ConnectED: Connecting Evidence with Decision Making

Funding

National Institute for Health and Social Care Delivery Research (NIHR) Health and Social Care Delivery Research Ref NIHR131345.

Research question

Can we improve research use in Adult Social Care by bringing together the worlds of research and practice, informed by the lived experience of service users and carers?

Background

Research active practitioners are rare within Adult Social Care, and the use of research to inform decision-making is not routine. The worlds of practice and research are often quite separate, and there is often a mismatch between the research produced by universities and other organisations, the needs of those working in Adult Social Care and those in receipt of their services. Evidence from the transformation of healthcare and healthcare research points to the importance of bringing the worlds of research and practice closer together, involving service users and carers, and investing in capacity building in social care staff. This is what we are seeking to do in this project.

Aims and objectives

The overarching aim of this project is to facilitate evidence-based decision-making in a range of Adult Social Care contexts, thereby improving outcomes for service users and carers and identifying successful strategies for developing evidence-based practice in Adult Social Care nationally. In order to meet this aim, the project has the following key objectives:

1.To build the capacity of social care workers (including senior practitioners and frontline workers, managers, commissioners and analysts) to identify, access and use research to improve decision-making.

2.Using co-production methods, to develop the ability of practitioners within Adult Social Care to undertake service evaluations, and to develop early-stage studies that can form the basis for future research proposals in priority areas.

3.To evaluate the impact of the project’s capacity-building activities on effective decision-making, and the use of evidence to inform policy and practice in Adult Social Care.

4.To identify factors that facilitate or impede capacity-building in evidence-based decision-making amongst those working in a complex social and organisational context, and successful implementation strategies that support better decision-making.

Methods

In each of our five partner agencies we will establish a three-person Research Practice Partnership comprising: A Researcher in Residence: we will locate a social care researcher in each agency, using a ‘researcher-in-residence’ model. An Evidence Champion: each agency will nominate members of staff to work with the researcher in residence to promote and embed the use of research in decision making. They will be known as evidence champions. User and Carer Advisors: each partnership will work closely with designated service users or carers who bring relevant expertise by experience.

Programme theory

In line with good practice, we have formed some hypotheses regarding what mechanisms are likely to operate, the contexts in which they might operate, and what one would find if they operated as expected (outcomes). These will be refined in discussion with participating agencies at the outset of the project and will help to direct the investigation and analyses. They will be revisited in light of the findings. Our programme theory posits that i) building capacity to use and produce research evidence at an individual, interpersonal and organisational level and ii) strengthening the relationship between practitioners, researchers and service users and carers, will result in improved evidence-based decision making and practice. The key mechanisms thought to achieve this are that: the Research Practice Partnerships will not only increase belief in the relevance and value of research but also increase self-efficacy and ability to use and produce research, by involving practitioners, service users and carers in the identification of research priorities and co-production of research activities (syntheses, evaluations) and learning activities (evidence master-classes, problem-based learning), supported by key skills training. The project consists of three, inter-connected workstreams.

Workstream 1

Connecting research evidence with key decision-makers The overall aim of this workstream is to facilitate the integration of research and practice at multiple levels within Adult Social Care, from those in leadership roles to the frontline workers. Working with their Researcher in Residence and Service User and Carer Advisor, Evidence Champions will identify those issues and decisions where research might be useful. The Researcher in Residence will then identify and critically appraise the evidence, and the Partnership will together consider its relevance and implications. The Research Practice Partnerships will then work with wider groups of staff to consider how best to embed its use in practice. Over the course of the project, the Evidence Champions will develop the skills required to source and appraise research. This will come from working closely with the Researchers in Residence, from participation in learning sets, access to training courses and master classes organised by the research team. Each Researcher in Residence will also take a lead role in working with particular groups of more senior staff, or staff not working on the front line, for example, elected members of councils, commissioners of services, senior managers, data analysts.

Workstream 2

Fostering research-practitioners and growing an evidence-based culture. ‘Learning by doing’ is the key principle in workstream 2, which is designed to develop a cadre of research-active practitioners, able to undertake applied research that can provide useful information for performance monitoring within their agencies and provide the basis for the development of a pipeline of research. Activities will involve social care professionals at all levels of the organisations, including social workers, occupational therapists, reablement workers and analysts. Each Research Practice Partnership will identify an area of practice that would benefit from a comprehensive synthesis of the available evidence, or a service innovation or current policy or practice for which no relevant or sound evidence-base currently exists. For services where no adequate evidence is currently available, the Partnership may decide to conduct exploratory research which could establish the need for careful evaluation, thereby potentially forming the basis of an application for externally funded research e.g. a feasibility study of an innovative idea, or a pilot study of a service for which little or no evidence is available.

Workstream 3

Assessing impact and identifying lessons learned Using a realist approach, this workstream is designed to assess the impact of the project and identify ‘lessons learned’ about what works, for whom, and in what circumstances in pursuit of sustainable improvements in research use in Adult Social Care. It will explore issues of implementation and acceptability, as well as the impact of workstreams 1 and 2. The findings will help the Partnership to sustain improvements in the use of research in decision-making, to lay the foundations for further developments and to provide a reference point for new partnerships seeking to embed research use in their work. Before the Research-Practice Partnerships begin operating, we will collect a range of baseline data regarding the nature and extent of research use within each participating agency. We will also work with each agency to identify the specific aims and objectives that each wants to achieve in relation to research use by the end of the project. Towards the end of the project, we will repeat the data collections and assess the extent to which each agency has improved in respect of research use in general, and in relation to their specific aspirations.

Timeline for delivery

The project will run for 42 months. We anticipate that the Research Practice Partnerships will begin work on Work Package 1 in Month 4, and work on Work Package 2 is expected to begin in Month 13. Work Package 3 runs throughout the project.

Anticipated impact

The ultimate beneficiaries of this project will be service users and carers in the agencies involved and, longer term, in other Adult Social Care services. Shorter term, the impacts we hope to achieve include:

1. Sustainable changes of organisational culture
2. The routine use of research in decision-making at all levels
3. A growth in within-agency service evaluation and exploratory research
4. Transferable knowledge about ‘what works’ in bringing about sustainable improvements in the use of research in Adult Social Care
5. The identification of relevant research questions, and 6. The emergence of a pipeline of research practitioners.

Dissemination

As well as having in place mechanisms for sharing information across the Partnership as a whole, we are collaborating with the Social Care Institute for Excellence to ensure wide dissemination of our findings, in a range of media that will ensure accessibility to all key stakeholders, including practitioners and experts by experience.

Who is leading the research?

Professor Geraldine Macdonald, Professor of Social Work, School for Policy Studies, University of Bristol.

Further information

CI Email: geraldine.macdonald@bristol.ac.uk

For more information or to get involved in this project, please contact bnssg.research@nhs.net.

The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care

Please find more information here.