Attorney urges study of doctors' professional relationships.
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Humans↗
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Why do we keep on meeting like this? The board as ritual in health and social care.
Despite their prevalence and longevity in many forms of social organization, most research on formal meetings suggests that they do not fulfil the instrumental purposes (e.g. setting strategy) that their constitutions propose. A three-year study of the Joint Commissioning Board for mental health in Somerset, UK, revealed that it was no exception. However, many of the participants on the Board suggested that it fulfilled important purposes that drew attention to its role as ritual. This paper examines the role of the Board in the light of the literature on ritual--in particular the work of the neo-Durkheimian tradition flowing from the work of Douglas--and locates the importance of the meeting in the formation of social solidarity. This theoretical perspective illuminates issues around classification and language which explain the disempowerment felt by some members of the Board. Finally, this paper identifies the challenges in engaging a broader range of stakeholders (including users and carers) in these rituals.
Ceremonial Behavior↗
Convergent evolution: the academic and policy roots of collaborative research.
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Cooperative Behavior↗
Health services research and development in practice: an Australian experience.
While there is a growing literature on how health services research can inform health policy decisions, the practical challenge is for health services researchers to develop an effective interface with health policy-making processes and to produce outputs that lead to outcomes. The experience of the Centre for Health Service Development at the University of Wollongong, Australia, is used to illustrate the issues so commonly described in the literature and to reflect on our experience of trying to remain viable while producing relevant and valid research. A case study in a specific policy area - namely, the development of case-mix classifications and information systems to inform policy and funding in the subacute and non-acute hospital and community care sectors - is used as a practical example of the research-policy interface.
Cooperative Behavior↗
Linkage and exchange at the organizational level: a model of collaboration between research and policy.
This paper describes an organization-level initiative designed to promote linkage and exchange between a research unit and the mental health policy branch of Ontario's provincial government. Using a framework that conceptualizes four tiers--inter-organizational relationship, interactive research projects, dissemination and policy formation--in the application of linkage and exchange to the research and policy development processes, we present an example in order to explore the issues that arise in each tier. We conclude that while such initiatives enhance the relevance of research in the policy development process, they also present challenges that must be recognized and managed.
Cooperative Behavior↗
Toward a communicative perspective of collaborating in research: the case of the researcher-decision-maker partnership.
In the shift to a post-industrial order, the production and use of knowledge is gaining greater importance in a world beyond science. Particularly in the health sciences, research foundations are emphasising the importance of translating research results into practice and are experimenting with various strategies to achieve this outcome, including requiring practitioners to become part of funded research teams. In this paper, we present a case of a partnership between researchers and decision-makers in Canada who collaborated on an investigation of implementing change in health care organisations. Grounded in this case and recent empirical work, we propose that such research collaborations can be best understood from a communicative perspective and as involving four key elements: relational stance that researchers and decision-makers assume toward each other; purpose at hand that situates occasions for developing and using knowledge; knowledge-sharing practices for translating knowledge; and forums in which researchers and practitioners access knowledge. Our analyses suggest that partnerships are most effective when researchers see the value of contextualising their work and decision-makers see how this work can help them accomplish their purpose at hand.
Canada↗
Partnership experiences: involving decision-makers in the research process.
OBJECTIVES: To describe researchers' experiences with involving health system managers and public policy-makers (i.e. decision-makers) in the research process, and decision-makers' experiences with the research process, including their assessments of the benefits and costs of the involvement, and their recommendations for facilitating it. METHODS: We conducted semi-structured interviews with principal investigators and research staff for the seven research programmes funded by the Canadian Health Services Research Foundation in the 1999 and 2000 competition years, and with the decision-makers they involved in the research programmes. RESULTS: We identify three models of decision-maker involvement--formal supporter, responsive audience, and integral partner--each of which yielded important contributions to the research process. Four factors--the stage of the research process, time commitment required, alignment between decision-maker expertise and programme needs, and an existing relationship between the researcher and decision-maker--influenced the role played by decision-makers. CONCLUSIONS: While on balance a beneficial experience, the further promotion of decision-maker involvement in the research process should involve helping researchers and decision-makers identify strategic opportunities for decision-maker involvement and support the costs associated with the involvement. Consideration should also be given to undertaking and evaluating interactions between researchers and decision-makers outside of the research process.
Canada↗
Implementation of an innovative grant programme to build partnerships between researchers, decision-makers and practitioners: the experience of the Quebec Social Research Council.
OBJECTIVES: This paper examines a grant programme developed by the Quebec Social Research Council in the 1990s to encourage the building of research partnerships between researchers, decision-makers and practitioners. In particular, it studies the perceptions of key participants concerning the reasons behind the programme's successful implementation and growth. METHODS: In addition to secondary data about institutional involvement in the programme, 10 researchers and administrators were consulted as key informants. The method of concept mapping was used in order to draw out a consensus on the different factors associated with the successful implementation of the programme. RESULTS: The participants identified 10 main factors that help explain the programme's successful implementation. These factors were then grouped into a model containing four dimensions: the leadership and coherence shown in the programme's implementation; the presence of a favourable political and social conjuncture; the programme's responsiveness to the needs of health and social services institutions; and the programme's responsiveness to the needs of the university milieu. CONCLUSIONS: Although this model remains specific to the prevailing situation in Quebec at the time of its application, it may help stimulate reflection and contribute to an understanding of how research policies can encourage partnerships between researchers, practitioners and decision-makers.
Cooperative Behavior↗
Creating a new articulation between research and practice through policy? The views and experiences of researchers and practitioners.
OBJECTIVES: In 1990, the Quebec Social Research Council - a body financing social research in Quebec, Canada - launched a new policy encouraging the development of social research units within health care organizations. Through financial incentives, it encouraged the implementation of long-term collaborations between researchers and practitioners with the purpose of transforming both scientific knowledge production and professional practices. This paper examines the perceptions of researchers and practitioners regarding the attributes and the usefulness of this collaborative research policy. METHODS: A self-administered survey was sent to all the researchers (n = 146; response rate 78.1%) and practitioners (n = 204; response rate 44.1%) involved in the 21 collaborative research teams funded in 1998. T-tests were performed in order to assess the difference between the perceptions of researchers and practitioners in five key dimensions of collaborative research. RESULTS: The results showed that, contrary to expectations, researchers and practitioners shared fairly similar views regarding the various dimensions of collaborative research. They both agreed that their involvement within collaborative research teams had contributed to the development of new skills and practices but had not facilitated their participation in external activities nor their involvement in networks and organizations that influence environments in which public policies and practices are deployed. They also both encountered some difficulties in putting the dimensions that they highly valued into practice. CONCLUSIONS: Collaborative research within health care organizations succeeded in fostering the implementation of new modes of knowledge production and intervention. Nevertheless, special attention needs to be given to the development of strategies to reduce the discrepancies between values and practices.
Cooperative Behavior↗
Novel mode of knowledge production? Producers and consumers in health services research.
OBJECTIVES: To investigate (1) what type of knowledge production characterizes health services research - academically based (mode 1) or socially distributed (mode 2); (2) how leaders in health services research link to users of the research; (3) how this research is influenced by its funding base; and (4) the development and dissemination strategies of investigators. METHODS: Four purposively selected case studies of contrasting health services research groups generated early propositions (70 interviews). These led to a postal survey of key stakeholder groups in one English National Health Service region (199 responses, 53% response rate). RESULTS: Health services research in the UK is characterized by: a mix of mode 1 and mode 2 output indicators; strong external relationship building by group leaders; a powerful driver from external finance; and extensive dissemination and development activity. CONCLUSIONS: Health services researchers may have to operate in both modes. Mode 1 retains considerable defensive power, so there are limits to the extent to which mode 2 research may develop.
Cardiovascular Diseases↗
Sharing and expanding academic and practitioner knowledge in health care.
The purpose of this paper is to expand understanding of academic-practitioner knowledge-sharing in the service of enhanced knowledge creation in health care. To this end, we describe the tacit and explicit knowledge of academics and practitioners and how this knowledge exists within their communities of practice. We also discuss benefits of, difficulties with, and some underlying dynamics of academic-practitioner knowledge-sharing. We then propose what might be done, based on appreciation of these dynamics, to foster joint knowledge-sharing and knowledge creation. We illustrate our arguments with examples from health care settings.
Cooperative Behavior↗
An assessment of parental satisfaction with mode of delivery of specialist advice for paediatric cardiology: face-to-face versus videoconference.
Comparisons of parental satisfaction were made after specialist paediatric cardiology consultations were conducted either by conventional face-to-face delivery or telemedicine. Satisfaction statements were rated by 100 parents: 20 who experienced telemedicine; 56 with new children seen in the outreach clinics; 24 with children on review whose next appointment was at the specialist centre. There was general satisfaction with both types of consultations, but significant differences were noted. Those who had videoconferences felt that they had received an explanation about how the specialist advice would be obtained, and that they could see the pictures being discussed clearly. Those who had experienced telemedicine believed that teleconsultations could save them travelling time and money and they found the technical aspects of sound and picture quality acceptable. They were not discomforted by the technology and felt reassured by the consultation with the specialist. However, there was some ambivalence towards the statements suggesting that teleconsultations could take the place of conventional face-to-face consultations.
Cardiology↗
On closer inspection: learning to look at the whole home environment.
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Air Pollution, Indoor↗
Annual report: September 2004 to November 2005.
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Annual Reports as Topic↗
A survey of 'teamwork' in mental health: is it achievable in practice?
As part of an ENB educational evaluation of teamworking in mental health, a report-and-respond survey was used as one of five data collection methods. This instrument disseminated earlier findings back to the participants and invited further comments. This article discusses the usefulness of this type of survey as a data collection tool and presents the findings of the survey which was administered to service professionals, educationalist, students, users and carers involved in mental health throughout England. The findings show that when groups of professionals are working within increasingly tight financial constraints and increased workloads, multiprofessional teamworking can be scarce in reality. These tensions present issues for nurse education and training at both pre- and post-registration levels in relation to the teaching of, for and about effective teamwork.
Data Collection↗
Social work roles in collaborative research.
Social workers in health care settings may be most effective in the development and implementation of collaborative research studies which jointly involve academic and health service institutions. This article describes: organizational issues significant to the integration of research into a health service system; interpersonal issues that effect the perspectives of research and service professionals in the daily operation of the research project; and social work skills for collaborative research studies. An on-going 5-year collaborative research study of approximately 7,000 participants will be used as a case example.
Data Collection↗
Social group work: building a professional collective of hospital social workers.
Deconstruction of traditional social work departments can isolate social workers from their primary source of professional affiliation, leaving them without the support to take stands on controversial patient care issues. This paper describes an alternative: the building of a powerful social work collective based on social group work theory that potentiates professional practice while transcending management forms. The model includes group supervision, but moves beyond it to utilize the social work group as a central organizing principle. At the heart of the collective are the elements of professional accountability, support, autonomy, and collaborative decision- making within democratic peer group structures. The authors highlight current management theory, distinctions that create an authentic social work value-based practice, and outcomes for social workers, their clients, and colleagues.
Conflict, Psychological↗
Out of the Ivory Tower: the value of collaborative research.
Collaboration is an underutilized strategy for combining the strengths and perspective of home health care professionals in service and academic settings. This paper explores the importance of collaborative research strategies, focusing on the role of the unique talents, resources, and perspectives offered by each health professional to the research process. Finally, personal, professional and organizational barriers to collaboration are examined in order to alert would-be researcher collaborators to obstacles they are likely to encounter. When both the strengths of and obstacles to collaborative research are anticipated, collaboration can encourage research that is relevant to the needs and experiences of both home health service providers and academicians.
Administrative Personnel↗