Gill Harvey - Academia.edu (original) (raw)

Papers by Gill Harvey

Research paper thumbnail of Getting evidence into practice: the role and function of facilitation

Journal of advanced nursing, 2002

Getting evidence into practice: the role and function of facilitation Aim of paper. This paper pr... more Getting evidence into practice: the role and function of facilitation Aim of paper. This paper presents the findings of a concept analysis of facilitation in relation to successful implementation of evidence into practice. Background. In 1998, we presented a conceptual framework that represented the interplay and interdependence of the many factors influencing the uptake of evidence into practice. One of the three elements of the framework was facilitation, alongside the nature of evidence and context. It was proposed that facilitators had a key role in helping individuals and teams understand what they needed to change and how they needed to change it. As part of the on-going development and refinement of the framework, the elements within it have undergone a concept analysis in order to provide theoretical and conceptual clarity. Methods. The concept analysis approach was used as a framework to review critically the research literature and seminal texts in order to establish the conceptual clarity and maturity of facilitation in relation to its role in the implementation of evidence-based practice.

Research paper thumbnail of Translating evidence into healthcare policy and practice: Single versus multi-faceted implementation strategies - is there a simple answer to a complex question?

International journal of health policy and management, 2015

How best to achieve the translation of research evidence into routine policy and practice remains... more How best to achieve the translation of research evidence into routine policy and practice remains an enduring challenge in health systems across the world. The complexities associated with changing behaviour at an individual, team, organizational and system level have led many academics to conclude that tailored, multifaceted strategies provide the most effective approach to knowledge translation. However, a recent overview of systematic reviews questions this position and sheds doubt as to whether multi-faceted strategies are any better than single ones. In this paper, we argue that this either-or distinction is too simplistic and fails to recognize the complexity that is inherent in knowledge translation. Drawing on organizational theory relating to boundaries and boundary management, we illustrate the need for translational strategies that take account of the type of knowledge to be implemented, the context of implementation and the people and processes involved. Citation: Harvey G, Kitson A. Translating evidence into healthcare policy and practice: Single versus multifaceted implementation strategies -is there a simple answer to a complex question? Int J Health Policy Manag 2015; 4: x-x.

Research paper thumbnail of Quality Improvement and Evidence-Based Practice: As One or at Odds in the Effort to Promote Better Health Care?

Worldviews on Evidence-based Nursing, 2005

... Correspondence: Address correspondence to Gill Harvey, RN, BNurs, RHV, PhD, Centre for Public... more ... Correspondence: Address correspondence to Gill Harvey, RN, BNurs, RHV, PhD, Centre for Public Policy and Management, Manchester Business School, University of Manchester, Booth Street West, Manchester M15 6PB United Kingdom; gill.harvey@mbs.ac.uk. ...

Research paper thumbnail of sources and resources

Research paper thumbnail of HEALTH SERVICES AND DELIVERY RESEARCH

Research paper thumbnail of EGPA-European Group of Public Administration

Research paper thumbnail of LIST OF CONTENTS

Research paper thumbnail of The RCN Dynamic Quality Improvement (DQI) Network

Research paper thumbnail of Framework for enabling the implementation of evidence-based practice: the PARIHS Project

Research paper thumbnail of Investigating turnaround in zero-star rated NHS organisations supported by the Performance Development Team of the Modernisation Agency

Research paper thumbnail of Medical work, medical knowledge and health care by Ellen Annandale, Mary Ann Elston and Lindsay Prior (eds). Blackwell Publishing Ltd, Oxford (2005)

Research paper thumbnail of Negotiating technological innovation in healthcare

Research paper thumbnail of Promoting continence in nursing homes in four European countries‐the use of PACES as a mechanism for improving continence care

Background Multi-faceted approaches are generally recognised as the most effective way to support... more Background Multi-faceted approaches are generally recognised as the most effective way to support the implementation of evidence into practice. Audit and feedback often constitute one element of a multi-faceted implementation package, alongside other strategies, such as interactive education and facilitated support mechanisms. This paper describes a multi-faceted implementation strategy that used the Joanna Briggs Institute Practical Application of Clinical Evidence System (PACES) as an online audit tool to support facilitators working to introduce evidence-based continence recommendations in nursing homes in four different European countries.

Research paper thumbnail of Enabling context with policy

As other chapters in this book highlight, there are many factors in the practice context that can... more As other chapters in this book highlight, there are many factors in the practice context that can influence the uptake of evidence into clinical practice—relationships amongst team members, support and commitment from leadership, and the extent to which evaluation ...

Research paper thumbnail of PP20 Improved Identification of Chronic Kidney Disease Cases in Primary Care

Quality problem: Undiagnosed chronic kidney disease (CKD) contributes to a high cost and care bur... more Quality problem: Undiagnosed chronic kidney disease (CKD) contributes to a high cost and care burden in secondary care. Uptake of evidence-based guidelines in primary care is inconsistent, resulting in variation in the detection and management of CKD. Initial assessment: Routinely collected general practice data in one UK region suggested a CKD prevalence of 4.1%, compared with an estimated national prevalence of 8.5%. Of patients on CKD registers, ∼30% were estimated to have suboptimal management according to Public Health Observatory analyses. Choice of solution: An evidence-based framework for implementation was developed. This informed the design of an improvement collaborative to work with a sample of 30 general practices. Implementation: A two-phase collaborative was implemented between September 2009 and March 2012. Key elements of the intervention included learning events, improvement targets, Plan-Do-Study-Act cycles, benchmarking of audit data, facilitator support and staff time reimbursement. Evaluation: Outcomes were evaluated against two indicators: number of patients with CKD on practice registers; percentage of patients achieving evidence-based blood pressure (BP) targets, as a marker for CKD care. In Phase 1, recorded prevalence of CKD in collaborative practices increased ∼2-fold more than that in comparator local practices; in Phase 2, this increased to 4-fold, indicating improved case identification. Management of BP according to guideline recommendations also improved. Lessons learned: An improvement collaborative with tailored facilitation support appears to promote the uptake of evidence-based guidance on the identification and management of CKD in primary care. A controlled evaluation study is needed to rigorously evaluate the impact of this promising improvement intervention.

Research paper thumbnail of Theories about boards

Research paper thumbnail of Joyce Wilkinson

Research paper thumbnail of Review: Talking about alcohol: communities of practice and patient pathways

Research paper thumbnail of Analysing organisational context: case studies on the contribution of absorptive capacity theory to understanding inter-organisational variation in performance improvement

Organisational context is frequently cited as an important consideration when implementing and ev... more Organisational context is frequently cited as an important consideration when implementing and evaluating quality improvement interventions in healthcare, but limited guidance is available on which aspects of context are most influential or modifiable. This paper examines how internal and external contextual factors mediate organisational-level performance improvement through applying the knowledge-based theory of absorptive capacity (AC). Three healthcare case studies are presented. Each case is a UK National Health Service organisation that had been identified as having performance problems. Qualitative data were collected through semi-structured interviews with general and clinical managers within the organisation and members of external teams supporting or overseeing performance improvement (n=22). Interview data were analysed using an existing AC framework from the literature. The organisation with the highest AC showed the quickest and most comprehensive performance improvement. Internal characteristics including strategic priorities, processes for managing information, communication and orientation to learning and development impacted on the organisation's ability to engage successfully with external stakeholders and make use of available knowledge. This enabled the organisation to thrive despite the challenging external environment. Lower levels of AC appeared to delay or limit the improvement trajectory. Developing a more detailed and nuanced understanding of how context influences improvement is an important step towards achieving more effective and sustainable quality improvement programmes in healthcare. AC, with its focus on knowledge and organisational learning, provides a useful way to explore the relationship between context and quality improvement and represents a potentially valuable area for future research and development.

Research paper thumbnail of Facilitating large-scale implementation of evidence based health care: insider accounts from a co-operative inquiry

Background: Facilitators are known to be influential in the implementation of evidence-based heal... more Background: Facilitators are known to be influential in the implementation of evidence-based health care (EBHC). However, little evidence exists on what it is that they do to support the implementation process. This research reports on how knowledge transfer associates (KTAs) working as part of the UK National Institute for Health Research 'Collaboration for Leadership in Applied Health Research and Care' for Greater Manchester (GM CLAHRC) facilitated the implementation of EBHC across several commissioning and provider health care agencies. Methods: A prospective co-operative inquiry with eight KTAs was carried out comprising of 11 regular group meetings where they reflected critically on their experiences. Twenty interviews were also conducted with other members of the GM CLAHRC Implementation Team to gain their perspectives of the KTAs facilitation role and process. Results: There were four phases to the facilitation of EBHC on a large scale: (1) Assisting with the decision on what EBHC to implement, in this phase, KTAs pulled together people and disparate strands of information to facilitate a decision on which EBHC should be implemented; (2) Planning of the implementation of EBHC, in which KTAs spent time gathering additional information and going between key people to plan the implementation; (3) Coordinating and implementing EBHC when KTAs recruited general practices and people for the implementation of EBHC; and (4) Evaluating the EBHC which required the KTAs to set up (new) systems to gather data for analysis. Over time, the KTAs demonstrated growing confidence and skills in aspects of facilitation: research, interpersonal communication, project management and change management skills.

Research paper thumbnail of Getting evidence into practice: the role and function of facilitation

Journal of advanced nursing, 2002

Getting evidence into practice: the role and function of facilitation Aim of paper. This paper pr... more Getting evidence into practice: the role and function of facilitation Aim of paper. This paper presents the findings of a concept analysis of facilitation in relation to successful implementation of evidence into practice. Background. In 1998, we presented a conceptual framework that represented the interplay and interdependence of the many factors influencing the uptake of evidence into practice. One of the three elements of the framework was facilitation, alongside the nature of evidence and context. It was proposed that facilitators had a key role in helping individuals and teams understand what they needed to change and how they needed to change it. As part of the on-going development and refinement of the framework, the elements within it have undergone a concept analysis in order to provide theoretical and conceptual clarity. Methods. The concept analysis approach was used as a framework to review critically the research literature and seminal texts in order to establish the conceptual clarity and maturity of facilitation in relation to its role in the implementation of evidence-based practice.

Research paper thumbnail of Translating evidence into healthcare policy and practice: Single versus multi-faceted implementation strategies - is there a simple answer to a complex question?

International journal of health policy and management, 2015

How best to achieve the translation of research evidence into routine policy and practice remains... more How best to achieve the translation of research evidence into routine policy and practice remains an enduring challenge in health systems across the world. The complexities associated with changing behaviour at an individual, team, organizational and system level have led many academics to conclude that tailored, multifaceted strategies provide the most effective approach to knowledge translation. However, a recent overview of systematic reviews questions this position and sheds doubt as to whether multi-faceted strategies are any better than single ones. In this paper, we argue that this either-or distinction is too simplistic and fails to recognize the complexity that is inherent in knowledge translation. Drawing on organizational theory relating to boundaries and boundary management, we illustrate the need for translational strategies that take account of the type of knowledge to be implemented, the context of implementation and the people and processes involved. Citation: Harvey G, Kitson A. Translating evidence into healthcare policy and practice: Single versus multifaceted implementation strategies -is there a simple answer to a complex question? Int J Health Policy Manag 2015; 4: x-x.

Research paper thumbnail of Quality Improvement and Evidence-Based Practice: As One or at Odds in the Effort to Promote Better Health Care?

Worldviews on Evidence-based Nursing, 2005

... Correspondence: Address correspondence to Gill Harvey, RN, BNurs, RHV, PhD, Centre for Public... more ... Correspondence: Address correspondence to Gill Harvey, RN, BNurs, RHV, PhD, Centre for Public Policy and Management, Manchester Business School, University of Manchester, Booth Street West, Manchester M15 6PB United Kingdom; gill.harvey@mbs.ac.uk. ...

Research paper thumbnail of sources and resources

Research paper thumbnail of HEALTH SERVICES AND DELIVERY RESEARCH

Research paper thumbnail of EGPA-European Group of Public Administration

Research paper thumbnail of LIST OF CONTENTS

Research paper thumbnail of The RCN Dynamic Quality Improvement (DQI) Network

Research paper thumbnail of Framework for enabling the implementation of evidence-based practice: the PARIHS Project

Research paper thumbnail of Investigating turnaround in zero-star rated NHS organisations supported by the Performance Development Team of the Modernisation Agency

Research paper thumbnail of Medical work, medical knowledge and health care by Ellen Annandale, Mary Ann Elston and Lindsay Prior (eds). Blackwell Publishing Ltd, Oxford (2005)

Research paper thumbnail of Negotiating technological innovation in healthcare

Research paper thumbnail of Promoting continence in nursing homes in four European countries‐the use of PACES as a mechanism for improving continence care

Background Multi-faceted approaches are generally recognised as the most effective way to support... more Background Multi-faceted approaches are generally recognised as the most effective way to support the implementation of evidence into practice. Audit and feedback often constitute one element of a multi-faceted implementation package, alongside other strategies, such as interactive education and facilitated support mechanisms. This paper describes a multi-faceted implementation strategy that used the Joanna Briggs Institute Practical Application of Clinical Evidence System (PACES) as an online audit tool to support facilitators working to introduce evidence-based continence recommendations in nursing homes in four different European countries.

Research paper thumbnail of Enabling context with policy

As other chapters in this book highlight, there are many factors in the practice context that can... more As other chapters in this book highlight, there are many factors in the practice context that can influence the uptake of evidence into clinical practice—relationships amongst team members, support and commitment from leadership, and the extent to which evaluation ...

Research paper thumbnail of PP20 Improved Identification of Chronic Kidney Disease Cases in Primary Care

Quality problem: Undiagnosed chronic kidney disease (CKD) contributes to a high cost and care bur... more Quality problem: Undiagnosed chronic kidney disease (CKD) contributes to a high cost and care burden in secondary care. Uptake of evidence-based guidelines in primary care is inconsistent, resulting in variation in the detection and management of CKD. Initial assessment: Routinely collected general practice data in one UK region suggested a CKD prevalence of 4.1%, compared with an estimated national prevalence of 8.5%. Of patients on CKD registers, ∼30% were estimated to have suboptimal management according to Public Health Observatory analyses. Choice of solution: An evidence-based framework for implementation was developed. This informed the design of an improvement collaborative to work with a sample of 30 general practices. Implementation: A two-phase collaborative was implemented between September 2009 and March 2012. Key elements of the intervention included learning events, improvement targets, Plan-Do-Study-Act cycles, benchmarking of audit data, facilitator support and staff time reimbursement. Evaluation: Outcomes were evaluated against two indicators: number of patients with CKD on practice registers; percentage of patients achieving evidence-based blood pressure (BP) targets, as a marker for CKD care. In Phase 1, recorded prevalence of CKD in collaborative practices increased ∼2-fold more than that in comparator local practices; in Phase 2, this increased to 4-fold, indicating improved case identification. Management of BP according to guideline recommendations also improved. Lessons learned: An improvement collaborative with tailored facilitation support appears to promote the uptake of evidence-based guidance on the identification and management of CKD in primary care. A controlled evaluation study is needed to rigorously evaluate the impact of this promising improvement intervention.

Research paper thumbnail of Theories about boards

Research paper thumbnail of Joyce Wilkinson

Research paper thumbnail of Review: Talking about alcohol: communities of practice and patient pathways

Research paper thumbnail of Analysing organisational context: case studies on the contribution of absorptive capacity theory to understanding inter-organisational variation in performance improvement

Organisational context is frequently cited as an important consideration when implementing and ev... more Organisational context is frequently cited as an important consideration when implementing and evaluating quality improvement interventions in healthcare, but limited guidance is available on which aspects of context are most influential or modifiable. This paper examines how internal and external contextual factors mediate organisational-level performance improvement through applying the knowledge-based theory of absorptive capacity (AC). Three healthcare case studies are presented. Each case is a UK National Health Service organisation that had been identified as having performance problems. Qualitative data were collected through semi-structured interviews with general and clinical managers within the organisation and members of external teams supporting or overseeing performance improvement (n=22). Interview data were analysed using an existing AC framework from the literature. The organisation with the highest AC showed the quickest and most comprehensive performance improvement. Internal characteristics including strategic priorities, processes for managing information, communication and orientation to learning and development impacted on the organisation's ability to engage successfully with external stakeholders and make use of available knowledge. This enabled the organisation to thrive despite the challenging external environment. Lower levels of AC appeared to delay or limit the improvement trajectory. Developing a more detailed and nuanced understanding of how context influences improvement is an important step towards achieving more effective and sustainable quality improvement programmes in healthcare. AC, with its focus on knowledge and organisational learning, provides a useful way to explore the relationship between context and quality improvement and represents a potentially valuable area for future research and development.

Research paper thumbnail of Facilitating large-scale implementation of evidence based health care: insider accounts from a co-operative inquiry

Background: Facilitators are known to be influential in the implementation of evidence-based heal... more Background: Facilitators are known to be influential in the implementation of evidence-based health care (EBHC). However, little evidence exists on what it is that they do to support the implementation process. This research reports on how knowledge transfer associates (KTAs) working as part of the UK National Institute for Health Research 'Collaboration for Leadership in Applied Health Research and Care' for Greater Manchester (GM CLAHRC) facilitated the implementation of EBHC across several commissioning and provider health care agencies. Methods: A prospective co-operative inquiry with eight KTAs was carried out comprising of 11 regular group meetings where they reflected critically on their experiences. Twenty interviews were also conducted with other members of the GM CLAHRC Implementation Team to gain their perspectives of the KTAs facilitation role and process. Results: There were four phases to the facilitation of EBHC on a large scale: (1) Assisting with the decision on what EBHC to implement, in this phase, KTAs pulled together people and disparate strands of information to facilitate a decision on which EBHC should be implemented; (2) Planning of the implementation of EBHC, in which KTAs spent time gathering additional information and going between key people to plan the implementation; (3) Coordinating and implementing EBHC when KTAs recruited general practices and people for the implementation of EBHC; and (4) Evaluating the EBHC which required the KTAs to set up (new) systems to gather data for analysis. Over time, the KTAs demonstrated growing confidence and skills in aspects of facilitation: research, interpersonal communication, project management and change management skills.