The Evolution of Knowledge Transfer Boundary Networks in Healthcare

Abstract

A particular concern within healthcare is the issue of research-informed practice. Failure to translate knowledge efficiently from research into practice potentially has consequences in terms of the quality of care or wasted resources, leading to an inefficient and unproductive health system. Effective techniques and approaches to address this knowledge gap (often called the ‘second translational gap’) are required. Literature suggests there is no ‘magic bullet’ to move healthcare research into improved clinical practice. This difficulty is linked, at least in part, to the organisational complexity of health systems including the National Health Service; there are multiple stakeholders, networks and professional and organisational silos. This study draws on data collection and analysis of a healthcare intervention borne from policy aimed specifically at addressing the second translational gap, i.e. moving research into clinical practice effectively and efficiently. The intervention was entitled the ‘Collaboration and Leadership in Applied Health Research and Care’ (CLAHRC), of which nine examples have been deployed in local health systems. North West London CLAHRC is an appropriate case study as its approach is consciously designed to create collaboration by establishing new networks that span different local health organisations and professions. The study is longitudinal and therefore enables a dynamic perspective that explores the impact of this carefully managed programme of activities on knowledge network evolution within this local context. Using a range of mixed methods, including semi-structured interviews, observation and Social Network Analysis I aimed to uncover how knowledge networks are instigated, how they are successfully developed and also how they are sustained over time, to deliver evidence-based medicine. The findings demonstrate and discuss the process through which a knowledge boundary network evolves and ultimately attains sustainability. It highlights how a mandated, structured inception and continued facilitation leads to increased interaction, a reduction in hierarchy and collaboration across boundaries. The findings are analysed with reference to extant literature and ultimately they contribute to the body of knowledge with regard to boundary network and community development. Finally, this study outlines the implications to future research and in particular the importance of the study to both healthcare practice and policy.