Title: Getting the most out of knowledge and innovation transfer (KIT) ‘agents’ in healthcare: a qualitative study
Funder: Division for Social Care and Health Research (Wales)

Abstract: This project aims to help NHS managers/practitioners get the most from research evidence and innovation for better service outcomes. Research identifies improved more efficient ways of planning purchasing or providing healthcare or indeed where interventions do little or negatively impact on healthcare. Yet this knowledge often fails to influence managers responsible for getting the best patient care out of limited resources (HM Treasury 2006; Mitton et al 2007). “Knowledge brokers” or “boundary spanners” (Dobbins et al 2009; Williams 2002) have been promoted as a means of addressing this research-practice gap by initiatives within CLAHRCs (Collaborations for Leadership in Applied Health Research and Care) and Service Delivery and Organisation (SDO). CLAHRC “Diffusion Fellows” and SDO “Management Fellows” are healthcare managers skilled in forming linkages connecting research to the health service workplace and communicating knowledge for innovation and improvement.This study focuses on the work of boundary spanners who we call “agents” of knowledge and innovation transfer (KIT). We will collect data to address six objectives. (1) To map the KIT intentions of the new Academic Health Science Networks (AHSNs) and the South East Wales Academic Health Science Partnership (SEWAHSP). Are KIT agents proposed? How many? What are the main features of their role? What structures are in place? How do they connect to CLAHRCs? This will be achieved through review of all 15 AHSN submissions and the SEWAHSP strategy supplemented by telephone interview with named regional leads (or alternate). (2) To describe and characterise the role of KIT agents their linkages relationships and engagement activities and develop a typology of roles. What do they do? How important are interpersonal relationships? What outcomes are expected? What performance measures are used? This will be addressed through reviewing documentary data (from job descriptions and so forth) and semi-structured interviews with 10-12 post-holders and their managers. Questions will be asked about motivations and expectations for the agent and their employer mechanisms used to capture knowledge and innovation and transfer it and indicators of success.(3) To report the perceived impact of KIT agents on managers’ practice. How does the work of KIT agents impact on healthcare practice? What works for whom in what circumstances? How is the impact of KIT activity understood by other managers? What is the influence of the organisation and wider policy context? Can benefits be sustained? Detailed case studies of KIT agents and their work will be the source material for this objective which is concerned to identify strategies that make a difference to practice. We will identify 10-12 KIT agents from the new AHSNs and SEWAHSP and collect data from: observation of KIT events/meetings (estimate three in each site); interviews with managers/practitioners researchers and KIT agents (estimate 60 interviews; discussing learning gains knowledge use behaviour change the organisation’s ‘absorptive capacity’ (Cohen & Levinthal 1990); audio-diaries kept by agents over 4-months. Participants will be asked to provide illustrations and reflexive commentary on successful as well as failed or incomplete transfer and reasons for it (exploring individual team organisational and policy factors).(4) To investigate how KIT agents can be best supported. We will use data from our detailed case studies and discussion in the action learning group of KIT agents (outside our case studies). (5) To generate a set of impact measures for assessing KIT activities. How is the impact of KIT activity understood by managers and NHS practitioners? What does successful transfer look like and how do we know? By working with a panel of 9-12 ‘experts’ (nominal group) and informed by the literature we will propose a set of measures for use in assessing the outcomes of transfer activity and test their feasibility as part of our analysis of our case study data.(6) To identify actionable findings and recommendations. Four strategies will be used to achieve this: an action learning set (ALS) comprising KIT agents beyond the case study group to discuss learning from the study; inclusion of an NHS manager as a member of the research team; regular feedback events with participants; and use of a project Advisory Group. These together provide early opportunity for improvement based on emergent lessons and should ensure that recommendations are acceptable credible and feasible with the people who would need to implement them. Our case studies will provide good opportunity for comparison and cross-pollination of strategies and tactics. The specific innovations and knowledge that agents are helping to transfer is diverse but address current concerns including service delivery and organisation challenges related to older people mental health chronic disease and cancer. This diversity will enable the detection both of content-specific knowledge transfer challenges as well as generic mechanisms that support transfer.Data collection and analysis will be informed by a well-used programme evaluation framework (Kirkpatrick 1979) and social marketing theory (as recently used by the Department of Health 2011). By identifying successes and difficulties the study will provide recommendations and offer actionable insights into how KIT events/people work in practice and how benefits can be maximised so helping NHS organisations make better use of knowledge and innovation.ReferencesHM Treasury (2006) A review of UK health research funding: Cooksey. London: HM TreasuryMitton C et al (2007) Knowledge transfer and exchange: Review and synthesis of the literature. Milbank Q 85:729-68Dobbins M et al (2009) A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implement Sci 4(1):23Williams P (2002) The Competent Boundary Spanner. Public Admin 80(1):103-24Cohen W Levinthal D (1990) Absorptive capacity: A new perspective on learning and innovation. Admin Sci Quart 53(1):128-52Kirkpatrick D (1979) Techniques for evaluating training programs Training Dev J. 33(6):78-92Department of Health (2011) Changing behaviour improving outcomes: a new social marketing strategy for public health. London.


Research activity codes: 8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE