Marshall Martin, Pagel Christina, French Catherine, Utley Martin, Allwood Dominique, Fulop Naomi, Pope Catherine, Banks Victoria, Goldmann Allan
UCL, London, UK Improvement Science London, London, UK.
Clinical Operational Research Unit and Department of Applied Health Research, UCL, London, UK.
BMJ Qual Saf. 2014 Oct;23(10):801-5. doi: 10.1136/bmjqs-2013-002779. Epub 2014 Jun 3.
The traditional separation of the producers of research evidence in academia from the users of that evidence in healthcare organisations has not succeeded in closing the gap between what is known about the organisation and delivery of health services and what is actually done in practice. As a consequence, there is growing interest in alternative models of knowledge creation and mobilisation, ones which emphasise collaboration, active participation of all stakeholders, and a commitment to shared learning. Such models have robust historical, philosophical and methodological foundations but have not yet been embraced by many of the people working in the health sector. This paper presents an emerging model of participation, the Researcher-in-Residence. The model positions the researcher as a core member of a delivery team, actively negotiating a body of expertise which is different from, but complementary to, the expertise of managers and clinicians. Three examples of in-residence models are presented: an anthropologist working as a member of an executive team, operational researchers working in a front-line delivery team, and a Health Services Researcher working across an integrated care organisation. Each of these examples illustrates the contribution that an embedded researcher can make to a service-based team. They also highlight a number of unanswered questions about the model, including the required level of experience of the researcher and their areas of expertise, the institutional facilitators and barriers to embedding the model, and the risk that the independence of an embedded researcher might be compromised. The Researcher-in-Residence model has the potential to engage both academics and practitioners in the promotion of evidence-informed service improvement, but further evaluation is required before the model should be routinely used in practice.
学术界研究证据的生产者与医疗保健机构中该证据的使用者之间传统上的分离，未能成功弥合关于卫生服务的组织与提供方面的已知情况与实际实践中所做之事之间的差距。因此，人们对知识创造和传播的替代模式越来越感兴趣，这些模式强调协作、所有利益相关者的积极参与以及对共享学习的承诺。此类模式有坚实的历史、哲学和方法论基础，但尚未被许多卫生部门的工作人员所接受。本文介绍了一种新兴的参与模式——驻院研究员模式。该模式将研究员定位为交付团队的核心成员，积极协商一套与管理人员和临床医生的专业知识不同但互补的专业知识体系。文中给出了三个驻院模式的例子：一位人类学家作为执行团队的成员开展工作、运筹学研究人员在一线交付团队中工作，以及一位卫生服务研究员在一个综合护理机构开展工作。这些例子中的每一个都说明了驻院研究员可以为基于服务的团队做出的贡献。它们还突出了关于该模式的一些未解决问题，包括研究员所需的经验水平及其专业领域、嵌入该模式的机构促进因素和障碍，以及驻院研究员的独立性可能受到损害的风险。驻院研究员模式有潜力促使学术界人士和从业者共同推动循证服务改进，但在该模式能够在实践中常规使用之前，还需要进一步评估。
