Addressing the challenges of knowledge co-production in quality improvement: learning from the implementation of the researcher-in-residence model
Addressing the challenges of knowledge co-production in quality improvement: learning from the implementation of the researcher-in-residence model
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DOI：
10.1136/bmjqs-2017-007127
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发表时间：
2019-01-01
影响因子：
5.4
通讯作者：
Marshall, Martin
中科院分区：
文献类型：
--
作者：
Vindrola-Padros, Cecilia;Eyre, Laura;Marshall, Martin
知识共同生产的概念用于卫生服务研究中，描述伙伴关系（可能涉及研究人员、从业者、管理者、专员或服务用户），其目的是创建、共享和谈判用于改进卫生服务的不同知识类型。迄今为止，已经提出了几种知识共同生产模型，其中一些涉及中介角色。本文探讨了这样一种模式：驻场研究人员（也称为“嵌入式研究人员”）。在这种模式中，研究人员在医疗保健组织内部工作，作为工作人员开展工作，同时还与学术机构保持联系。作为当地团队的一部分，研究人员协商基于研究的知识的含义和使用，以共同生产对当地环境敏感的知识。尽管这种模式正在传播，并且似乎有潜力利用共同产生的知识来改变实践，但其使用过程中也出现了一些挑战。其中包括研究人员在将自己融入实践环境、在所在组织中保持明确的关注点以及保持学术专业身份方面所经历的挑战。在本文中，我们通过研究在英国实施的三个独立案例研究来探索这些挑战，每个案例都试图共同开展相关研究项目以提高护理质量。我们探讨这些问题在实践中如何发挥作用，以及驻场研究人员解决这些问题所采用的策略。在描述和分析这些策略时，我们希望未来能够更有效地使用参与式知识合作生产方法。
The concept of knowledge co-production is used in health services research to describe partnerships (which can involve researchers, practitioners, managers, commissioners or service users) with the purpose of creating, sharing and negotiating different knowledge types used to make improvements in health services. Several knowledge co-production models have been proposed to date, some involving intermediary roles. This paper explores one such model, researchers-in-residence (also known as 'embedded researchers'). In this model, researchers work inside healthcare organisations, operating as staff members while also maintaining an affiliation with academic institutions. As part of the local team, researchers negotiate the meaning and use of research-based knowledge to co-produce knowledge, which is sensitive to the local context. Even though this model is spreading and appears to have potential for using co-produced knowledge to make changes in practice, a number of challenges with its use are emerging. These include challenges experienced by the researchers in embedding themselves within the practice environment, preserving a clear focus within their host organisations and maintaining academic professional identity. In this paper, we provide an exploration of these challenges by examining three independent case studies implemented in the UK, each of which attempted to co-produce relevant research projects to improve the quality of care. We explore how these played out in practice and the strategies used by the researchers-in-residence to address them. In describing and analysing these strategies, we hope that participatory approaches to knowledge co-production can be used more effectively in the future.