Table 2

Mechanisms through which research engagement may improve healthcare performance

Mechanisms identified in the focused reviewInsights from the wider review
By product papers
Broad impactSpecific impact
  • Research-active staff may differ from their peers in non-research-active settings because of: personal characteristics, multidisciplinary collaboration, additional training and education or specialisation

  • An increasing recognition of the ‘by-product’ type benefits from research engagement has encouraged further thinking about how best to build on and regularise these opportunities

  • Change in attitudes and behaviour that research engagement can promote

  • Involvement in the processes of research

▸ Greater awareness and understanding of the specific research findings
 Organisation▸ Use of the infrastructure created to support trials more widely, or for a longer period, to improve patient care▸ Applying the processes and protocols developed in a specific study (not counting any impact from regimens in the intervention arm) to all patients with specific illness, irrespective of their involvement in the trial
Network papers
  • Increased relevance of the research

  • Increased knowledge and understanding of the findings gained through participation in the research

  • Clinician participation in research networks particularly effective when the science is changing rapidly and when keeping up-to-date is critical

  • Mechanisms such as practice facilitators, project development meetings and network convocations allow two-way knowledge exchange throughout a research network, enabling clinicians to engage with question generation and the resulting research, and ensuring that the research is more relevant to practitioners

  • Limitations about what can be achieved by research networks

  • Need for a supportive context that enables clinicians and their organisations to participate in research and research networks

  • Evidence of a growing international interest in the benefits that might come from research networks

  • Centres within networks build up a record of implementing research findings

  • Network membership increases the likelihood of physicians recommending guideline concordant treatment

  • Organisations affiliated to a network adopt an integrated, programmatic approach to improving the quality of care, including the professional education, training and national meetings provided

Intervention papers
 Organisation▸ The importance of effective collaboration and the need for a supportive context
  • Healthcare organisations and systems provide the context within which research engagement operates at other levels

  • Organisations in which the research function is fully integrated into the organisational structure can out-perform other organisations that pay less heed to research and its outputs