The use of research evidence to change clinical practice and delivery of services remains a significant challenge. QI offers a tools and methods to support this ‘knowledge to practice’ process. However, most research on QI focuses on the use of knowledge and not knowledge creation. Stuart Green was funded by CLAHRC NWL to undertake research to address this gap through an exploration of the social process of co- creating knowledge within a QI project team.
This was a four-year study in which the researcher was part of the QI project team. Data were generated through participant observations, interviews and documentary analysis. The analysis included generating a narrative of the project, and the use of Knowledge Mobilisation and Implementation Science frameworks.
This research offered a window on the social construction of a QI project using theoretical approaches to help identify and understand what happened. The improvement work was both social and technical as it relied on social practices to generate the work that was required to support the ‘knowledge to practice’ process. QI methods were able to draw on the tacit knowledge and experiences of stakeholders which was captured in outputs from workshops, which in turn were used in the co-design of interventions. This process of simultaneous knowledge ‘use’ and ‘creation’ contributed to the collective understandings and meanings which comprise the social practices of QI. However, as noted, issues of responsibility and accountability posed a significant challenge, and a careful balance needed to be found between the use of the data for managing performance and supporting staff to reflect on their practice.
This research was undertaken in part fulfilment of a Doctor of Public Health in the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine supervised by Professor Nicholas Mays and Professor Carl May.