Does Research Help Inform a Healthcare Organisation’s Purpose? A Perspective of One New Zealand District Health Board
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Background: The body of work set out to answer the question “does research overall help to inform a healthcare organisation’s purpose?” To align health care research activity to a District Health Board (DHB) organisational purpose would seem to be a logical aim. In 2011, a New Zealand (NZ) government Health Select Committee recommended that DHBs undertake research as a frontline activity. In its response, the NZ Government indicated that while clinical research may play some role it was not considered to be a frontline activity of the. In 2017, the first ever NZ Health Research Strategy 2017-2027 has indicated movement in the government’s stance. The strategy has recognised opportunities across the health sector, and particularly in the DHBs, to improve the environment and culture for research and innovation, by investing in research infrastructure and effective governance to support it. The setting for this study was Waitematā DHB, a NZ publicly funded healthcare delivery organisation that hosts research. In 2015, it established a research governance group charged with providing direction for research and clinical audit, development of a purposeful five-year research strategy and to provide oversight of its implementation. Aim: To analyse and critique the type of research undertaken at Waitematā DHB in the years 2008 – 2015 and to guage the perceived value of the research to inform this DHB’s stated purpose to relive suffering, promote wellness and prevent, cure and ameliorate ill health. Purpose: Generating greater awareness of the research activity in the DHB may help to elevate this activity from a relatively adjunct status to one that can be more fully appreciated, knowingly resourced and strategically valued. Method: This is a mixed method study in four parts. The first two parts were retrospectively focused analyses utilising the DHB’s research and knowledge management database resource and locality documents to appreciate the type of research activity and who conducts it. Two surveys were undertaken in Part 3, the first focused on the researchers to establish the outcomes from their locality approved research. The second survey canvassed the opinions of organisational decision makers with regard to the DHB’s capacity to conduct, acquire and use of research knowledge. The final part utilised qualitative interviews with a small number of key clinician researchers, to gain their perspectives the research question. Results: The results indicate that research happens in this DHB, even where the business is not centrally funded to conduct research. A lack of obvious and consistent communication of the organisation’s provision for research in its planning has encouraged the development of research silos and led to broad variation in research types. In addition, clinical leaders and managers were unsure the DHB’s business processes supported the translation of the knowledge from research to the local context. Their perception was that the DHB’s business leaders were disengaged with research because business processes do not easily align to research timelines. Other suggested barriers emanate from the constraints of daily frontline clinician busyness, and an overall staff conservatism and resistance to change. The general consensus was that evidence from robust and scientifically sound local research should inform this DHB’s purpose. To achieve this, the DHB executive leadership needs to more overtly support research and researchers in the DHB, in line with its research strategy and national directives.