.

LEARN ABOUT: Qualitative Interview

• Case study: Case study method is used to find more information through carefully analyzing existing cases. It is very often used for business research or to gather empirical evidence for investigation purpose. It is a method to investigate a problem within its real life context through existing cases. The researcher has to carefully analyse making sure the parameter and variables in the existing case are the same as to the case that is being investigated. Using the findings from the case study, conclusions can be drawn regarding the topic that is being studied.

For example: A report mentioning the solution provided by a company to its client. The challenges they faced during initiation and deployment, the findings of the case and solutions they offered for the problems. Such case studies are used by most companies as it forms an empirical evidence for the company to promote in order to get more business.

• Observational method:   Observational method is a process to observe and gather data from its target. Since it is a qualitative method it is time consuming and very personal. It can be said that observational research method is a part of ethnographic research which is also used to gather empirical evidence. This is usually a qualitative form of research, however in some cases it can be quantitative as well depending on what is being studied.

For example: setting up a research to observe a particular animal in the rain-forests of amazon. Such a research usually take a lot of time as observation has to be done for a set amount of time to study patterns or behavior of the subject. Another example used widely nowadays is to observe people shopping in a mall to figure out buying behavior of consumers.

• One-on-one interview: Such a method is purely qualitative and one of the most widely used. The reason being it enables a researcher get precise meaningful data if the right questions are asked. It is a conversational method where in-depth data can be gathered depending on where the conversation leads.

For example: A one-on-one interview with the finance minister to gather data on financial policies of the country and its implications on the public.

• Focus groups: Focus groups are used when a researcher wants to find answers to why, what and how questions. A small group is generally chosen for such a method and it is not necessary to interact with the group in person. A moderator is generally needed in case the group is being addressed in person. This is widely used by product companies to collect data about their brands and the product.

For example: A mobile phone manufacturer wanting to have a feedback on the dimensions of one of their models which is yet to be launched. Such studies help the company meet the demand of the customer and position their model appropriately in the market.

• Text analysis: Text analysis method is a little new compared to the other types. Such a method is used to analyse social life by going through images or words used by the individual. In today’s world, with social media playing a major part of everyone’s life, such a method enables the research to follow the pattern that relates to his study.

For example: A lot of companies ask for feedback from the customer in detail mentioning how satisfied are they with their customer support team. Such data enables the researcher to take appropriate decisions to make their support team better.

Sometimes a combination of the methods is also needed for some questions that cannot be answered using only one type of method especially when a researcher needs to gain a complete understanding of complex subject matter.

We recently published a blog that talks about examples of qualitative data in education ; why don’t you check it out for more ideas?

Since empirical research is based on observation and capturing experiences, it is important to plan the steps to conduct the experiment and how to analyse it. This will enable the researcher to resolve problems or obstacles which can occur during the experiment.

Step #1: Define the purpose of the research

This is the step where the researcher has to answer questions like what exactly do I want to find out? What is the problem statement? Are there any issues in terms of the availability of knowledge, data, time or resources. Will this research be more beneficial than what it will cost.

Before going ahead, a researcher has to clearly define his purpose for the research and set up a plan to carry out further tasks.

Step #2 : Supporting theories and relevant literature

The researcher needs to find out if there are theories which can be linked to his research problem . He has to figure out if any theory can help him support his findings. All kind of relevant literature will help the researcher to find if there are others who have researched this before, or what are the problems faced during this research. The researcher will also have to set up assumptions and also find out if there is any history regarding his research problem

Step #3: Creation of Hypothesis and measurement

Before beginning the actual research he needs to provide himself a working hypothesis or guess what will be the probable result. Researcher has to set up variables, decide the environment for the research and find out how can he relate between the variables.

Researcher will also need to define the units of measurements, tolerable degree for errors, and find out if the measurement chosen will be acceptable by others.

Step #4: Methodology, research design and data collection

In this step, the researcher has to define a strategy for conducting his research. He has to set up experiments to collect data which will enable him to propose the hypothesis. The researcher will decide whether he will need experimental or non experimental method for conducting the research. The type of research design will vary depending on the field in which the research is being conducted. Last but not the least, the researcher will have to find out parameters that will affect the validity of the research design. Data collection will need to be done by choosing appropriate samples depending on the research question. To carry out the research, he can use one of the many sampling techniques. Once data collection is complete, researcher will have empirical data which needs to be analysed.

LEARN ABOUT: Best Data Collection Tools

Step #5: Data Analysis and result

Data analysis can be done in two ways, qualitatively and quantitatively. Researcher will need to find out what qualitative method or quantitative method will be needed or will he need a combination of both. Depending on the unit of analysis of his data, he will know if his hypothesis is supported or rejected. Analyzing this data is the most important part to support his hypothesis.

Step #6: Conclusion

A report will need to be made with the findings of the research. The researcher can give the theories and literature that support his research. He can make suggestions or recommendations for further research on his topic.

A.D. de Groot, a famous dutch psychologist and a chess expert conducted some of the most notable experiments using chess in the 1940’s. During his study, he came up with a cycle which is consistent and now widely used to conduct empirical research. It consists of 5 phases with each phase being as important as the next one. The empirical cycle captures the process of coming up with hypothesis about how certain subjects work or behave and then testing these hypothesis against empirical data in a systematic and rigorous approach. It can be said that it characterizes the deductive approach to science. Following is the empirical cycle.

• Observation: At this phase an idea is sparked for proposing a hypothesis. During this phase empirical data is gathered using observation. For example: a particular species of flower bloom in a different color only during a specific season.
• Induction: Inductive reasoning is then carried out to form a general conclusion from the data gathered through observation. For example: As stated above it is observed that the species of flower blooms in a different color during a specific season. A researcher may ask a question “does the temperature in the season cause the color change in the flower?” He can assume that is the case, however it is a mere conjecture and hence an experiment needs to be set up to support this hypothesis. So he tags a few set of flowers kept at a different temperature and observes if they still change the color?
• Deduction: This phase helps the researcher to deduce a conclusion out of his experiment. This has to be based on logic and rationality to come up with specific unbiased results.For example: In the experiment, if the tagged flowers in a different temperature environment do not change the color then it can be concluded that temperature plays a role in changing the color of the bloom.
• Testing: This phase involves the researcher to return to empirical methods to put his hypothesis to the test. The researcher now needs to make sense of his data and hence needs to use statistical analysis plans to determine the temperature and bloom color relationship. If the researcher finds out that most flowers bloom a different color when exposed to the certain temperature and the others do not when the temperature is different, he has found support to his hypothesis. Please note this not proof but just a support to his hypothesis.
• Evaluation: This phase is generally forgotten by most but is an important one to keep gaining knowledge. During this phase the researcher puts forth the data he has collected, the support argument and his conclusion. The researcher also states the limitations for the experiment and his hypothesis and suggests tips for others to pick it up and continue a more in-depth research for others in the future. LEARN MORE: Population vs Sample

LEARN MORE: Population vs Sample

There is a reason why empirical research is one of the most widely used method. There are a few advantages associated with it. Following are a few of them.

• It is used to authenticate traditional research through various experiments and observations.
• This research methodology makes the research being conducted more competent and authentic.
• It enables a researcher understand the dynamic changes that can happen and change his strategy accordingly.
• The level of control in such a research is high so the researcher can control multiple variables.
• It plays a vital role in increasing internal validity .

Even though empirical research makes the research more competent and authentic, it does have a few disadvantages. Following are a few of them.

• Such a research needs patience as it can be very time consuming. The researcher has to collect data from multiple sources and the parameters involved are quite a few, which will lead to a time consuming research.
• Most of the time, a researcher will need to conduct research at different locations or in different environments, this can lead to an expensive affair.
• There are a few rules in which experiments can be performed and hence permissions are needed. Many a times, it is very difficult to get certain permissions to carry out different methods of this research.
• Collection of data can be a problem sometimes, as it has to be collected from a variety of sources through different methods.

LEARN ABOUT:  Social Communication Questionnaire

Empirical research is important in today’s world because most people believe in something only that they can see, hear or experience. It is used to validate multiple hypothesis and increase human knowledge and continue doing it to keep advancing in various fields.

For example: Pharmaceutical companies use empirical research to try out a specific drug on controlled groups or random groups to study the effect and cause. This way, they prove certain theories they had proposed for the specific drug. Such research is very important as sometimes it can lead to finding a cure for a disease that has existed for many years. It is useful in science and many other fields like history, social sciences, business, etc.

LEARN ABOUT: 12 Best Tools for Researchers

With the advancement in today’s world, empirical research has become critical and a norm in many fields to support their hypothesis and gain more knowledge. The methods mentioned above are very useful for carrying out such research. However, a number of new methods will keep coming up as the nature of new investigative questions keeps getting unique or changing.

Create a single source of real data with a built-for-insights platform. Store past data, add nuggets of insights, and import research data from various sources into a CRM for insights. Build on ever-growing research with a real-time dashboard in a unified research management platform to turn insights into knowledge.

LEARN MORE         FREE TRIAL

MORE LIKE THIS

The Power of AI in Customer Experience — Tuesday CX Thoughts

Apr 16, 2024

Employee Lifecycle Management Software: Top of 2024

Apr 15, 2024

Top 15 Sentiment Analysis Software That Should Be on Your List

Top 13 A/B Testing Software for Optimizing Your Website

Apr 12, 2024

Other categories

• Academic Research
• Artificial Intelligence
• Assessments
• Brand Awareness
• Case Studies
• Communities
• Consumer Insights
• Customer effort score
• Customer Engagement
• Customer Experience
• Customer Loyalty
• Customer Research
• Customer Satisfaction
• Employee Benefits
• Employee Engagement
• Employee Retention
• Friday Five
• General Data Protection Regulation
• Insights Hub
• Life@QuestionPro
• Market Research
• Mobile diaries
• Mobile Surveys
• New Features
• Online Communities
• Question Types
• Questionnaire
• QuestionPro Products
• Release Notes
• Research Tools and Apps
• Revenue at Risk
• Survey Templates
• Training Tips
• Uncategorized
• Video Learning Series
• What’s Coming Up
• Workforce Intelligence

Canvas | University | Ask a Librarian

• Library Homepage
• Arrendale Library

Empirical Research: Quantitative & Qualitative

• Empirical Research

Introduction: What is Empirical Research?

Quantitative methods, qualitative methods.

• Quantitative vs. Qualitative
• Reference Works for Social Sciences Research
• Contact Us!

 Call us at 706-776-0111

  Chat with a Librarian

  Send Us Email

  Library Hours

Empirical research  is based on phenomena that can be observed and measured. Empirical research derives knowledge from actual experience rather than from theory or belief. 

Key characteristics of empirical research include:

• Specific research questions to be answered;
• Definitions of the population, behavior, or phenomena being studied;
• Description of the methodology or research design used to study this population or phenomena, including selection criteria, controls, and testing instruments (such as surveys);
• Two basic research processes or methods in empirical research: quantitative methods and qualitative methods (see the rest of the guide for more about these methods).

(based on the original from the Connelly LIbrary of LaSalle University)

Empirical Research: Qualitative vs. Quantitative

Learn about common types of journal articles that use APA Style, including empirical studies; meta-analyses; literature reviews; and replication, theoretical, and methodological articles.

Academic Writer

© 2024 American Psychological Association.

• More about Academic Writer ...

Quantitative Research

A quantitative research project is characterized by having a population about which the researcher wants to draw conclusions, but it is not possible to collect data on the entire population.

• For an observational study, it is necessary to select a proper, statistical random sample and to use methods of statistical inference to draw conclusions about the population. 
• For an experimental study, it is necessary to have a random assignment of subjects to experimental and control groups in order to use methods of statistical inference.

Statistical methods are used in all three stages of a quantitative research project.

For observational studies, the data are collected using statistical sampling theory. Then, the sample data are analyzed using descriptive statistical analysis. Finally, generalizations are made from the sample data to the entire population using statistical inference.

For experimental studies, the subjects are allocated to experimental and control group using randomizing methods. Then, the experimental data are analyzed using descriptive statistical analysis. Finally, just as for observational data, generalizations are made to a larger population.

Iversen, G. (2004). Quantitative research . In M. Lewis-Beck, A. Bryman, & T. Liao (Eds.), Encyclopedia of social science research methods . (pp. 897-898). Thousand Oaks, CA: SAGE Publications, Inc.

Qualitative Research

What makes a work deserving of the label qualitative research is the demonstrable effort to produce richly and relevantly detailed descriptions and particularized interpretations of people and the social, linguistic, material, and other practices and events that shape and are shaped by them.

Qualitative research typically includes, but is not limited to, discerning the perspectives of these people, or what is often referred to as the actor’s point of view. Although both philosophically and methodologically a highly diverse entity, qualitative research is marked by certain defining imperatives that include its case (as opposed to its variable) orientation, sensitivity to cultural and historical context, and reflexivity. 

In its many guises, qualitative research is a form of empirical inquiry that typically entails some form of purposive sampling for information-rich cases; in-depth interviews and open-ended interviews, lengthy participant/field observations, and/or document or artifact study; and techniques for analysis and interpretation of data that move beyond the data generated and their surface appearances. 

Sandelowski, M. (2004).  Qualitative research . In M. Lewis-Beck, A. Bryman, & T. Liao (Eds.),  Encyclopedia of social science research methods . (pp. 893-894). Thousand Oaks, CA: SAGE Publications, Inc.

• Next: Quantitative vs. Qualitative >>
• Last Updated: Mar 22, 2024 10:47 AM
• URL: https://library.piedmont.edu/empirical-research
• Ebooks & Online Video
• New Materials
• Renew Checkouts
• Faculty Resources
• Friends of the Library
• Library Services
• Request Books from Demorest
• Our Mission
• Library History
• Ask a Librarian!
• Making Citations
• Working Online

Arrendale Library Piedmont University 706-776-0111

• Connelly Library

Qualitative and Quantitative Research

What is "empirical research".

• empirical research
• Locating Articles in Cinahl and PsycInfo
• Locating Articles in PubMed
• Getting the Articles

Empirical research  is based on observed and measured phenomena and derives knowledge from actual experience rather than from theory or belief. 

How do you know if a study is empirical? Read the subheadings within the article, book, or report and look for a description of the research "methodology."  Ask yourself: Could I recreate this study and test these results?

Key characteristics to look for:

• Specific research questions  to be answered
• Definition of the  population, behavior, or   phenomena  being studied
• Description of the  process  used to study this population or phenomena, including selection criteria, controls, and testing instruments (such as surveys)

Another hint: some scholarly journals use a specific layout, called the "IMRaD" format, to communicate empirical research findings. Such articles typically have 4 components:

• Introduction : sometimes called "literature review" -- what is currently known about the topic -- usually includes a theoretical framework and/or discussion of previous studies
• Methodology:  sometimes called "research design" --  how to recreate the study -- usually describes the population, research process, and analytical tools
• Results : sometimes called "findings"  --  what was learned through the study -- usually appears as statistical data or as substantial quotations from research participants
• Discussion : sometimes called "conclusion" or "implications" -- why the study is important -- usually describes how the research results influence professional practices or future studies
• << Previous: Home
• Next: Locating Articles in Cinahl and PsycInfo >>

© Copyright La Salle University. All rights reserved.

Have a language expert improve your writing

Run a free plagiarism check in 10 minutes, generate accurate citations for free.

• Knowledge Base

Methodology

• What Is Qualitative Research? | Methods & Examples

What Is Qualitative Research? | Methods & Examples

Published on June 19, 2020 by Pritha Bhandari . Revised on June 22, 2023.

Qualitative research involves collecting and analyzing non-numerical data (e.g., text, video, or audio) to understand concepts, opinions, or experiences. It can be used to gather in-depth insights into a problem or generate new ideas for research.

Qualitative research is the opposite of quantitative research , which involves collecting and analyzing numerical data for statistical analysis.

Qualitative research is commonly used in the humanities and social sciences, in subjects such as anthropology, sociology, education, health sciences, history, etc.

• How does social media shape body image in teenagers?
• How do children and adults interpret healthy eating in the UK?
• What factors influence employee retention in a large organization?
• How is anxiety experienced around the world?
• How can teachers integrate social issues into science curriculums?

Table of contents

Approaches to qualitative research, qualitative research methods, qualitative data analysis, advantages of qualitative research, disadvantages of qualitative research, other interesting articles, frequently asked questions about qualitative research.

Qualitative research is used to understand how people experience the world. While there are many approaches to qualitative research, they tend to be flexible and focus on retaining rich meaning when interpreting data.

Common approaches include grounded theory, ethnography , action research , phenomenological research, and narrative research. They share some similarities, but emphasize different aims and perspectives.

Note that qualitative research is at risk for certain research biases including the Hawthorne effect , observer bias , recall bias , and social desirability bias . While not always totally avoidable, awareness of potential biases as you collect and analyze your data can prevent them from impacting your work too much.

Here's why students love Scribbr's proofreading services

Discover proofreading & editing

Each of the research approaches involve using one or more data collection methods . These are some of the most common qualitative methods:

• Observations: recording what you have seen, heard, or encountered in detailed field notes.
• Interviews:  personally asking people questions in one-on-one conversations.
• Focus groups: asking questions and generating discussion among a group of people.
• Surveys : distributing questionnaires with open-ended questions.
• Secondary research: collecting existing data in the form of texts, images, audio or video recordings, etc.
• You take field notes with observations and reflect on your own experiences of the company culture.
• You distribute open-ended surveys to employees across all the company’s offices by email to find out if the culture varies across locations.
• You conduct in-depth interviews with employees in your office to learn about their experiences and perspectives in greater detail.

Qualitative researchers often consider themselves “instruments” in research because all observations, interpretations and analyses are filtered through their own personal lens.

For this reason, when writing up your methodology for qualitative research, it’s important to reflect on your approach and to thoroughly explain the choices you made in collecting and analyzing the data.

Qualitative data can take the form of texts, photos, videos and audio. For example, you might be working with interview transcripts, survey responses, fieldnotes, or recordings from natural settings.

Most types of qualitative data analysis share the same five steps:

• Prepare and organize your data. This may mean transcribing interviews or typing up fieldnotes.
• Review and explore your data. Examine the data for patterns or repeated ideas that emerge.
• Develop a data coding system. Based on your initial ideas, establish a set of codes that you can apply to categorize your data.
• Assign codes to the data. For example, in qualitative survey analysis, this may mean going through each participant’s responses and tagging them with codes in a spreadsheet. As you go through your data, you can create new codes to add to your system if necessary.
• Identify recurring themes. Link codes together into cohesive, overarching themes.

There are several specific approaches to analyzing qualitative data. Although these methods share similar processes, they emphasize different concepts.

Qualitative research often tries to preserve the voice and perspective of participants and can be adjusted as new research questions arise. Qualitative research is good for:

• Flexibility

The data collection and analysis process can be adapted as new ideas or patterns emerge. They are not rigidly decided beforehand.

• Natural settings

Data collection occurs in real-world contexts or in naturalistic ways.

• Meaningful insights

Detailed descriptions of people’s experiences, feelings and perceptions can be used in designing, testing or improving systems or products.

• Generation of new ideas

Open-ended responses mean that researchers can uncover novel problems or opportunities that they wouldn’t have thought of otherwise.

Prevent plagiarism. Run a free check.

Researchers must consider practical and theoretical limitations in analyzing and interpreting their data. Qualitative research suffers from:

• Unreliability

The real-world setting often makes qualitative research unreliable because of uncontrolled factors that affect the data.

• Subjectivity

Due to the researcher’s primary role in analyzing and interpreting data, qualitative research cannot be replicated . The researcher decides what is important and what is irrelevant in data analysis, so interpretations of the same data can vary greatly.

• Limited generalizability

Small samples are often used to gather detailed data about specific contexts. Despite rigorous analysis procedures, it is difficult to draw generalizable conclusions because the data may be biased and unrepresentative of the wider population .

• Labor-intensive

Although software can be used to manage and record large amounts of text, data analysis often has to be checked or performed manually.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Chi square goodness of fit test
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Inclusion and exclusion criteria

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

Quantitative research deals with numbers and statistics, while qualitative research deals with words and meanings.

Quantitative methods allow you to systematically measure variables and test hypotheses . Qualitative methods allow you to explore concepts and experiences in more detail.

There are five common approaches to qualitative research :

• Grounded theory involves collecting data in order to develop new theories.
• Ethnography involves immersing yourself in a group or organization to understand its culture.
• Narrative research involves interpreting stories to understand how people make sense of their experiences and perceptions.
• Phenomenological research involves investigating phenomena through people’s lived experiences.
• Action research links theory and practice in several cycles to drive innovative changes.

Data collection is the systematic process by which observations or measurements are gathered in research. It is used in many different contexts by academics, governments, businesses, and other organizations.

There are various approaches to qualitative data analysis , but they all share five steps in common:

• Prepare and organize your data.
• Review and explore your data.
• Develop a data coding system.
• Assign codes to the data.
• Identify recurring themes.

The specifics of each step depend on the focus of the analysis. Some common approaches include textual analysis , thematic analysis , and discourse analysis .

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

Bhandari, P. (2023, June 22). What Is Qualitative Research? | Methods & Examples. Scribbr. Retrieved April 16, 2024, from https://www.scribbr.com/methodology/qualitative-research/

Is this article helpful?

Pritha Bhandari

Other students also liked, qualitative vs. quantitative research | differences, examples & methods, how to do thematic analysis | step-by-step guide & examples, what is your plagiarism score.

Challenges and Opportunities in Qualitative Research pp 1–5 Cite as

Introduction: Qualitative Research Methods in Empirical Social Sciences Studies—Young Scholars’ Perspectives and Experiences

• Kwok Kuen Tsang 4 ,
• Dian Liu 5 &
• Yanbi Hong 6  
• First Online: 05 January 2019

1307 Accesses

Positivism is a dominant ideology in social sciences research. It assumes that the social world is an objectively and externally existing object. Therefore, patterns of social world are waiting for us as researchers to discover, predict, and even control. In order to achieve these, positivists suggest we investigate the social world applying scientific methods, which are value-free, objective, and with structured strategies and procedures of inquires similar to those applied in natural sciences. By using scientific methods, positivists believe that researchers can discover the social world and find out the truth. In social sciences, due to the long-term ideology emphasizing the statistical measurements in empirical studies, quantitative research methods have long been favored.

This is a preview of subscription content, log in via an institution .

Buying options

• Available as PDF
• Read on any device
• Instant download
• Own it forever
• Available as EPUB and PDF
• Compact, lightweight edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Amos, H. J. (2002). Doing qualitative research in education settings . Albany: Stat University of New York Press.

Google Scholar  

Babbie, E. (2015). The practice of social research (15th ed.). Belmont: Thomson Wadsworth.

Bryman, A. (2004). Quantity and quality in social research . London: Routledge.

Creswell, J. W. (2007). Qualitative inquiry & research design: Choosing among five approaches (2nd ed.). Thousand Oaks: Sage Publications.

Denzin, N. K., & Lincoln, Y. S. (1994). Introduction: Entering the field of qualitative research. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (pp. 1–18). Thousand Oaks: Sage Publications.

Esterberg, K. G. (2002). Qualitative methods in social research . Boston: McGraw-Hill.

Knoblauch, H. (2013). Qualitative methods at the crossroads: Recent developments in interpretive social research. Forum: Qualitative Social Research, 14 (3), Article 12. http://www.qualitative-research.net/index.php/fqs/article/view/2063 .

Rennie, D. L., Watson, K. D., & Monteiro, A. M. (2002). The rise of qualitative research in psychology. Canadian Psychology, 43 (3), 179–189.

Article   Google Scholar  

Savin-Baden, M., & Major, C. H. (2010). Introduction: The uncertanity of wisdom. In M. Savin-Baden & C. H. Major (Eds.), New approahces to qualitative research: Wisdom and uncertainty (pp. 1–5). London: Routledge.

Chapter   Google Scholar  

Download references

Author information

Authors and affiliations.

College of Educational Administration, Faculty of Education, Beijing Normal University, Beijing, China

Kwok Kuen Tsang

Department of Media and Social Sciences, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway

Department of Sociology, School of Humanities, Southeast University, Nanjing, China

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Kwok Kuen Tsang .

Editor information

Editors and affiliations.

Faculty of Education, Beijing Normal University, Beijing, China

Faculty of Social Sciences, University of Stavanger, Stavanger, Norway

School of Humanities, Southeast University, Nanjing, Jiangsu, China

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Cite this chapter.

Tsang, K.K., Liu, D., Hong, Y. (2019). Introduction: Qualitative Research Methods in Empirical Social Sciences Studies—Young Scholars’ Perspectives and Experiences. In: Tsang, K., Liu, D., Hong, Y. (eds) Challenges and Opportunities in Qualitative Research. Springer, Singapore. https://doi.org/10.1007/978-981-13-5811-1_1

Download citation

DOI : https://doi.org/10.1007/978-981-13-5811-1_1

Published : 05 January 2019

Publisher Name : Springer, Singapore

Print ISBN : 978-981-13-5810-4

Online ISBN : 978-981-13-5811-1

eBook Packages : Social Sciences Social Sciences (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

To read this content please select one of the options below:

Please note you do not have access to teaching notes, defining qualitative management research: an empirical investigation.

Qualitative Research in Organizations and Management

ISSN : 1746-5648

Article publication date: 15 May 2007

The purpose of this paper is to report the findings of research which explores how the concept qualitative management research is variably constructed and defined by those who have a direct interest in, and influence upon, important aspects of qualitative management research.

Design/methodology/approach

Information was gathered through the use of semi‐structured interviews conducted with 44 individuals who were drawn from four observer‐identified types of “expert” informant who were taken to generally represent key groups of stakeholders in the conduct, evaluation and dissemination of qualitative management research. Interview data from these individuals were analysed though an iterative process using the NVivo software package to inductively generate definitional categories and explore aspects of their interrelationships.

From data analysis it was apparent that there are eight different, but often interrelated, ways in which interviewees define qualitative management research. The philosophical dimensions of each of these variable definitions are outlined and their relationships to the methodological literature are explored. The variety identified amongst informants, indicates how there is a potential dissensus possible regarding what qualitative management research might entail, as well as regarding its provenance and its academic status. This dissensus potentially can create problems with regard to its evaluation.

Originality/value

So whist there is little evidence to suggest any systematic relationship between the variable institutional backgrounds of informants and how they variably define and perceive qualitative management research, philosophical influences upon this contested terrain are explored and the implications of the identified dissensus for how qualitative management research is perceived and evaluated is discussed. The implications of this evidently contested terrain are discussed with particular reference to the future constitution of qualitative management research and its evaluation.

• Qualitative methods
• Qualitative research
• Management research
• Epistemology

Johnson, P. , Buehring, A. , Cassell, C. and Symon, G. (2007), "Defining qualitative management research: an empirical investigation", Qualitative Research in Organizations and Management , Vol. 2 No. 1, pp. 23-42. https://doi.org/10.1108/17465640710749108

Emerald Group Publishing Limited

Copyright © 2007, Emerald Group Publishing Limited

Related articles

We’re listening — tell us what you think, something didn’t work….

Report bugs here

All feedback is valuable

Please share your general feedback

Join us on our journey

Platform update page.

Visit emeraldpublishing.com/platformupdate to discover the latest news and updates

Questions & More Information

Answers to the most commonly asked questions here

An official website of the United States government

The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings
• Browse Titles

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Scarbrough H, D’Andreta D, Evans S, et al. Networked innovation in the health sector: comparative qualitative study of the role of Collaborations for Leadership in Applied Health Research and Care in translating research into practice. Southampton (UK): NIHR Journals Library; 2014 May. (Health Services and Delivery Research, No. 2.13.)

Networked innovation in the health sector: comparative qualitative study of the role of Collaborations for Leadership in Applied Health Research and Care in translating research into practice.

Chapter 4 empirical analysis and findings: qualitative investigation.

• Introduction

As noted previously, to be able to address the different dimensions of CLAHRC activity relevant to our study, we adopted a ‘multilevel’ approach in our fieldwork and analysis 97 that sought to integrate evidence from both our CLAHRC-level and our project-level data collection to provide a coherent, narratively structured account of the CLAHRCs’ development.

The overall approach that we adopted to data analysis incorporated a hybrid process combining both inductive and deductive thematic analysis of interview data. 98 At a basic level, thematic analysis of interview data is simply where coding ‘is used to break up and segment the data into simpler, general categories and expand and tease out the data in order to formulate new questions and levels of interpretation’ (p. 30). 99 It was important to recognise that, in building our study on a theoretical concern with networked innovation, 31 , 79 we had already made assumptions and developed ideas about the focus for the analysis. However, it was also important to allow our analysis to be data driven to allow new ideas to emerge during the process of coding. Therefore, we needed to develop an approach that allowed us to make use of our preconceived ideas and theoretical underpinning, while still maintaining the inductive flexibility of an approach that supports the generation and development of new ideas.

As interpretive research still needs to demonstrate credibility and trustworthiness through being founded on a systematic evidence of the research process, our data analysis was supported by a structured method that combined steps in which we were ‘data driven’ and inductively developed codes based on interesting ideas and themes that emerged from our study of transcripts, together with incorporating phases of review in which we reflected on how these ideas fitted in with the overall objectives of our study. Therefore, although our research analysis was based on a linear ‘step-by-step’ procedure, this still facilitated an iterative and reflexive process. 98 However, in following a structured approach, we were able to continually reframe our analysis both based on ideas from inductive study, and allowing our theoretical grounding to be an integral part of the generation of codes.

We used NVivo to support our data analysis. While NVivo can be used to support a more objective and logical categorisation of codes, we should recognise that this is only an aid to the organisation of the material and is not in itself an interpretive device.

To structure the individual case narratives outlined below, we have adopted three major headings which reflect our conceptual framework and support critical concerns around the development of the CLAHRCs. These headings are as follows: governance, management and organisation; collaboration and networks; and KT. To begin our account, however, we focus on the way in which the goals of the CLAHRC initiative were appropriated by individual CLAHRCs in terms of the vision which they defined for themselves.

The vision of the Collaborations for Leadership in Applied Health Research and Care

As the three case sites of translational initiatives within the UK were all created through the same UK NIHR funding programme, they were all designed to meet the same aim and generic mission. However, there was significant flexibility in the way in which this mission was interpreted by the leaders of different CLAHRCs. We term these interpretive acts of leadership as different ‘visions’ of collaborative translational research. Within our study we have explored how the vision of each CLAHRC has emerged from and interacted with the structuring of the initiative, particularly in terms of management and governance. By studying the CLAHRCs’ development over time, then, the qualitative fieldwork has been able to explore how these distinctive features of each CLAHRC influence their approach to KT.

• Bluetown Collaboration for Leadership in Applied Health Research and Care

The Bluetown CLAHRC is based on a partnership with organisations from a large urban area. It is led by a university hospital with an established strong reputation in conducting research. The health-care partners are representative of a range of organisation types, including acute hospital, primary care and mental health trusts, which includes both organisations with extensive research experience and those that have been previously less involved. The CLAHRC was originally established around a simple ‘hub-and-spoke’ model of a small central management team and nine clinical project teams. The core of the CLAHRC, including its management team and several of the clinical project teams, is centred on a traditional medical school public health department with high-profile academic expertise in clinical sciences research, and historic links with the lead NHS site. Each project team is largely composed of members based in the same geographical base, with a number of teams based at the university, and other clinical project teams are located within one of the health-care partnership organisations. Specialist support services were included as a CLAHRC-wide resource, providing each clinical project team with access to people who could contribute medical sociology, health economics, methods such as systematic reviewing, and statistical expertise.

The director was integral to developing the vision for this CLAHRC and for embedding this within the different clinical projects. Throughout the development of this CLAHRC, his vision has been strongly influential on the form that the work programmes within the CLAHRC have taken as they have progressed. In particular, a clinical scientific tradition was incorporated into the design of study protocols at the start of the programme, with particular attention being placed on scientific methodological rigour, especially the production of outputs suitable for top-quality, peer-reviewed academic publication. In particular, all of the clinical projects were designed as prospective evaluation clinical-academic research studies and, therefore, constituted a set of work programmes all linked by a common scientific approach.

It’s to prospectively evaluate service delivery as it happens. And where possible to interact, you know, with managers and how the service delivery takes place. So that the product will be examples where this has happened prospectively and good examples that have been published in good places. In the process of doing that to export the idea or develop the idea in the local area. BLUETOWN001

This illustrates a cornerstone of the Bluetown CLAHRC model: the vision emphasises that the quality of the evidence being produced is crucial to its ultimate impact. As a result, the vision of this CLAHRC was founded on the view that any programme of work should first be grounded in a rigorous scientific approach, as only high-quality evidence should be taken up within health-care policy and practice.

Management, governance and organisation

The CLAHRC was originally formed around a small central leadership team, with the vision of the director strongly influencing the focus and direction of the CLAHRC model. As the director had a historically strong reputation in the local area, this helped to legitimise the CLAHRC as something that was perceived as of value by those in senior positions within the partner organisations.

The vision of the core management team has been strongly influential on the approach that each programme of work uses. Each programme of work is expected to use a rigorous scientific design and methodology in order to produce robust evidence that is suitable for publication in high-quality academic journals. Therefore, the model builds on the approach to scientific work that was historically conducted by the lead organisations, with the CLAHRC emphasising that through these work programmes the teams should foster collaborative relationships with relevant service areas. This vision is emphasised through the role of the leaders within each of the project teams, who provide scientific and methodological direction to the programme of work. However, although there is recognition of the overarching objectives expected from each team by the central management, there is no CLAHRC-wide strategy for how each team should be structured or how collaborative relationships should be formed and developed. As a result, the lead of each project team has been provided with extensive flexibility on how their individual programme is organised. As a consequence, each team tended to foster relationships with particular groups and communities as relevant to the local services on which they were gathering evaluative evidence. The influence of the CLAHRC was important here in formalising and legitimising this collaboration between clinical academics and targeted groups in the NHS.

Without CLAHRC, we would have some of those connections but I think the momentum, thrust and energy that’s going into current programme really wouldn’t be there . . . associating with individuals from other fields, groups that we wouldn’t normally be part of. This has really allowed us to reflect more objectively on work, and the direction we’re going. BLUETOWN022

Structural features of the CLAHRC were used to communicate the overarching objectives of central management to the clinical project teams. This involved regular interactions between the centre and projects, management representation at project team meetings, and programmed meetings for project leaders and project managers. The positions which project members held in other environments (i.e. outside of their own team environment) were typically construed as ‘honorary’ – that is, not part of the main role which project members perform within their clinical team or central management group ( Box 1 ).

Case example: organisational processes by which the CLAHRC vision is distributed Observation of the interactions within a project meeting illustrated how the vision of the overall initiative is emphasised through the presence of a member of the core management (more...)

Although the majority of clinical project team members share similar types of disciplinary expertise, with most having clinical–academic experience, the structural organisation of the initiative provides access to other types of expertise. The extent of the CLAHRC-wide resources means that individuals with expertise such as health economics, statistics, systematic reviewing, sociology and communication are easily available for project teams to access. With the sociology theme, for example, each project team allocated a small proportion of their own resources to support the employment of a select number of people with this type of expertise. Although these team members come from different working cultures from the majority of the CLAHRC members, it is clear to the clinical project teams that the director values and respects the expertise that these individuals can provide. This helps to legitimise their contribution within the teams, even in sociological territory, which such teams would not normally view as part of their remit. At the start of CLAHRC, the cross-cutting activity for sociology was an undefined programme of work, but this provided an opportunity for these members to liaise with the clinical project teams to identify how they could support their programme of work. As relationships were built up, they quickly identified certain project teams where they could add value to the other work that was already planned by the team lead.

We are officially termed as a cross-cutting theme but we’re also embedded in the individual research, as in our jobs are paid out of individual projects. BLUETOWN003

This cross-cutting work has become an embedded part of a proportion of the clinical project teams. Although they provide a different type of expertise to the clinical projects, the members of this cross-cutting theme enact their role in such a way as to fit in with the overall work programme. While, overall, the cross-cutting theme constitutes only a small part of the CLAHRC, resources were deliberately allocated so that the members of this group would be highly skilled and experienced, and therefore able to achieve this. They have also been able to contribute guidance to more junior members of the project teams who are involved with areas that overlap with their area of expertise, such as qualitative components. Observation from in-depth studies of the four clinical themes indicates that this approach has facilitated the ‘embedding’ of the cross-cutting theme members within the project teams.

Networks and collaboration

The qualitative interviews demonstrated that from the early stages of the CLAHRC’s development, a clear objective was understood to focus on working with stakeholder groups, such as collaborating with NHS practitioners and managers within the clinical project work. There was also acknowledgement that this required some compromise with established academic work practices, with some effort being required to produce work that is suitable for practitioners.

Getting researchers to understand practitioners is a covert aim of CLAHRC. So that you don’t go away for five years and then tell them what they should have done in the first place because practitioners don’t want to hear that. CMBLUETOWN007

The activity of each of the clinical project teams means that they create links to defined health-care organisations involved in the CLAHRC partnership. The interaction between members of the project team (e.g. the project lead) is integral to fostering the relationships among the official partner organisations of the CLAHRC. As many senior CLAHRC members had pre-existing collaborative relationships with NHS trusts, they were able to enact ‘senior’ boundary-spanning roles. Many of the theme leads were in clinical–academic dual activity roles and held honorary contract positions with NHS organisations. However, their leadership typically reflected the wider ‘epistemic’ community of a university setting, emphasising academic values rather than the practical concerns seen in the health service environment. For university-based teams, the collaborative interaction was framed by the values of the academic community, with high-level academic publication considered as important for demonstrating value to these groups. This was seen as consistent with the vision of the CLAHRC, in that the collaboration is seen as creating a culture within health-care settings which is more receptive to high-quality scientific evidence.

It’s nonsense to say . . . the PCT health, local authority or the voluntary sector don’t consider evidence. They do. They just consider evidence perhaps in a different way than you or I perhaps might consider evidence . . . The CLAHRC process is about the better, the optimal decision making that we can bring, the greater rigour, to set different parameters for making the decision. That is the value. BLUETOWN014

Thus, the CLAHRC emphasises clinical–academic evaluation of service delivery in terms of producing high-quality evidence. As a result, the CLAHRC’s applied health research is conducted on the terms set by the clinical–academic community, to which other groups must be able to fit in. At the same time, the CLAHRC’s strong scientific reputation within certain fields helps it to build links with communities that value this type of evidence, such as national policy groups and certain local clinical groups. Certain groups of health-care managers and policy makers were perceived as valuing exactly this type of evidence.

Publishing all this information in top quality journals as absolutely, absolutely key. Not just to the academic credibility of CLAHRC but to the managerial credibility of CLAHRC . . . dealing with managers, when they want to know how good somebody is the first thing they do is see whether other academics respect that person. And one method of that is you publish in the top journals. They don’t want to deal with somebody who’s not up there at the cutting edge. They want to be with the front people. BLUETOWN001

The work taking place within these themes tends to be dominated by the traditions of the theme lead and the culture where the theme is physically located. Non-health care-based teams do use ‘in-built boundary spanners’, pre-existing contacts and mechanisms such as advisory boards to draw on insights about the local health-care context ( Box 2 ). This approach enables the teams to focus on their own academic areas of expertise but perhaps supports depth rather than breadth of approach.

Case example: clinical boundary spanner within a university-based team Although this CLAHRC did not have a formalised structure within its functional design to facilitate connections between clinical project teams, the flexibility provided for each subgroup (more...)

Bluetown CLAHRC also includes a number of themes based directly in health-care organisations. As the teams working on these themes are closer to the issues of practice, their work has the potential to more easily impact on health-care practice. In ‘speaking the same language’ as the practice and community groups they intend to impact, they are in a better position to integrate the perspectives of these groups. This should facilitate the implementation of findings and local impact that these groups will have. However, as these teams are further away from the core CLAHRC, greater attention has been required to ensure that these themes feel part of the Bluetown CLAHRC community.

Knowledge translation

Bluetown CLAHRC was not built on an explicit CLAHRC-wide strategy for KT. However, as each project team was provided with extensive flexibility in how they organised their clinical study, each individual theme has developed their own strategy for dissemination of outputs, with a flexibility to interpret the aims of the CLAHRC to fit their own clinical context. As a result, the themes have developed their own tailored approaches to relating their findings to local health-care practice and policy. These are not, however, related to an overall CLAHRC plan or strategy for this approach to the work. Additionally, these approaches do not appear to be shared between the themes, and their context-specific design may potentially limit wider application.

Overall, the Bluetown CLAHRC is formed from members who represent both academic disciplines and health-care professional groups. This means that the cumulative work of Bluetown CLAHRC has the potential to innovatively incorporate many different perspectives and draw from different types of expertise. However, currently, these tend to focus on project–team connections, which limit the potential of a co-ordinated Bluetown CLAHRC effect across the region. The lack of a co-ordinated strategy to link with the different types and levels of the Bluetown partners may have limited the capacity-building of the CLAHRC as a whole, notwithstanding the benefit of the strong relationships fostered by each individual team.

As the CLAHRC developed, a new theme of knowledge management was developed by the central CLAHRC management team. This was designed as a high-level cross-cutting theme. The activity was separate from the clinical project work.

But having said all that I am very keen to in addition add a specific knowledge management function to the CLAHRC but I am very clear this is not based on discoveries made in the CLAHRC, although I would not exclude those, but it’s not based on that, it’s based on the knowledge out there in the world, what can we make of that. So knowledge exchange if you like. BLUETOWN001

However, it drew on the infrastructure that the teams had used and fostered during the early stages of the CLAHRC. In particular, it was felt that, as the clinical project teams had demonstrated activity within the NHS organisations at an early stage, NHS managers and executives valued the work of the CLAHRC, and that this facilitated buy-in for this new venture.

Due to the financial model of the CLAHRC, no specific funding was allocated to this area. However, NIHR Flexibility and Sustainability Funding money was allocated to this activity. As part of this, the core management team was expanded to include support for the clinical teams and CLAHRC as a whole with external engagement and communication and dissemination activities. In addition, a knowledge-exchange forum was developed. This was targeted at high-level managers within NHS and local authority organisations. The meetings acted as a place where NHS organisations could discuss issues that they considered important areas for further work, and the CLAHRC team developed these ideas into discrete programmes of work in which they provided the resource for tailored evidence to be produced.

In this sense, as led by the director, this CLAHRC has evolved to incorporate new objectives as it has developed over time. However, the original vision of the CLAHRC model has been central to supporting the development of these new components. In particular, the knowledge-exchange forum has drawn on the connections fostered by the clinical teams, and the reputation established within partner organisations and beyond. This has allowed them to generate a membership of executive-level personnel who are in decision-making and management positions within their own organisations. Overall, the conceptual vision of the CLAHRC has helped to expand the CLAHRC programme of work beyond the initial set of clinical projects ( Box 3 ).

Case example: evolving collaborative relationships to provide additional services Theme 1 was built on what they describe as ‘a unique opportunity offered by these changes to carry out longitudinal studies into the interaction between changing (more...)

Reflections on the Bluetown Collaboration for Leadership in Applied Health Research and Care model and its development over time

The Bluetown CLAHRC’s vision and structure enables it to collaborate readily with those communities that are more aligned with the working practices of its members. The partner organisations and the members involved in the initiative, therefore, tend to support the principle that only rigorous evidence should be used to inform service developments. However, within this constraint, the Bluetown initiative does support new operational approaches, and in particular emphasises that project teams need to develop collaborative relationships with external communities, especially management and decision-makers.

With no overarching CLAHRC-wide strategy to support KT activity, each theme has developed approaches tailored to their own local communities and clinical context to support the mobilisation of the knowledge produced through their programme of work. However, as the CLAHRC has progressed over time, central management have augmented the original structure to develop new aspects to support overall Bluetown CLAHRC work. For example, they identified that CLAHRC-wide support was required to support the dissemination activities of the individual project teams. As a result, new central support was established to facilitate engagement of the project teams with end-users of their research, and to support the translation of research findings through a CLAHRC-wide communication strategy within the region.

• Greentown Collaboration for Leadership in Applied Health Research and Care

The Greentown CLAHRC is led by a mental health trust, and the core of the initiative builds on established academic-research links between this health-care trust, a university hospital acute trust, and a university institution. However, an aim of this CLAHRC is to spread beyond the organisations that have traditionally been involved with research in order to build research capacity in localities further away from this core. As such, partner organisations are spread over a large geographical area, comprising a mix of urban and rural areas. The overall aim of the CLAHRC is to use an organisational learning model to facilitate a change in how research is conducted and utilised within the region. One key component of the model of this CLAHRC is about using the research experience of members from the ‘core’ organisations as a foundation from which this expertise can be dispersed and built on in other areas that have not traditionally worked in this way.

One of the things that CLAHRC was trying to do is move outside traditional university clinical centres, that would be located in this region . . . So it was not just about getting research into practice per se but broadening research into practice . . . In [another area] it’s red neck territory . . . best practice isn’t as evident over there as it is around the university, the trusts closely located to the university. GREENTOWN001

The CLAHRC model is built on an organisational learning approach which aims to close the gap between academia and practice. Within this approach, the vision of this CLAHRC is to develop the initiative in such a way that it can bring about a ‘step-change’ in how research is delivered and services are designed by facilitating a change in how the different communities involved conceptualise and undertake these types of activities. From the outset, the Greentown CLAHRC model created a number of structural features which were intended to embed this vision into its operational organisation. Key features include the clustering of work programmes within a small number of defined clinical themes, which support the building of communities around these clinical areas. There was also resourcing of dedicated ‘knowledge broker’ roles, through which a selected group of practitioners would support KT from project teams to the wider NHS. Cross-cutting themes were formed with the aim of providing clinical project team members with specialist forms of expertise in areas such as KT, synthesis of evidence, external engagement and communication, and statistical support. A CLAHRC-wide approach guided a similar constitution for all project teams, which included explicit mechanisms to support boundary spanning between different communities, through incorporating links within the structure of the CLAHRC to support the contact academics have with practitioners and managers in health services. This illustrates a key attribute of the Greentown vision for the CLAHRC in which the model that is being developed is designed to close the gap between research and practice by changing the working culture of the various stakeholder groups involved. However, as the CLAHRC has progressed, issues with the original approach were recognised, and amendments to this vision have been undertaken.

Greentown CLAHRC has had several changes in leadership since the decision to apply for a CLAHRC was made, with each one bringing different types of professional expertise to the role, ranging from clinical–academic, through business school academic, to health-services executive management. These changes in leadership are reflected in the ways in which the vision and approach of the CLAHRC has evolved from its conception and funding application through to its latter stages. Each new director has contributed a particular characteristic to the CLAHRC through their leadership. As the first director of the CLAHRC observed, the novelty of the role itself created a need for it to be ‘interpreted’ and ‘enacted’:

Even if they’d had a visible leadership role before the structured things were set up the brokering, engagement, it can be quite intangible. These sort of things have come to the fore . . . I am doing a leadership role that’s much more strategic and autonomous and I think there will be a degree of variability and interpretation of what the role is and how it’s enacted. My first port of call was to get practice on board. Those chief execs are quite frightening people sometimes. So get practice on board. So I went round every trust board that was a partner in CLAHRC and presented the CLAHRC. GREENTOWN001

As this suggests, the agency demonstrated by the leadership of the CLAHRC has been important in shaping its approach to KT. The original head of the CLAHRC bid was a clinical academic with a strong reputation in mental health research. A change in leadership was made to a specialist in organisational studies, with the aim of emphasising that the CLAHRC model was about a different way of working compared with traditional, standalone clinical–academic projects.

Overall, however, Greentown CLAHRC is structured around a set of clinical research programmes of work designed by clinical academics (i.e. typically a professor from one of the medical school clinical subdisciplines). These focus on applied health research issues to do with the delivery of services for chronic and mental health conditions. Although the basic form of the clinical themes persisted over time, they were eventually complemented by the creation of explicit structures for cross-cutting work. A considerable proportion of the finance was reallocated away from clinical research into implementation science to emphasise the integral role of this approach to their proposal. This process of evolving the planned model for the CLAHRC has generally been viewed as a positive process that enabled the CLAHRC strategy to be well defined by the time it started, supporting earlier progress.

And I mean, that letter and the feedback, you know, it was fairly explicit and it provided a platform for the reworking in the bid. You know, along implementation lines and gave me legitimacy to lead it . . . And I think that referral process was really useful for us. I think we were able to hit the ground running to a much greater extent than the other CLAHRCs. GREENTOWN001

Initiative-wide structures connected each clinical project team to members who provided specialist academic expertise, such as KT or statistical support. These fitted in with CLAHRC-wide activities, and were incorporated into the Greentown CLAHRC organisational model as a way of facilitating the sharing of different types of expertise with members from varied disciplinary and professional backgrounds.

This incorporation of this greater emphasis on implementation work was included after the majority of the core individuals had already ‘signed up’ to be part of the bid, and at a point when much of the focus for the clinical research projects had already been decided. In effect, the new KT strategy was grafted onto a CLAHRC structure that had evolved around a more traditional clinical–academic research model. Therefore, this new emphasis on an explicit implementation strategy had to be adopted by CLAHRC members with established interpretations of their roles, and where much of the content of the CLAHRC’s work programme had already been specified.

The majority of CLAHRC members are employed by the university, and many are co-located. However, as the CLAHRC spans multiple university departments, bringing together academics from a clinical–academic background within community health sciences, and social sciences from business and sociology departments, it created significant challenges for members with different types of expertise trying to work together.

For the clinical scientists this is a completely new way for them to do any work . . . They’ve never thought about the wider implementation aspects and actually how do you physically get research into practice. GREENTOWN002

As Greentown CLAHRC is built on a cross-disciplinary academic collaboration, this CLAHRC has faced additional challenges of working across the academic norms and practices of several different academic disciplines, including clinical sciences, nursing and allied health, and management and social sciences. In practice, it has sometimes been difficult to align these different spheres, especially in relating the conceptual remit of the cross-cutting themes. A further change to the leadership was made in the middle phase of the CLAHRC’s time frame, bringing in a director with a background in NHS executive management. This move helped to bring about a shift towards greater engagement with different types and levels of NHS organisations, in order to make the CLAHRC more NHS facing. At the same time, a key part of the restructuring from the mid-term review of Greentown was designed to combat uncertainty about the role of different programme components, and particularly the cross-cutting themes. In particular, as the CLAHRC’s vision emphasised new ways of working, it had been difficult for individuals to comprehend what their role should involve, or to fit this into traditional career trajectories.

As part of this restructuring, roles were divided into academic and non-academic parts, with the aim of allowing each member to focus on their own form of expertise, and to provide clear access to other types of skills. As a result, the CLAHRC was able to become more NHS facing, with a clearly defined team to assist with the delivery of research to practitioner and policy communities.

A typical configuration for the arrangement of positions within project teams had been designed by central management and was used across the initiative. Each core team was established around the team leader, which generally involved other colleagues from within the same academic subdivisions, and the employment of other team members who had trained within similar academic areas to fill designated roles for research and management of the programme of work. Additionally, management created a team structure that aimed to create connections between the core members of each project team, and other team members who could contribute different forms of expertise. These included ‘knowledge broker’ roles aimed at facilitating externally directed ties within health-care or community organisations. These acted as an explicit mechanism to support KT between different communities. An account provided by one team member who had taken on one such externally focused ‘knowledge brokering’ position describes some of her responsibilities within the team, and highlights how working across boundaries was achieved. She describes how an important part of this aspiration is for the team members in the designated brokering positions to spend time with external groups who are relevant stakeholders for to the intervention they are studying.

I did a lot of meetings etc., doing a presentation, explaining about the project. You need to tell them what’s happening with the project and how it’s going to be implemented locally, what the practice can have on them. And they’re a key part of making it work. Whether you . . . take their ideas up or we’re bringing ideas from the [initiative] to them, I just think it works both ways. So that won’t work or this won’t work and what about these participants, how is that going to work? Is there any money for that and then have we got stuff for that. Stuff that people in the university don’t understand.

Members in defined boundary-spanning roles within academic-centred project teams describe how they use team meetings to, for example, bring in insights about public health issues to the academic core team members. We observed in one discussion how project meetings were used as a place where the implications of the information provided by external groups was incorporated into a discussion on developing a sustainable implementation of the intervention which the project team were researching. Senior academic members of the team integrated this information by aligning it with the scientific and methodological approach for the project work, such as considering how this related to the study design, and the implications changes to the protocol would have on demonstrating the academic rigour required for high-quality journal publications.

I think a CLAHRC is about doing things differently to what’s been done before. I think the only way to do that is to bring in people who have different backgrounds and different experiences, who understand the world in a different way. Because I think one of the problems that the CLAHRCs are set up to address is that academic research is done for academics and clinical research is done for clinicians and the twain don’t meet. And I think this CLAHRC has been sensible in bringing in people from different backgrounds. GREENTOWN002

The structure of Greentown is centred on themes defined by related clinical areas. This supports the achievement of collaboration between CLAHRC members and relevant stakeholders in the local area. The commonality of many activities covering mental health, and related projects within the stroke rehabilitation theme, has provided an opportunity for CLAHRC members to develop communities around these clinical areas. In building on the formal roles to link project teams with external groups, efforts were made from the project team leadership to develop relationships with communities relevant to their research topic. With the senior leaders already having a reputation within their field, this provided a platform for connecting with stakeholders from within the local region, and in presenting a body of ‘CLAHRC-type’ work to national clinical groups.

As part of the CLAHRC-wide strategy, the building of ‘communities of practice’ is actively promoted as an approach which can ultimately support the implementation of evidence into local policy and practice. Four groups are perceived as particularly important: academics, clinical practitioners, health services decision-makers (managers and commissioners) and service user representatives. In particular, creating connections and building on links of existing networks of practitioners is viewed as a strategy to support this aim. In addition, the importance of developing relationships with opinion leaders within the local area has been described as an important part of the implementation process. The CLAHRC has developed an inclusive register of associates, where anyone who is interested in the CLAHRC work can sign up to receive updates about the CLAHRC work and are invited to events. Many of the activities and events are formed around the clinical topics that are of mutual interest, which forms an emergent community for people within the local area to connect to certain groups within the CLAHRC.

Greentown adopted an explicitly translational approach for informing external communities, such as commissioners, decision-makers and clinical practitioners, about the results of the clinical teams’ programme of work. This was based on a standard template and style of writing which emphasises the implications for policy and practice. These ‘bite-sized’ outputs operate as a tool to support KT of the work of the CLAHRC to the local practitioner and commissioning community. They require the academic teams (with assistance from specialist support members of the CLAHRC, and those with insight into practice) to tailor the way in which their work is presented for different types of audiences ( Box 4 ).

Case example: using a workshop event to discuss interim findings and facilitate KT A clinical project team organised a workshop to share interim findings from their programme of work. This both acted as a strategic tool for the dissemination of the study (more...)

In addition to organisational-level mechanisms, roles performed by individuals acted as bridges to support KT between different communities. Members in defined boundary-spanning roles within academic-centred project teams describe how they use team meetings to bring insight to the academic core team members relating to issues about using the public health intervention in a community setting:

I add an ability to look at things from an outsider’s perspective and say, ‘why are you doing it that way?’ And I think there’s as much challenge to academia as there is to the NHS. I think this CLAHRC along with the others were set up with ‘we’re the academics, we’ve got the knowledge, we’re going to tell you what you need to know’. And actually one of the biggest shifts that’s happening here is that academics have to get a sort of understanding of a new process around the democratisation of research. GREENTOWN009

Ultimately, these individuals were able to work with the academic team by enacting roles, such as ‘translating’ how information should be presented for different audiences. They also acted as ‘interpreters’ when providing insights into the practical implications of particular implementations of interventions, and helped to negotiate or legitimise the CLAHRC’s work in non-academic settings:

One of the goals was to try and encourage evidence based practice, and it’s using people like [the clinical practitioner who is a team member] to try and overcome some of the barriers. He’s very useful, as being a clinician he would command quite a lot of respect. GREENTOWN018

However, this KT occurred very much at the periphery of the project team’s work, with little impact on academic work practices. The creation of explicit knowledge-broker roles provided a formalised link for the team to work with those with academic expertise, and we observed how the project team meetings were used by its members as a focused time and space in which the insight and knowledge of those from beyond the community of the core team, such as academic advisors, and those representing the vision of the central management of the initiative, could be considered.

Reflections on the Greentown Collaboration for Leadership in Applied Health Research and Care model and its development over time

As noted, this CLAHRC has explicitly aimed at developing a model in which its members work in new and different ways. However, the qualitative data suggest that, in practice, there have been issues with the effectiveness of the CLAHRC’s original model. Some members (including leads) have failed to fully engage with the work of the CLAHRC (a key objective of the CLAHRC model), as they have struggled to understand the purpose and remit of certain elements of this CLAHRC’s structure (e.g. what the purpose of the implementation theme is; what the role of knowledge brokers is), and how they can integrate the CLAHRC model into achieving clinical sciences programmes of work.

The changes that took place in the mid-term of the CLAHRC’s life cycle were designed to take these challenges into account. Overall, the vision of the CLAHRC was reaffirmed, including the organisational learning model and its structural features and roles. However, it was recognised that the original CLAHRC model had led to some confusion about the contribution of particular roles and themes. As a result, the restructuring involved redefining roles to emphasise the specialisms of particular members, while providing greater resources for individuals with the expertise to make the CLAHRC more ‘NHS facing’.

• Browntown Collaboration for Leadership in Applied Health Research and Care

Browntown CLAHRC is based on a partnership between the universities and health-care organisations within a region that comprises several metropolitan boroughs. The core activity of the initiative is centred on organisations based within the same city that have historically been engaged with research activity. Many of the CLAHRC members are employed either by the universities or by the acute health-care organisation within this city, but the CLAHRC was also designed to build extensive numbers of new collaborative relationships between different communities based across these organisations. In particular, the initiative brings together academics from across different departments and universities who have not previously worked together. In addition, a range of health-care organisations are involved as partners, including acute hospital trusts, primary trusts and mental health services.

This vision of the CLAHRC is described as bringing about a step-change in the way research evidence is used, so as to influence the design of health-care services within the region and to improve their quality and effectiveness.

I initially thought the initiative would have been that the content and the research questions that were there, although soon I began to realise that although they’re important, it was about a much bigger transformation in the way that things are done. To get a paradigm shift really. BROWNTOWN014

The metropolitan area has a high level of health inequalities, and the CLAHRC programme of work is structured around groupings of clinical research projects for various long-term conditions which are undertaken using an applied health approach. In addition, there are a number of separate activities that use KT approaches to undertake later-stage implementation programmes of work designed to directly interact with and impact current health-care policy and services. There is a strong emphasis on capacity building within the various partner organisations across the region in relation to developing expertise on how evidence is handled. Overall, both the clinical research projects and the KT programmes of work are based on a model of integrating members from both research and practice by embedding a focus on practice-based issues.

It’s about addressing the second gap in translation. So it’s about getting research very close to practice or as part of practice. So it’s about undertaking applied research or making sure that research is implemented into practice . . . I don’t think it’s on practice, it’s research with practice . . . really integrating research as practice almost to improve services as you go along through reflection and action. The implementation arm is exactly the same, it’s really trying to get research so close to practice that you can’t really see a difference. So I think it’s about the full bridge really. So it’s about not saying research is one place and practice is another, it’s about trying to make things a lot more connected and integrated. BROWNTOWN021

The CLAHRC’s leadership is largely from an allied health and nursing background, with the CLAHRC membership including a high percentage of academic researchers and health-care practitioners with an allied health background. The vision of this CLAHRC is consequently informed by the practice-based approaches traditionally used within allied health professions, including an operating model centred on applied activities that aim to seamlessly integrate research and practice. However, while the approach of this CLAHRC fits well with the working practices of the allied health professions (both research and practice), it faces greater challenges to involve other groups, such as academics from other disciplines.

Browntown CLAHRC is built around a novel collaboration between the two main academic centres within the region: one which focuses on traditional forms of clinical science work, and another with expertise in allied health. This allied health ethos is reflected in the types of partnerships that are being built with the NHS, with strong links with senior and middle-level management in nursing and allied health within the partner trusts. These have been influential in informing the Browntown programmes of work.

This is not centric about the university. This is about an NHS collaboration that is distributed across a health environment, a health economy . . . It is about long-term conditions, and about knowledge mobilisation. BROWNTOWN002

In practice, this CLAHRC model faced challenges in creating a coherent overall programme of work that integrated members from a wide range of professional and disciplinary backgrounds, including different types of academics, and different groups of health-care practitioners. Nevertheless, especially at the core management level, the overall emphasis of the CLAHRC is to develop integrated work programmes involving both academic and NHS groups, and for these connections to be across different levels (i.e. to create links at high- and medium-level health-care management, and also NHS practice-level participation), and also to build the work of the CLAHRC across the whole Browntown region. In particular, the capacity-building objective of the CLAHRC is about building up the skills and expertise in all partner organisations, and ultimately bringing about an evidence-based applied health research culture across the Browntown region.

Overall, Browntown CLAHRC is formed from members of a wide mixture of academic disciplines and different groups of health-care professionals. This heterogeneous composition means that the work of Browntown CLAHRC has the potential to innovatively incorporate many different perspectives and draw from different types of expertise. This provides this CLAHRC with a strong foundation to develop a novel approach for an inclusive and collaborative model of applied research – one better able to span the boundaries between the ‘producers’ and ‘users’ and research. The clinical project work is structured into a small number of clusters which each constitute a programme of work within a common clinical topic. This deployment of members into relatively large subcommunities helps to foster collaboration between members who come from different departments and organisations. On being involved in a project that was one of a set within a larger programme of work, one respondent comments about the benefits of belonging to the translational initiative, as opposed to doing standalone project work:

It was a group of like-minded people where we could work together, because often we would all be doing independent things and not working together. So it was an opportunity for people to work together in some sort of funded activity which would have more power and influence than an individual academic working on their own. BROWNTOWN010

It was felt that having an interlinked set of projects could potentially have a greater impact. The overall programmes of work were often designed to inform different levels or aspects of health services for the same clinical areas. This more ‘holistic’ package of activity was perceived to have the potential to have a greater impact. In belonging to a larger team, there could be a co-ordinated presentation of activities to policy groups, with team members able to draw on the established connections with other groups to legitimise their own work through the high reputation of other colleagues. However, as members remain part of their ‘home’ organisation, this presents some operational challenges, as limited day-to-day interaction can mean that some members cannot easily access tacit information, or do not have a day-to-day reinforcement of the CLAHRC ‘approach’.

Many of the team members have several roles across different parts of the initiative, such as being members of clinical project teams while holding positions within the core management of the initiative. The central management team comprises a large group of CLAHRC members, meaning that internally the CLAHRC adheres to a distributed leadership style. This helps to support the diffusion of the values and aspirations of the central management team within the project work, and helps to reinforce the vision of the CLAHRC across the whole work programme. Many senior CLAHRC members, both from within the core management and the theme leads, are implicit boundary spanners – sometimes by dint of having ‘dual contracts’ with both NHS and university bodies – who contribute hybrid expertise and ‘belong’ to more than one community. They help to support the aim that the various programmes of work should incorporate different perspectives. The overlap between a large core management group and those in positions of leadership within the project teams helps to spread this vision. A smaller core group co-ordinates the overall CLAHRC-wide organisation, and presents the external-facing view of this CLAHRC model, and is influential in driving the vision throughout the CLAHRC. Overall, the onus is on project leadership to co-ordinate the different types of knowledge into one coherent programme. The leaders of the CLAHRC itself view their role as one of facilitating a new form of collaboration, rather than providing specific scientific or methodological expertise ( Box 5 ).

Case example: the role of a project team leader The role of the project leader is to co-ordinate different areas of work that are producing knowledge aligned to different disciplines, with the aim of producing one coherent programme of work. In working (more...)

The work taking place within these themes or project work is not dominated by the vision or traditions of one individual (e.g. the theme lead), but a culture has been created where individuals can contribute from their own perspective. As there is no one dominant culture influencing the approach of the work programmes, members with ‘specialist’ types of expertise are integrated members of project teams, allowing different types of knowledge to routinely inform the programme of work.

In [this translational initiative] you’re going into situations all the time where everyone in the room has got lots of different roles. That can be a bit of a challenge at times with people having to approach things from lots of different perspectives. It’s very much going in and out of roles sometimes. BROWNTOWN013

Members within the Browntown CLAHRC typically evolved more flexible and overlapping roles, reflecting the need for expertise to support different aspects of the work programme across the initiative.

Although the overall theme of each programme of work remained largely unchanged during the study period, the CLAHRC model and leadership in Browntown has allowed different groups to shape the focus and direction of the work packages. By collaboratively working with other stakeholder groups, the work packages were shaped by the values and insight of different communities, in what one respondent describes as an ‘organic process’.

It’s a tool for facilitating research, applied healthcare research. To enable patients and clinicians and commissioners to make sense of decisions about what to, about what types of treatment to provide . . . The overall structure of the research design didn’t change but it was such an organic process really, what we set out to do is what we’re doing, but their support and interest and feedback was important. CMBROWNTOWN002

In describing the work programme within the clinical theme, the participant highlights the flexibility of the plans for the project work, and how this allowed the integration of insights from different groups to inform and shape the direction of the work ( Box 6 ).

Case example: collaboration with different types of communities In this example, we observed a situation where a project team responded to external groups’ requests for outputs to inform their service development by refocusing their research from (more...)

The project teams across the CLAHRC were composed of a mix of academics from different disciplines and clinical practitioners. The senior management group actively encouraged teams to continue developing their original proposals based on discussion and dialogue with stakeholder groups. This more emergent approach was enabled by certain features of the CLAHRC model and membership. Within the project team, for example, several of the team members were what we will term ‘hybrid’ individuals, that is, they were affiliated to both academic and practitioner communities, and they helped to foster an environment where no one group dominated the direction of work programmes. Instead, all team members were encouraged to actively interact with other groups, and to be flexible in doing their project work. Thus, the vision of the CLAHRC fostered an environment where members were encouraged to develop new work practices and build relationships, rather than to conform to particular disciplinary approaches.

Across the Browntown CLAHRC, many of the members were able to act as boundary spanners precisely by virtue of their ‘hybrid’ academic and health practitioner background. This supported a more fluid integration between research and practice and the building of sustainable relationships, as the overlapping roles conferred membership of both the CLAHRC community and of external groups of managers and commissioners. At the same time, those in leadership positions helped to create an environment where knowledge from different perspectives was routinely shared across teams. Boundary-spanning mechanisms, such as project meetings, were used to support the fluid integration of different perspectives into the various components of work involved.

You see everyone has got a different perspective. Whether you’re a commissioner, you know, perhaps coming from a public health or social services background, but you’re commissioning. Or a manager in the NHS, perhaps social services seconded to NHS. Or a doctor or a nurse or a psychologist or a GP or a service user. You’ve all got a different understanding of what the care pathway is and what needs to be done to improve it. And so very much we deliberately wanted to incorporate a collaborative project between all those different groups. BROWNTOWN008

This CLAHRC’s KT approach drew from an established implementation model, the Canadian ‘knowledge into action’ cycle. In particular, many of the members of Browntown CLAHRC come from the NHS partner organisations, and many of the academics involved with this CLAHRC also hold NHS contracts and have been practically involved with roles at the local NHS organisations. In this sense, the CLAHRC organisation itself acts as a key mechanism to support the translation of knowledge between different communities.

I think CLAHRC is a boundary spanner. That’s its job, that’s what it is. Because the organisations, the NHS organisations, I mean, they do talk to each other because of, you know, Department of Health policy and stuff but they all have different ways of implementing policy. And so they don’t necessarily talk to each other but through us there’s work happening that can be, you know, translated across the different organisations. So we do act as kind of a, it’s almost like a phone exchange. BROWNTOWN017

The Browntown CLAHRC model included a number of work programmes which were designed from the outset to focus on explicit late-stage implementation activity that would produce tangible impact at an early stage in the CLAHRC time frame. These themes were not designed to produce new research evidence, but were intended to align with the NIHR aim of learning more about KT by conducting implementation activity.

We need to demonstrate progress with implementation from the start of CLAHRC. They are implementation projects using research methods, as well as making a difference to practice, and we’re very much committed to adding to the body of knowledge about knowledge translation . . . Implementation work is really a cross between action research and participatory research, and you need to shape the projects as you work with the key stakeholders. BROWNTOWN001

The implementation programmes of work were designed to produce results and impact on practice at an early stage. Thus, although they drew on established research expertise, they also emphasised collaboration with the local partners, including at all levels (executives, middle-management and ground-level staff) with whom the activities were taking place. These strands of work thus helped to reinforce and promote the expectation that all programmes of work, including the research themes, would generate outputs that could be applied to inform health-care practice.

The KT themes, in particular, focus on developing evidence that will help to make a practical difference to local health-care services. The clinical priorities for implementation are identified collaboratively, and the project work is seen as socially embedded in the organisations where change is happening. This facilitates the effective translation of knowledge into action by individuals and teams.

There’s a sense in which often researchers come to the NHS with their research ideas and then you try and get sign-up from them to take a project forward. This is turning the coin over completely and it’s saying, ‘we’re a resource; we want to work with you. What are your priorities?’ It’s been getting that ownership that I think has meant that we work in a different way, but also we get a different response back from NHS managers and clinicians. But also seeing, I guess it’s the role of brokers in all of this. BROWNTOWN001

The main focus of the work of these themes is on piloting and evaluating innovative strategies for implementation, which are then planned to be rolled out across the NIHR CLAHRC for Browntown partnership (with further evaluation of their impact). One key mechanism in this effort involves focusing resources on individuals who are employed by the health-care trusts. A role was designed for these members to act as ‘facilitators’ to build up research activity within their organisations based on the priorities and general ethos of Browntown CLAHRC-type work.

We have what are called ‘research and development facilitators’. The model which was developed was to actively engage each partner healthcare organisation by having a person working within them. So we would bring CLAHRC to these organisations. My role is to bring research evidence to my organisation, and encourage people to use the research evidence much more determining the way that work is completed. And also to help people here to articulate some of their, some of the issues which they have which could have a research solution. They could find a solution through research or at least some preliminary studies. BROWNTOWN022

It is clear from our analysis that members from throughout the CLAHRC recognise that there is an underlying strategy for this initiative to facilitate KT, and that this is conceptualised as involving an integrated, collaborative approach between academics, health-care practitioners and managers in order to facilitate implementation work. Thus, although the CLAHRC does designate certain work packages as ‘implementation’ projects, the vision enacted throughout the CLAHRC emphasises the need to bridge the second translational gap, and not limit KT activity to discrete programmes of work.

It’s not that simple as just having an implementation arm in CLAHRC . . . I think that a lot of people have been practitioners and have done research, there are very few pure academics who have never really linked in and have been in practice or not in the NHS . . . if you look at nearly every lead they’ve either been a practitioner or had a role in the NHS before as well as doing research. They’re all boundary spanners. BROWNTOWN021

However, while this priority given to KT is very apparent at the core management level of the CLAHRC, it is perhaps more difficult for this type of approach to radically influence all areas of the CLAHRC work, and in particular for innovation approaches to inform the approach of the research-focused clinical theme work. In addition, the challenges of conducting implementation research are also highlighted, as the inductive co-production approach here differs from the design of conventional academic projects. Thus, while achieving KT through the seamless integration of research and practice is an important part of the Browntown CLAHRC vision, it depends heavily on the contribution of those occupying ‘hybrid roles’. Crucially, the individuals within these roles are not deemed peripheral to the project teams, but are well positioned to incorporate insights from different community perspectives into the work of the teams.

I work between a number of different organisations, so principally the NHS and academia. It was useful that I am actually from an academic background myself. It makes it a little bit easier in terms of understanding what academic opportunities there might be which the NHS might be able to tap into . . . I work with the initiative really because I work for the NHS and ensure that the CLAHRC work is embedded within this NHS organisation. So it’s very much that boundary-spanning role, I have two identities. BROWNTOWN022

Reflections on the Browntown Collaboration for Leadership in Applied Health Research and Care model and its development over time

The vision of the Browntown CLAHRC collaboration aims to foster a change in the culture of members across the partner organisations by building the capacity of its members to engage with applied health activities. The fact that the core of the CLAHRC is not university-centric, but is instead based on the traditions of allied health academics and practitioners, has helped to privilege health services’ concerns in shaping the programme of work. Although discrete KT activities were established at its inception, the vision of the Browntown CLAHRC is for all programmes of work to engage with diverse perspectives and traditions. In this way, the CLAHRC builds capacity for innovation through a work environment where work practices are able to draw on a diverse range of perspectives.

The Browntown CLAHRC has evolved incrementally over time as new activities have been developed in response to partner need. From its inception, the CLAHRC has emphasised the scope for such incremental growth both through grafting on new programmes of work and through the expansion of the CLAHRC community to include new types of partners. Although not emphasised in the original bid, collaboration with industry has also emerged as an important strand of this evolution. One result of this approach has been the ability of the CLAHRC Browntown model to adapt to a changing policy landscape, as the ‘organisational memory’ of relationships with the primary care trusts has been used to forge relationships with new commissioning organisations.

• Comparative analysis of Collaboration for Leadership in Applied Health Research and Care models and their enactments

The CLAHRCs were given extensive flexibility in interpreting the NIHR remit. They thus represent a ‘natural experiment’ in how to focus, organise and manage applied health research, which will have an impact on a local health-care environment. Our study of three CLAHRCs has highlighted how it has been necessary for each model to be tailored to their own local context.

The senior management of Bluetown CLAHRC strongly emphasises a common vision throughout its work, and contributes technical scientific support to work programmes. The ambition here is to produce high-quality scientific evidence through a rigorous methodological approach. Within this broad remit, each project team has extensive flexibility in the operational management of their work programmes. Instead of drawing on a CLAHRC-wide approach for KT, each project team here developed their own approach to translating the findings from their work programmes into practice. In this sense, the Bluetown model for KT is about supporting the operational autonomy of each project team to develop its own locally tailored approach.

Greentown CLAHRC draws on an explicit CLAHRC-wide organisational structure to facilitate KT activity. This structure emphasises a common operational management championed by the core leadership. The overall approach draws on a cross-disciplinary conceptual model which integrates different types of knowledge, including both clinical and social science academic traditions. However, each project team develops its own approach to accessing and developing requisite scientific and technical expertise, which allows team members to retain their pre-existing working practices.

The Browntown CLAHRC model was based on adapting the explicit Canadian framework for KT. Operationally, the CLAHRC work was situated within heterogeneous teams embedded within the local partner organisations. This, together with features such as overlapping community memberships and hybrid roles, helped to support the fluid, and often tacit, integration of different types of knowledge across all work programmes.

Notably, all three of the CLAHRCs we studied were able to develop and adapt their model over the 5-year funding time frame. The focus of these developments, and the extent to which modifications occurred, varied depending on each CLAHRC context. Bluetown CLAHRC started with a conventional model of the relationship between research and practice, which allowed work activity to commence straight away, and did not require radical changes to the working practices of its members. However, as the CLAHRC developed over time, new activities were introduced to support KT and knowledge management and engagement activities. Importantly, the established relationships of the early CLAHRC model are credited with helping to gain support for these new types of activities.

Greentown CLAHRC has experienced several changes in leadership since the initial formation of its model. Its development over time has particularly focused on refining the original organisational learning model in order to improve effectiveness. As such, this CLAHRC has engaged in changes to its operational management by restructuring the groups within the CLAHRC, and, in particular, making adaptations to the work of the specialist support services to support the clinical project teams more effectively.

The model of Browntown CLAHRC has evolved incrementally and has maintained consistent support for capacity building across local health-care communities. In particular, this CLAHRC has sought to develop and integrate new work programmes reflective of its overall vision into its CLAHRC community. It has continually expanded its engagement with its original health-care partners, and also new types of stakeholder groups, such as industry. In keeping with its distributed leadership style, the central management team itself grew over time, so as to assimilate representatives of different work components and incorporate their views into the organisation of the CLAHRC’s work. Our study of the three different CLAHRC helps to explain the way in which the broad CLAHRC remit has been appropriated in distinctive ways, according to the social networks and local contexts which have shaped the CLAHRCs’ development. In the process, we have observed also the generative effect of leadership and vision. These variations in the interpretation and enactment of the CLAHRC mission underlines the importance of their differing network structures and sense-making cognitions as addressed through the other research strands in our study (and succeeding sections of this report). In respect of KT, it is clear that each CLAHRC has developed its own distinctive approach, some aspects of which are managed and articulated at senior management level, while others (e.g. the implications of hybrid roles) make a more implicit contribution.

• USA and Canada qualitative analysis

The next part of the report will describe, analyse and discuss the three North American cases. The first case is the Canada-Coordination, an initiative involving a number of health-care players in the Ottawa district, Ontario (Canada), and aiming to improve the co-ordination and quality of health-care delivery. The initiative is specifically addressed to a small number of children with complex care needs (these children have at least five different specialists who follow them). At the time of our fieldwork, the Canada-Coordination initiative included 23 such children. The second case is the Canada-Translation, an initiative involving a community hospital (Com-Hospital) and a large university (Uni-Canada) in the same city in Quebec, aiming to promote KT processes from academic (Uni-Canada) to practitioners (Com-Hospital) and, more generally, aiming to increase collaboration and cross-fertilisation activities between the hospital and the university. The third case is US-Health, an initiative involving a number of universities, hospitals and consultant companies specialising in health-care management and applied research and aiming to promote implementation research across the USA.

All three initiatives are different to the CLAHRCs in terms of size, being either somewhat smaller (e.g. the Canada-Translation) or larger (US-Health). In addition, their thematic focus and governance arrangements are necessarily different to the CLAHRCs’ (e.g. the Canada-Coordination is more focused on KT and collaboration across existing health-care organisations). However, these three cases were chosen because they are all organised to promote implementation research and KT processes on a networked basis, by exploiting existing networks and/or facilitating the creation of new collaborative networks.

The qualitative analysis of the North American cases, in line with the CLAHRCs analysis, is structured as follows (for each case): firstly, we introduce the case; secondly, we break down the analysis into the three main theoretical elements (or dimensions) of the framework supporting this study (governance and management aspects, networks and collaborations, and KT); and, thirdly, we discuss the implications of the case. As with the CLAHRCs qualitative analysis, each case involves three case examples, one for each dimension of the framework. We conclude this section with a discussion of the three initiatives and a comparison between these (North American) cases and the UK CLAHRCs.

• Canada-Coordination pilot project

Canada-Coordination is a pilot project housed at the White Hospital, located in Ottawa, ON, Canada, and involves the hospital itself (a world-class tertiary paediatric centre), and several paediatric organisations and agencies in the Ottawa community.

The pilot project involves four main players (organisations): (1) the Regional Community Care Access Centre (RCAC), which is a community health provider that organises home, school, and hospital care, developing customised ‘care plans’ and providing support from health-care professionals, nurses, physiotherapists, social workers, registered dieticians, occupational therapists, speech therapists, and personal support workers to provide a range of care and support services; (2) the Ottawa Association to Support Children (OASC), which is another community health provider that provides specialised care for children and youth in Ontario with multiple physical, developmental, and associated behavioural needs; (3) the social services (SS), which is an agency that develops case resolution mechanisms to provide recommendations and referrals for families with children with complex care needs who are experiencing difficulties accessing support and services in the community; and (4) the White Hospital, which is the ‘hub’ of the project in that the children with complex care needs are patients of the hospital and, therefore, the main treatments are provided at the White Hospital.

The pilot project funds three key people to manage the project: (1) a project manager, (2) the most responsible physician and (3) the nurse co-ordinator. The project manager supervises the pilot project: she ensures that processes, communication pathways and flow maps have been developed; conducts staff training sessions; co-ordinates the meetings and presentations for the steering and advisory committees; and prepares reports. The most responsible physician reviews the overall complex medical needs of each child and co-ordinates communication with all the specialists at the White Hospital, other tertiary paediatric centres specialists, and the community physicians. The nurse co-ordinator works very closely with the most responsible physician, interfacing between the doctors, nurses, and managers at the White Hospital, and the other agencies; the nurse co-ordinator is the link person for all of the families of the children in the project. Interestingly, along with a solid governance structure, informal relationships played a central role in the pilot project, as is outlined in the example below ( Box 7 ).

Case example: governance structure and informal relationships The governance structure of the pilot project is relatively formal including steering and advisory committees that meet monthly in addition to an external entity – the White Hospital (more...)

From the case example in Box 7 , it is clear that informal relationships facilitated tight collaborations and promoted trust among the players involved in the pilot project. The development of trust, as we will show below, was also a relevant element in supporting the health-care network of the Ottawa community.

The pilot project exploits existing networks between the players involved including RCAC, OASC, SS, independent paediatricians, and the White Hospital personnel (doctors, nurses and staff). In fact, while the project involved hiring some key people who could facilitate collaboration among the players, many of the relationships between, for example, social services (RCAC) and the nurses and doctors in the hospital (the White Hospital) were already tight. This aspect (prior networks) has positively affected the overall project because while formal networks are relatively easy to establish, it takes time for people to begin working together productively. Interestingly, the pilot project network developed collaborations aimed at improving the quality of health-care delivery that were not limited to the players that were involved in the initial project. In fact, the managers (of the four agencies) soon realised that in order to clearly identify the needs of the children involved in the pilot project, it was important to involve the patients directly. Therefore, the project manager, in accordance with the directors of RCAC, OASC, and SS, decided to involve the parents of two children involved in the project. This involvement included having the parents sitting in the steering committee of the project that meets monthly and makes decisions regarding how the co-ordination of care at the White Hospital and across its network can be improved.

As the project manager highlighted regarding the evaluation process of the project: ‘So the two parents from family forum that also sit on our steering committee for this Pilot Project reviewed our questionnaires and helped us get to the questions we wanted so that it’s more a participatory evaluation approach’. This quote underlines a collaborative climate where actors belonging to different networks are willing to bring their contributions and are supported by a common aim: to identify ways to improve the quality of health-care delivery services for children with complex care needs. One of the most relevant issues that emerged from the feedback with the (two) families who sit in the steering committee was the difficulty of having all of the different community services up to date with the most recent changes regarding the children’s condition – this problem was made very challenging by the fact that each child is frequently seen by a number of specialists.

Knowledge translation within Canada-Coordination was focused on relations between clinicians and with family members of the children involved. It was facilitated not only by direct interactions among these groups, but also by the development of artefacts that could help span the boundaries between them. In this context, the introduction of the Single Point of Care (SPOC) document is an important example because it radically improved the relationship between the White Hospital and the health-care networks. The SPOC is a paper-based medical sheet including all basic information about a child’s health, such as current health status, current treatments (medications), and any other detail that can be helpful at school (e.g. current allergies) or in emergency situations (particular drugs that the child needs to take if his/her condition suddenly becomes severe or life-threatening). The SPOC is issued by the White Hospital and is carried by the families, who now no longer have the difficult and at times confusing task of collating themselves all the medical information related to their children produced by different specialists. The SPOC is also shared with a number of organisations in the Ottawa community, such as police and schools. In particular, it is very relevant that, for example, if the child develops a new allergy or changes one medication, the school nurse is aware of the changes. While the creation of the SPOC will be broadly discussed in the next section – the SPOC being a KT tool – the following case is meaningful in highlighting how SPOC contributed to promoting networks and collaboration across different players in the Ottawa community ( Box 8 ).

Case example: SPOC as a tool for KT The SPOC originated from discussions between the families of the children involved in the pilot project and the doctors and managers during steering committee sessions. Its value is highlighted here through the example (more...)

The SPOC also helped to reduce redundant examinations because the parents show the medical sheet to each specialist who would edit it as appropriate and gather information about forthcoming tests. In sum, the introduction of the SPOC improved efficiency (being a co-ordination mechanism for different specialists) and provided the families with more awareness about the conditions of their children. In fact, while on the one hand the SPOC is acknowledged by any doctor as an official document because it is issued by a hospital, on the other hand, the (simple) way the SPOC is structured allows the family to interpret (in general terms) the health status of their child.

In sum, according to the project founders (the leaders of RCAC, OASC and SS), the involvement of the parents had produced significant benefits. This point was also confirmed by a number of interviews that we conducted with the families of the children involved in the pilot project because a number of issues of the families in terms of co-ordination emerged that could be brought up for discussion in the project meetings (steering committee).

Reflections on the pilot project model and its development over time

The pilot project is an example of how informal networks are effective in promoting KT and collaboration across community partners, including health-care partners such as a hospital and the SS, yet also including also non-health-care partners such as the police department and the schools. The management of the project includes periodic controls undertaken by an independent entity that is the White Hospital Research Institute. The White Hospital Research Institute surveys doctors and families of the children involved in the project and makes sure that co-ordination and health-care delivery services are continuously improved. This is evidenced by feedback from both clinicians and patient families.

• Canada-Translation Centre

The Canada-Translation Centre is an initiative that originates at Com-Hospital, a community and university affiliated health centre in Quebec, Canada, and that serves a multicultural population in southern Quebec.

The Canada-Translation Centre started in 2010 with the aim to promote and co-ordinate clinical research carried out by clinicians who work at Com-Hospital and are also appointed by Uni-Canada, a university in Quebec. According to the regulatory framework of the Canada-Translation Centre, it carries out clinical, epidemiological, and health services research studies, provides consultation to other researchers in the hospital, and provides educational services, including seminars and workshops, related to research.

The Canada-Translation Centre is led by Johanna, Associate Professor at Uni-Canada and the vice president (VP) of Academic Affairs at Com-Hospital. The Canada-Translation Centre organises monthly meetings (last Thursday of every month) that are held in the hospital. As at the time of our research the Canada-Translation Centre was in its initial stage of development, the main objective of the meetings that we observed involved the establishment of guidelines and systems.

From a governance perspective, the three main bodies that collaborate with the Canada-Translation Centre are (a) the REC, which is responsible for reviewing the scientific and ethical aspects of all research projects involving human subjects; (b) the research review office, which is co-ordinated by the research administrative secretary and provides administrative support to both the EC and the REC; and (c) the Quality Assessment (QA) Unit, which provides assistance to hospital staff on various aspects of QA analysis and evaluation, that is, projects that assess current performance or practice.

The governance aspects of the Canada-Translation Centre are extremely formalised, reflecting the interest of the academics at Uni-Canada to secure control of the development of the project, especially in its early stages. The board of directors supervises all research activities, while the VP of Academic Affairs (who is also the Canada-Translation Centre’s Director) supervises all main research committees. The Quality and Risk Management Committee is an independent body chaired by the VP of Professional Services. According to an interview with Johanna, the rationale of this design lies in the desire to have objective control of research activities by an independent body (the Quality Committee).

The network of the Canada-Translation Centre is formed by people who work in the hospital who also have at least a teaching appointment or, more often, a professorial appointment, at Uni-Canada. The design of the three key bodies of the centre sought to promote collaboration and cross-fertilisation between the hospital and Uni-Canada. In particular, within Family Medicine at Uni-Canada there are four departments that have been always very independent and loosely coupled; however, with the start of the Canada-Translation Centre, members of these four departments started meeting twice a month to try and pursue common research objectives. In sum, the main objectives of the Canada-Translation Centre are to (1) tighten the collaboration between Uni-Canada and Com-Hospital by promoting networks and (2) bring in expertise from external collaborations.

In terms of improving the network within the Canada-Translation Centre (Com-Hospital and Uni-Canada) one of the initial challenges was to try to build relationships between key actors who had no experience of working together. For instance, quality and risk management staff rarely interacted with academics prior to the start of the project. This group quickly became committed to collaborating with the academic groups, as highlighted by the director of the quality and risk management at Com-Hospital:

And I convinced Johanna that the uniqueness of the relationship between Quality and Research here has to live somehow and has to be formalised in whatever plan she does. And I think she saw that as an opportunity. If it were someone else here than me I don’t know if it would work the same. It’s just because I started out working in Research and I, you know, I did that for ten, twelve years and I know the language and I know their challenges and I know, you know, how they think and how they . . . operate.

While it is important that people within Com-Hospital are able to work together (e.g. the research team and the quality and risk management department, as per what was highlighted above), it is also relevant that the (more practice-oriented) researchers at Com-Hospital collaborate and develop networks with the professors at Uni-Canada. The associate dean of Inter-Hospital Affairs plays a role in doing this by trying to promote fruitful collaborations between the hospital and the university. As he highlighted to us:

It was a natural thing to develop research along these lines. Again my role has been to facilitate communication between the hospital and the university, both with the Dean of Medicine and with other research leaders within the university. I’m not a researcher myself. My role is mainly to put people together. And to use the links that we have with the Ministries to help support what the hospitals do. The other way in which I interplay with the hospital is I’m on the board of directors. So being on the board of directors of course some of these initiatives to fund this research infrastructure comes to the board and at times I speak to it in a supportive fashion in order to help promote this venture for the hospital.

Included in the Canada-Translation Centre mission for the period 2010–15 there are five main domains of research to be pursued:

• to support and conduct high quality clinical and health services research relevant to the patients and services provided by Com-Hospital
• to promote KT and exchange activities to support evidence-informed decision-making in practice, management and policy
• to provide decision support for clinical and management leaders through high-quality rapid systematic reviews of scientific evidence
• to support the application of evidence through quality improvement and other implementation initiatives
• to provide a high-quality training programme and environment for students interested in research careers.

From the above it is clear that the Canada-Translation Centre has a specific focus on KT. In fact, each research member (i.e. a professor) must also be a clinician (i.e. he/she needs to spend a minimum number of hours per week in the hospital), a rule which is aimed at promoting applied research. As outlined by the case example below ( Box 9 ), one of the strategies that the Canada-Translation Centre adopts for promoting implementation research is to work on small projects whose short-term tangible results are directly testable in the hospital environment.

Case example: short-term implementation research One example of how the Canada-Translation Centre promotes implementation research is to try to develop very small projects where implementation requires months if not just weeks. Through the exploitation (more...)

Reflections on the Canada-Translation Center model and its development over time

In contrast with the pilot project in Ottawa, this initiative is much more complex and involves more than 50 people including Com-Hospital physicians, Uni-Canada’s academics, and administrative personnel. Staff involved are fully aware of the barriers between academics and practitioners and between people who work in different departments (in the case of Com-Hospital) and in different institutions (at the hospital and at Uni-Canada). Therefore, specific boundary spanners – such as the associate dean of Inter-Hospital affairs – were identified to connect people with different background, professional and personal interests.

US-Health is a model of field-based research designed to promote innovation in health-care delivery by promoting the diffusion of research into practice. The US-Health initiative promotes innovation in health-care delivery by speeding up the development, implementation, diffusion, and uptake of evidence-based tools, strategies, and findings. In particular, US-Health develops and aims to disseminate scientific evidence to improve health-care delivery systems.

The US-Health network includes a number of large partnerships (the ‘contractors’) and collaborating organisations that provide health care to more than 100 million Americans and is a 5-year implementation model of research that is field based and that fosters public–private collaboration aiming to provide concrete results in the short term. The US-Health partnerships involve most US states and provide access to large numbers of providers, major health plans, hospitals, long-term care facilities, ambulatory care settings, and other health-care structures. Each partnership includes health-care systems with large, robust databases, clinical and research expertise, and the authority to implement health-care innovations.

US-Health focuses on a wide variety of demand-driven, practical, applied topics of interest to the partnerships’ own operational leaders as well as the project funders. The programme emphasises projects that are addressed to user needs and operational interests and which, ideally, are expected to be generalisable across a number of settings.

US-Health partnerships operate under multi-year contracts. Proposals are bid on a rolling basis throughout each 5-year cycle. Projects need to be undertaken in the short term; they are awarded under separate task orders and are completed within 12–24 months. Also, the US-Health network is promoted by a national health agency called Federal-Health. Federal-Health’s mission is to improve the quality, safety, efficiency, and effectiveness of US health care. Federal-Health supports research that helps people make more informed decisions and improves the quality of health-care services.

US-Health’s research has two main characteristics: it is practice based and implementation oriented. Thus, it supports field-based research to explore practical, applied topics that are responsive to diverse user needs and operational interests. By testing innovations directly in the practical settings in which they are intended to be adopted, US-Health increases the likelihood of their eventual successful uptake. US-Health research is also designed to increase knowledge about the process of implementing innovations and the contextual factors influencing implementation. It aims to promote understanding of how and why specific strategies work or fail.

The governance structure of US-Health is relatively flat. Federal-Health is the government organisation that manages the tendering process for contracts, and US-Health (the network) is one of the recipients of these contracts. Informal relationships between Federal-Health and its collaborations over time, however, help to ensure that contracts are tailored to the strengths of members of the US-Health network. For example, Federal-Health frequently discusses potential research projects with the contractors of previous bids to elicit their interest.

Once a contract is signed, a project officer is assigned to each contractor; there are few project officers who manage multiple contracts nationwide. The main task of the project officer is to make sure that all milestones are met during the very short period of the contract. Moreover, the project officer can review ongoing documents, can come to visit a contractor to see how the research project progresses, and can provide suggestions and indications. The project officers need to write periodic reports for Federal-Health; therefore, Federal-Health can closely monitor each contractor (and each research project). The way a contractor (e.g. a member of the US-Health network) manages the research project is very subjective. While a proposal on how they will reach the objectives needs to be provided to Federal-Health, no specific guidelines on how to undertake the research are given. However, the contracts (and the research projects) are generally very specific in their objectives and concrete results. Very often, the research output is a ‘toolkit’, that is, a document with specific recommendations on how to manage a health-care problem in practice.

Many of the people whom we interviewed and who were involved in one or more US-Health research projects (i.e. contracts) highlighted that the success of the project depended to a large extent on the project officer. The effects of the project officer role can be both positive and negative, as shown by the example below ( Box 10 ).

Case example: the role of project officers in US-Health This interview was undertaken with a professor in a department of family medicine who has been involved in a Federal-Health project for several years. She describes with examples points of strength (more...)

US-Health has a very complex network including, as we previously noted, a number of large partnerships. In this section we provide some insights that focus on two main partnerships where we were able to conduct interviews: Health-partnership and Health-Consulting. We chose these two networks because they are very different (one is a partnership whose participants are academics while the other is a consultant company with expertise in health care). Although collaboration on bid writing between partners was limited by a lack of funding, some collaboration did take place across US-Health contractors.

Health-partnership (primary contractor) is a partnership led by a US university (name not disclosed) which managed some 10 contracts with Federal-Health within US-Health. The contracts of Health-partnership involve themes such as improving hepatitis C virus-screening practices and testing uptake in select primary care providers, preventing pressure ulcers in hospitals, co-ordinating care across primary care practices, using innovative communication technology to improve the health of minorities, avoiding readmissions in hospitals using technology, and reducing infections caused by particular bacteria.

Health-Consulting is a much smaller entity, being a private consultancy company with some 15 senior consultants. As a result, it is not in a position to develop clinical research involving patients. Health-Consulting’s strategy within US-Health was, therefore, to find collaborators (subcontractors) who could undertake implementation research in health-care structures. To do this, they drew on a wide network of subcontractors. The contracts managed by Health-Consulting focused on the relationship between patient information management in hospitals and risks of complications and mortality while patients are hospitalised (this contract investigates both electronic and paper-based medical records) and on the development of performance measures for injurious falls in nursing homes and rehospitalisation of patients discharged from hospitals to home care. Although collaboration on bid writing between partners was limited by a lack of funding, some collaboration did take place across US-Health contractors.

With the overall goal of translating research into practice, US-Health links many of the largest health-care systems in the USA with top health services researchers who are identified through a tendering process and are managed through short- to medium-term contracts.

It provides a network of delivery-affiliated researchers and sites with a means of testing the application and uptake of research knowledge. US-Health is the successor to another large-scale initiative which was completed in 2005. All of the large partnerships (i.e. the prime contractors who work with a specified range of other organisations) have a demonstrated capacity to turn research into practice for proven interventions, targeting those who manage, deliver or receive health-care services. As per the above, both Health-partnership and Health-Consulting develop research that is focused on a wide variety of demand-driven, practical, applied topics which are of interest to the partnerships’ own operational leaders as well as to the project funders. The overall programme (US-Health) emphasises projects that are broadly responsive to user needs and operational interests and which are expected to be generalisable across a number of settings. An example of implementation research conducted by Health-Consulting is outlined in the case example below ( Box 11 ).

Case example: implementation research at Health-Consulting Health-Consulting developed a tool to improve pharmacists’ communications with patients. This was informed by evidence that only 12% of US adults understand and use health information (more...)

Reflections on the US-Health model and its development over time

The US-Health case, if compared with the two other North American cases, involves a number of partnerships, each partnership involving a number of organisations and players. Moreover, the funding model is quite unique, depending on bids for contracts (very often agreed between parties – e.g. Federal-Health and, in our case, US-Health). Even though there was little interaction across the US-Health network as a whole, collaborations proliferated within partnerships. Moreover, most projects have been successful and some projects were adopted nationwide.

Included under terms of UK Non-commercial Government License .

• Cite this Page Scarbrough H, D’Andreta D, Evans S, et al. Networked innovation in the health sector: comparative qualitative study of the role of Collaborations for Leadership in Applied Health Research and Care in translating research into practice. Southampton (UK): NIHR Journals Library; 2014 May. (Health Services and Delivery Research, No. 2.13.) Chapter 4, Empirical analysis and findings: qualitative investigation.
• PDF version of this title (2.6M)

In this Page

Other titles in this collection.

• Health Services and Delivery Research

Recent Activity

• Empirical analysis and findings: qualitative investigation - Networked innovatio... Empirical analysis and findings: qualitative investigation - Networked innovation in the health sector: comparative qualitative study of the role of Collaborations for Leadership in Applied Health Research and Care in translating research into practice

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

Connect with NLM

National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894

Web Policies FOIA HHS Vulnerability Disclosure

Help Accessibility Careers