Susan Calnan
This blog post is based on the Evidence & Policy article, ‘Experiences and perceptions of evidence use among senior health service decision makers in Ireland: a qualitative study.’
How do senior health service decision makers use evidence to inform their work and decision-making and what types of evidence do they use? What are the potential barriers and facilitators to research use by health service decision makers and are there ways to improve its usage?
We wanted to explore these questions in our qualitative study published in Evidence & Policy, which was conducted in Ireland’s national health service, the Health Service Executive (HSE). Our focus was on senior decision makers working in the organisation’s Healthcare Strategy, Clinical and Operations divisions, where evidence use has the potential to inform the quality and delivery of health services and workforce planning.
We conducted semi-structured interviews with 17 participants between August 2021 and January 2022.
How and what types of evidence do health service decision makers use in their work?
Participants in our study reported using a varied and dynamic approach to evidence use, whereby the types and source of evidence depended on the issue or question at hand:
- Rather than one type of evidence taking precedence, the range and combination of different types from multiple sources were perceived as particularly useful;
- Participants described using evidence to inform a variety of decisions such as planning improvements in healthcare services, proposing practice change or developing guidance, workforce planning and service evaluation;
- Sources of evidence varied from local data generated within the health service to external national and international sources.
What are the potential barriers and facilitators to research use in the health service?
A range of potential barriers and facilitators to research use were cited by participants in this study, including those at the level of the individual, organisation, research, and social, economic and political levels:
- Although participants generally held positive beliefs about research evidence, they viewed organisational culture as a potential barrier, including a lack of understanding or value placed on research by others in the organisation;
- The relevance and quality of some research were also noted as potential barriers, and participants highlighted the importance of conducting research that was meaningful for the health service;
- Time was cited as a further barrier, both in terms of individual time to engage with research and time to undertake the research itself;
- The broader economic and political context also posed challenges, including the lack of funding for research posts and the need for greater political will to support wider systemic reform of the research ecosystem;
- Key facilitators included existing structures within the organisation, particularly the Library Service and Research & Development Unit, and organisational resources (e.g. access to research, technical infrastructure) were deemed crucial to enable research use;
- Links with external organisations, particularly universities, were valued as an important facilitator to enable research use and develop research expertise.
What are the recommended supports or strategies to enhance evidence-informed decision making?
The need for a multi-component approach to encourage evidence use was recognised by participants in this study.
Recommendations included:
- Ensuring that research is easier to absorb – for example, by distilling key messages from the research and leveraging social media/webinars to communicate key findings;
- Explaining the ‘currency’ of the research more clearly, including how it is relevant to the health service and desired outcomes in the system;
- Integrating research expertise into teams and providing more protected time to do research as part of the job;
- Developing a ‘strategic vision’ for research in the organisation, e.g. through a research framework or strategy that sets out clear research priorities and ensures that research questions align with health service priorities;
- Increasing the visibility of and access to existing research support structures in the organisation, e.g. Research & Development Unit;
- Creating a centralised hub or repository for research in the organisation to facilitate access to and avoid duplication of research;
- Fostering stronger connections between the health service, researchers and academic institutions;
- Providing opportunities for health service stakeholders to inform research priorities to ensure that research conducted is meaningful for the service;
- Creating more opportunities for embedded research within the organisation;
- Ensuring better top-down resourcing for research and the political will to support wider systemic reform of the research ecosystem.
Image credit: Pixaby
Susan Calnan is a post-doctoral researcher at the School of Public Health, University College Cork. Her research interests include implementation research and knowledge translation.
Read the original research in Evidence & Policy:
Calnan, S. and McHugh, S. (2023). Experiences and perceptions of evidence use among senior health service decision makers in Ireland: a qualitative study. Evidence & Policy, DOI: 10.1332/174426421X16917571241005.
If you enjoyed this blog post, you may also be interested in reading:
Improving evidence use: a systematic scoping review of local models of knowledge mobilisation OPEN ACCESS
Use of research evidence in legislatures: a systematic review OPEN ACCESS
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