Professor of Public Health, London School of Hygiene and Tropical Medicine, UK.
Programme Manager, National Voices.
J Health Serv Res Policy. 2021 Jan;26(1):28-36. doi: 10.1177/1355819620928368. Epub 2020 Jun 2.
To improve the provision of health care, academics can be asked to collaborate with clinicians, and clinicians with patients. Generating good evidence on health care practice depends on these collaborations working well. Yet such relationships are not the norm. We examine how social science research and health care improvement practice were linked through a programme designed to broker collaborations between clinicians, academics, and patients to improve health care - the UK National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Northwest London. We discuss the successes and challenges of the collaboration and make suggestions on how to develop synergistic relationships that facilitate co-production of social science knowledge and its translation into practice.
A qualitative approach was used, including ethnographic elements and critical, reflexive dialogue between members of the two collaborating teams.
Key challenges and remedies were connected with the risks associated with new ways of working. These risks included differing ideas between collaborators about the purpose, value, and expectations of research, and institutional opposition. Dialogue between collaborators did not mean absence of tensions or clashes. Risk-taking was unpopular - institutions, funders, and partners did not always support it, despite simultaneously demanding 'innovation' in producing research that influenced practice.
Our path was made smoother because we had funding to support the creation of a 'potential space' to experiment with different ways of working. Other factors that can enhance collaboration include a shared commitment to dialogical practice, a recognition of the legitimacy of different partners' knowledge, a long timeframe to identify and resolve problems, the maintenance of an enabling environment for collaboration, a willingness to work iteratively and reflexively, and a shared end goal.
为了改善医疗服务,学术人员可以被要求与临床医生合作,临床医生可以与患者合作。关于医疗实践的良好证据取决于这些合作关系的良好运作。然而,这种关系并不常见。我们通过一个旨在促进临床医生、学者和患者之间合作以改善医疗保健的计划来研究社会科学研究和医疗保健改进实践是如何联系在一起的 - 英国国家卫生研究院合作领导在伦敦西北部的应用健康研究和护理。我们讨论了合作的成功和挑战,并就如何发展协同关系提出了建议,以促进社会科学知识的共同产生及其转化为实践。
采用定性方法,包括民族志元素和两个合作团队成员之间的批判性、反思性对话。
关键挑战和补救措施与新工作方式相关的风险有关。这些风险包括合作者之间对研究的目的、价值和期望的不同看法,以及机构的反对。合作者之间的对话并不意味着不存在紧张或冲突。冒险不受欢迎 - 尽管同时要求在产生影响实践的研究方面进行“创新”,但机构、资助者和合作伙伴并不总是支持它。
我们的道路更加顺畅,因为我们有资金来支持创造一个“潜在空间”,以尝试不同的工作方式。其他可以增强合作的因素包括对对话实践的共同承诺、对不同合作伙伴知识的合法性的认识、确定和解决问题的长时间框架、为合作提供有利环境的维护、愿意迭代和反思工作,以及共同的最终目标。