Engaging NHS Managers and organisations in research
Below is a summary of how we are engaging NHS Managers and Organisations in research.
Follow the links below to find out more.
Is doing more research in an organisation a pathway to better outcomes?
Most organisations know that research is good for patient care. Research can help us understand what treatments work, and why. We are also seeing more evidence of patients wanting to take part in research, and enjoying participation (see NIHR report)
However, we also know that translating research to patient benefit - that is, engagement with research – is not easy. There is a long pathway between starting research and seeing care change and patients benefit.
Getting NHS organisations to take part in research can be a challenge – a recent BMJ paper highlighted some of these.
However, there is increasing evidence that engagement in research also leads to patient benefit. That is, patients may have better care and outcomes, simply because the organisation caring for them is doing research.
Amy Downing and colleagues explored participation in cancer research among hospitals. They compared patient outcomes in hospitals doing more and less research, and found that patient survival was better in hospitals that were highly active in research. Of course, those hospitals may be located in different places, or serve different populations. However, the benefits of research remained, even when analyses controlled for all those differences, and there was also a ‘dose response’ effect.
Another recent study showed that Research active Trusts had lower risk-adjusted mortality for acute admissions (Ozdemir et al)
A recent NIHR funded review found a number of studies, and many reported benefits. These were more often in relation to measures of the process of care (such as delivery of evidence based care) but a number of studies supported the Downing findings and showed benefits in terms of patient health.
Is involvement in research a lever to quality improvement?
Of course, teasing out these relationships and proving they demonstrate cause and effect is difficult – these issues are not amenable to trials. We are unlikely to ever have a definitive test, and it is more a case of assessing when the evidence is sufficient, rather than definitive.
If this finding is valid, can it be used as a driver of quality improvement?
First, how does this occur? We don’t actually know at the moment, although a variety of reasons have been discussed. Taking part in research may see the introduction of new technology or skills needed to do the research. It may reflect ‘softer’ effects such as motivating staff.
The second key question is: how can this relationship be used for quality improvement?
Participation in research is something that is fairly easily quantified, and could be used in incentive or other quality improvement systems. There is potential to use this as a lever to generate patient benefit. However, caution is required, as a heavy handed application here could have important unintended consequences.
As a first step in making this a lever for quality improvement, William van’t Hoff and colleagues have worked with the CQC to build research into inspections (see details of the initiative).
Working in partnership with the HRA, MHRA and CQC to develop new research indicators for use in the CQC’s extensive inspection programme. William van’t Hoff, NIHR Clinical Director for NHS Engagement, said:
“Evidence is emerging that patients have better outcomes at research-active hospitals, regardless of whether they took part in the research studies. Well-led healthcare organisations support patients to join cutting-edge research projects and clinical trials. We are delighted to be working with our research partners and CQC to help more NHS and care organisations recognise the value that clinical research plays in improving health.”
These indicators will give NHS organisations the opportunity to showcase research as part of their assessment by the CQC, demonstrating their commitment to high quality patient care.
VICTOR research impact tool
Linking research participation to quality improvement will be easier if organisations can better demonstrate how research has made a difference
CLAHRC YH has co-produced a tool called VICTOR (Visible impact of research) to help organisations make these impacts visible
The tool has its own website and further details can be found here