Putting Evidence Into Practice
Scaling up healthcare innovation across the globe
A multi-disciplinary team led by Professor Currie worked with healthcare organisations through regional initiatives, Collaboration for Leadership in Applied Health Research and Care (CLAHRC), to develop a new implementation model that has accelerated the uptake of evidence in practice, resulting in improved services. Managerial and patient benefit has been derived in maternity, musculoskeletal disease, mental health and cancer services in the West Midlands, and in Australia and India, where the implementation model has also been adopted.
Billions are spent on generating research evidence to explore what clinical interventions work to address long-term health conditions, in terms of effectiveness, cost efficiency, and patient experience. However, such research evidence is slow to trickle into frontline service delivery. This is the known as the ‘translational challenge’; a gap between clinical research and the application of that knowledge in standard practice. Professor Currie's research team have bridged that gap, by developing and applying an implementation model, founded on organisation science research.
Professor Currie was appointed Deputy Director of the CLAHRC West Midlands, and led a WBS-based research team working at the centre of the CLAHRC throughout the 2014 - 2019 phase. Drawing on the findings of the earlier research into “what works” for effective knowledge transfer of evidence-based innovation in complex health settings, the team undertook a comprehensive programme of applied research. This programme, conducted under a cross-cutting Implementation and Organisational Studies theme within the CLAHRC, delivered state-of-the-art management expertise for the implementation of evidence-based innovation across four clinical service themes, relating to maternity and child health, youth mental health, disease prevention and chronic disease. This research identified:
What healthcare providers should do to ensure receptive context for evidence-based innovation, specifically how best to mobilise knowledge, including in Australia and India
How leadership should be distributed across healthcare providers to support implementation and scale-up of evidence-based innovation, including in India and Australia
What human resource policies and practices healthcare providers should implement to best engage their clinical workforce in implementing and scaling up evidence-based innovation
How middle managers represent crucial conduits in scaling up evidence-based healthcare
Professor Currie and the WBS research team worked alongside hospital practitioners and clinical academics to ensure evidence-based innovation was embedded in frontline practice more effectively, using approaches to implementation derived from their organisation science-focused research. This has resulted in the following benefits for CLAHRC West Midlands:
Improving Maternity Services: supported implementation of a maternity triage system (BSOTS) by providing lessons focused upon clinical engagement, midwifery leadership and strategies to adapt the intervention for different maternity units. Following the WBS implementation support, the evidence-based triage system has been introduced in 14 maternity units, with another 27 in progress, with 54% of women seen within 15 minutes (compared to 39% before).
Improving Musculoskeletal Services: supported implementation and scale-up of non-surgical service model called ‘STarT Back’ – Stratified care for low back pain. This new model results in greater health benefits, achieved at a lower average healthcare cost, with an average saving to health services of £34.39 per patient and societal savings of £675 per patient.
Improving Youth Mental Health Services: drawing upon research insights about the need for distributed leadership to scale up innovation and the knowledge brokering capabilities of middle managers to embed innovation in practice, the research team from WBS worked alongside frontline clinicians and managers to put the Dimensions of Health and Wellbeing Tool in place to support patient self-management. This tool has improved early intervention and clinical outcomes of young people with mental ill-health.
Further afield, Professor Currie’s research has influenced the Monash Centre for Health Research & Improvement in Australia and the Schizophrenia Research Foundation in India, helping to build leadership capacity, develop their workforce, and enact strategies to implement and scale up healthcare innovations.