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BackgroundCollaborations for Leadership in Applied Health Research and Care (CLAHRCs) were an initiative of the National Institute for Health Research in response to a new research and development strategy in the NHS: ‘Best Research for Best Health’. They were designed to address the ‘second gap in translation’ identified by the Cooksey review; namely, the need to improve health care in the UK by translating clinical research into practice more effectively. Nine CLAHRCs, each encompassing a university in partnership with local NHS bodies, were funded over the period 2008–13.AimsThe aim of this report is to provide an independent and theory-based evaluation of CLAHRCs as a new form of networked innovation in the health sector. This evaluation is based on an intensive research study involving three CLAHRCs in the UK and three international organisations (one in the USA and two in Canada). This study was carried out over two overlapping time phases so as to capture changes in the CLAHRCs over time. Networked innovation in the health sector is conceptualised as involving the translation of knowledge via informal social networks.MethodsA mix of research methods was used to help ensure the validity and generalisability of the study. These methods addressed the development of each CLAHRC over time, over multiple levels of analysis, and with particular reference to the translation of knowledge across the groups involved, and the quality of the informal underpinning network ties that supported such translation. Research methods, therefore, included a qualitative enquiry based on case studies and case analysis, cognitive mapping methods, and social network analysis.FindingsThrough our study, we found that each one of our samples of CLAHRCs appropriated the CLAHRC idea in a particular way, depending on their different interpretations or ‘visions’ of the CLAHRC’s role in knowledge translation (KT), and different operating models of how such visions could be achieved. These helped to shape the development of social networks (centralised vs. decentralised) and each CLAHRC’s approach to KT activity (‘bridging’ vs. ‘blurring’ the boundaries between professional groups). Through a comparative analysis, we develop an analytical model of the resultant capabilities which each case, including our international sites, developed for undertaking innovation, encompassing a combination of both ‘integrative capability’ (the ability to move back and forth between scientific evidence and practical application) and ‘relational capability’ (the ability of groups and organisations to work together). This extends previous models of KT by highlighting the effects of leadership and management, and the emergence of social network structures. We further highlight the implications of this analysis for policy and practice by discussing how network structures and boundary-spanning roles and activities can be tailored to different KT objectives.ConclusionsDifferent interpretations and enactments of the CLAHRC mission ultimately led to differing capabilities for KT among our studied initiatives. Further research could usefully explore how these different capabilities are produced, and how they may be more or less appropriate for particular national health-care settings, with a view to improving the design blueprint for future KT initiatives.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

ObjectivesWe contribute to existing knowledge translation (KT) literature by developing the notion of ‘enactment’ and illustrate this through an interpretative, comparative case-study analysis of three Collaborations for Leadership in Applied Health Research and Care (CLAHRC) initiatives. We argue for a focus on the way in which the CLAHRC model has been ‘enacted’ as central to the different KT challenges and capabilities encountered.MethodsA comparative, mixed method study created a typology of enactments (Classical, Home-grown and Imported) using qualitative analysis and social network analysis.ResultsWe identify systematic differences in the enactment of the CLAHRC model. The sources of these different enactments are subsequently related to variation in formative interpretations and leadership styles, the implementation of different governance structures, and the relative epistemic differences between the professional groups involved.ConclusionsEnactment concerns the creative agency of individuals and groups in constituting a particular context for their work through their local interpretation of a particular KT model. Our theory of enactment goes beyond highlighting variation between CLAHRCs, to explore the mechanisms that influence the way a particular model is interpreted and acted upon. We thus encourage less focus on conceptual models and more on the formative role played by leaders of KT initiatives.

In this paper, we illustrate the link between social network structures, dominant cognitive frames on network purpose and the innovative power of a network, through a mixed-method comparative analysis of two knowledge translation networks (KTNs) in the English National Health Service (NHS). Our findings illustrate several challenges for networked forms of organization linked to different manifestations of social networks (centralized/decentralized) and dominant cognitive frames (polarizing/loosely clustered). Our paper contributes a better understanding of how dominant frames on network purpose emerge alongside the development of network structure itself, and explores how this interplay between dominant frames and social networks impacts upon the collaborative work that supports the network’s innovative power.

In healthcare, development of shared interpretations between groups is important for successful innovation but this poses a challenge in network settings that encompass multiple bases of power and a multiplicity of, sometimes conflicting, ideologies. It is especially difficult to engrain a single coherent mission or ideology because resources are widely distributed and centralized hierarchical control is limited. This suggests the importance of conducting research that places cognitions, social networks and power dynamics in an investigatory framework. We develop such a framework to comparatively analyse two healthcare initiatives in the UK and consider process power as invested in social network structures alongside meaning power as invested in the dominant network ideology and the cognitive schemas of network members. Our findings show how conflict and consensus in the ideological field gave rise to frustration and tension around the legitimizing and de- legitmizing network activities and how this influ...

As knowledge translation is seen as important for improving the effectiveness of healthcare, recent policy attention has focused on developing initiatives that encourage collaboration between the ‘...