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针对研究活动的持续合作性优先事项设定:一种缩小研究与实践转化差距的能力建设方法。

On-going collaborative priority-setting for research activity: a method of capacity building to reduce the research-practice translational gap.

作者信息

Cooke Jo, Ariss Steven, Smith Christine, Read Jennifer

机构信息

NIHR Collaboration and Leadership in Applied Health Research and Care for Yorkshire and Humber (CLAHRC YH), Sheffield, South Yorkshire, S10 2JF, UK.

STH NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, South Yorkshire, S10 2JF, UK.

出版信息

Health Res Policy Syst. 2015 May 7;13:25. doi: 10.1186/s12961-015-0014-y.

Abstract

BACKGROUND

International policy suggests that collaborative priority setting (CPS) between researchers and end users of research should shape the research agenda, and can increase capacity to address the research-practice translational gap. There is limited research evidence to guide how this should be done to meet the needs of dynamic healthcare systems. One-off priority setting events and time-lag between decision and action prove problematic. This study illustrates the use of CPS in a UK research collaboration called Collaboration and Leadership in Applied Health Research and Care (CLAHRC).

METHODS

Data were collected from a north of England CLAHRC through semi-structured interviews with 28 interviewees and a workshop of key stakeholders (n = 21) including academics, NHS clinicians, and managers. Documentary analysis of internal reports and CLAHRC annual reports for the first two and half years was also undertaken. These data were thematically coded.

RESULTS

Methods of CPS linked to the developmental phase of the CLAHRC. Early methods included pre-existing historical partnerships with on-going dialogue. Later, new platforms for on-going discussions were formed. Consensus techniques with staged project development were also used. All methods demonstrated actual or potential change in practice and services. Impact was enabled through the flexibility of research and implementation work streams; 'matched' funding arrangements to support alignment of priorities in partner organisations; the size of the collaboration offering a resource to meet project needs; and the length of the programme providing stability and long term relationships. Difficulties included tensions between being responsive to priorities and the possibility of 'drift' within project work, between academics and practice, and between service providers and commissioners in the health services. Providing protected 'matched' time proved difficult for some NHS managers, which put increasing work pressure on them. CPS is more time consuming than traditional approaches to project development.

CONCLUSIONS

CPS can produce needs-led projects that are bedded in services using a variety of methods. Contributing factors for effective CPS include flexibility in use and type of available resources, flexible work plans, and responsive leadership. The CLAHRC model provides a translational infrastructure that enables CPS that can impact on healthcare systems.

摘要

背景

国际政策表明,研究人员与研究最终用户之间的协作式优先级设定(CPS)应塑造研究议程,并可提高解决研究与实践转化差距的能力。目前指导如何开展此项工作以满足动态医疗系统需求的研究证据有限。一次性的优先级设定活动以及决策与行动之间的时间滞后被证明存在问题。本研究阐述了CPS在英国一个名为应用健康研究与护理协作与领导力(CLAHRC)的研究合作中的应用。

方法

通过对28名受访者进行半结构化访谈以及与包括学者、国民保健服务(NHS)临床医生和管理人员在内的关键利益相关者(n = 21)举办研讨会,从英格兰北部的一个CLAHRC收集数据。还对前两年半的内部报告和CLAHRC年度报告进行了文献分析。这些数据进行了主题编码。

结果

CPS方法与CLAHRC的发展阶段相关联。早期方法包括与持续对话的既有历史伙伴关系。后来,形成了持续讨论的新平台。还采用了分阶段项目开发的共识技术。所有方法都展示了实践和服务中的实际或潜在变化。通过研究和实施工作流程的灵活性实现了影响;“匹配”的资金安排以支持合作伙伴组织中优先事项的协调一致;合作规模提供了满足项目需求的资源;以及项目持续时间提供了稳定性和长期关系。困难包括在响应优先事项与项目工作中“偏离”可能性之间、学者与实践之间以及卫生服务中的服务提供者与专员之间的紧张关系。为一些NHS管理人员提供受保护的“匹配”时间被证明很困难,这给他们带来了越来越大的工作压力。CPS比传统的项目开发方法更耗时。

结论

CPS可以通过多种方法产生以需求为导向且融入服务的项目。有效CPS的促成因素包括可用资源的使用和类型的灵活性、灵活的工作计划以及响应式领导。CLAHRC模式提供了一个转化基础设施,使CPS能够对医疗系统产生影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21ac/4455707/341262c02817/12961_2015_14_Fig1_HTML.jpg

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