It seems sensible to assume that healthcare organisations that do research provide better care. However, up until now, there has been little evidence to support this. A new evidence synthesis study funded by the NIHR Health Services and Delivery Research Programme aims to address this. It concludes that where clinicians and health-care organisations engage with research, there is a greater likelihood of a positive impact on health care performance.
A review in 2011 found ‘no apparent evidence’ that patients treated by practitioners or in institutions that were research-active did worse than patients treated elsewhere. The 2013 review aims to update and expand this work, drawing on more recently published literature from wider sources to explore how research engagement might improve health care performance.
What did they do?
The study adopted an ‘hourglass’ review consisting of a wide planning and mapping stage, followed by a highly focussed review and subsequently a wider but less systematic review. They included papers that looked at the effect of being research active on clinical performance, where ‘research active’ was defined as:
- Staff that undertook research studies
- Staff that received or provided research training
- Staff or organisations that participated in or supported networks to identify the needs for further research
- Staff that played an active role within the whole research cycle, including research design
- Organisations that supported their staff to be engaged in research
And ‘Performance’ was defined as improvements in the processes and outcomes of care.
What were the results?
The team found evidence that collaborative and action research were effective methods of research engagement that improved health-care performance. The improvements were demonstrated in health care processes as well as some improvement in patient outcomes.
Additionally, it found that organisations that fully incorporated research function into their structure had better health care performance (i.e. improvements in the processes and outcomes of care) than organisations that did not take this integrated approach.
We still don't know why these improvements were observed. This is most likely due to a complicated network of mechanisms at work, each of which operating differently depending on the context. Evidence of each mechanism is also limited and therefore more research is needed.
What does this mean for charities?
This study showed that engagement of clinicians and organisations in research brought a definite improvement in clinical processes and some improvement in patient outcomes.
Our vision for research in the NHS outlines steps to ensure NHS staff see the importance of research, how to use its findings to improve care, and know how to take part in research. This study shows how important this call is, not just to make sure that more NHS staff can take part in research and help their patients take part, but that this process of taking part can help the whole NHS provide a better service and improve health outcomes for patients.