Our main research focus is on promoting the implementation of evidence-based practice into routine health care. We are also developing a closely related theme of educational research and actively contribute expertise in primary care research to other programmes within the Leeds Institute of Health Sciences.
Implementation Research
Clinical research continually produces new evidence that can benefit patients. This evidence does not reliably find its way into everyday patient care. In both policy and research, the selection of implementation strategies tend to be driven by combinations of habit, pragmatism and varied assumptions about how the world works rather than evidence. Policy needs to be informed by rigorous evidence on the cost-effectiveness of implementation strategies, the mechanisms by which they work and which contextual factors enable change. We work with NHS and research partners on a programme of work comprising three themes:
1. Measuring and understanding the uptake of evidence-based practice
Work in this theme is mainly based around hypothesis generating studies, qualitative and quantitative, to describe and explain the uptake of evidence-based practice. This will entail:
- Identifying health problems with high impacts (e.g. mortality, morbidity, costs) where there are potentially significant gaps between evidence and practice
- Developing criteria and methods for measuring the implementation of evidence-based practice;
- Identifying patterns of variations in implementation (e.g. areas of care where all or most practices perform poorly, subsets of practices or patients consistently associated with poorer performance); and
- The use of individual and system-level theories and frameworks in diagnosing the most important causes of inappropriate variations that are amenable to change.
2. Changing clinical and organisational practice
Work in this theme is mainly based around hypothesis testing studies to estimate the effects of implementation strategies with embedded process evaluations to explore causal mechanisms. It will entail:
- The design of implementation strategies targeting the most important determinants of practice based upon available systematic reviews, diagnostic analyses (theme 1) and the explicit mapping of intervention elements to key determinants of change;
- Randomised and quasi-experimental studies to evaluate the cost-effectiveness of interventions; and
- Theory-based process evaluations, using qualitative and quantitative methods, embedded within intervention studies to explore and explain effects
3. Methodology
The work within this theme inherently incorporates many of the methodological aspects and tasks embedded in the aforementioned themes. However, one further critical objective is to critically engage with national and international researchers and quality improvement leaders in order to advance the methodological and epistemological debate about how research can best inform and influence the implementation of high quality health care.
Educational Research
We are presently developing a portfolio of educational research, which closely complements our work on implementation. Current areas of interest include:
- The relationship between participation in teaching and quality of care
- Communities of learning in primary care
- The virtual learning environment
- Sustainable health education
- Consultations across culture-linguistic barriers
Getting Involved in Research
If you would like more information about research projects within our department please contact Professor Robbie Foy: r.foy@leeds.ac.uk
Fort information about other primary care research projects please contact John Hodgson at the Primary Care Research Network (N&Y):
John Hodgson
Clinical Trials Coordinator
Primary Care Research Network (N&Y)
john.hodgson@nyren.co.uk
www.nyren.co.uk