Abstract
BackgroundHealth systems in Australia and worldwide are increasingly expected to conduct research and quality improvement activities in addition to delivering clinical care and training health professionals. This study aims to inform a research impact evaluation at a regional Australian Hospital and Health Service by developing a programme theory showing how research investment is expected to have impact.MethodsThis qualitative study, representing the first phase of a larger mixed methods research impact evaluation at the Townsville Hospital and Health Service (THHS), adopts a realist-informed design involving the development of a programme theory. Data were obtained between February and May 2019 from strategic documentation and interviews with six current and former health service executives and senior employees. Inductive themes were integrated into a conceptual framework to visually represent the programme theory.ResultsResearch at THHS has developed organically as the service has matured into a regional tertiary referral service serving a diverse rural and remote population across northern Queensland. Throughout this journey, individual THHS leaders often adopted a research development mantle despite disincentives arising from a performance-driven reporting and activity-based funding service context. Impact expectations from research investment at THHS were identified in the categories of enhanced research activity and capacity among clinicians, and improved clinical practice, health workforce capability and stability, and patient and population health. Seven contextual factors were identified as potential enablers or obstacles to these impact expectations and ambitions.ConclusionsBy identifying both relevant impact types and key contextual factors, this study offers programme theory to inform a planned research impact evaluation at THHS. The conceptual framework may be useful in other regionally based health service settings. More broadly, there are opportunities for future research to test and refine hybrid versions of linear and realist research impact evaluation models that combine resource-intensive, theory-driven approaches with policy practicality.
Highlights
Health systems in Australia and worldwide are increasingly expected to conduct research and quality improvement activities in addition to delivering clinical care and training health professionals [1, 2]
This study aims to inform a research impact evaluation suited to a regional Australian health service setting by developing a programme theory showing how research investment was expected to have impact within Townsville Hospital and Health Service (THHS)
Results are first reported as a narrative description of the research development journey at THHS
Summary
Health systems in Australia and worldwide are increasingly expected to conduct research and quality improvement activities in addition to delivering clinical care and training health professionals [1, 2]. In Australia, achieving the vision of “better health through research” [2, 3] requires investment in different types of biomedical, services and systems research that involve engaging practicing clinicians in the research process to maximise health returns for patients and populations [3]. Reflecting the range of possible interpretations of ‘impact’, research impact evaluations and assessments employ a range of different frameworks, most of which are variations of logic models that attempt to link research inputs and outputs to downstream impacts [8, 9]. This study aims to inform a research impact evaluation at a regional Australian Hospital and Health Service by developing a programme theory showing how research investment is expected to have impact
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