engaging stakeholders in healthcare

Connect for Health is an evidence-based weight management program with clinical- and family-facing components for delivery in pediatric primary care for families of children ages 2 to 12 years. Their support is necessary because they provide resources, skills and knowledge required for project’s implementation. A systematic review of barriers to and facilitators of the use of evidence by policymakers. The stakeholder engagement study (SEE-Impact) and the project being studied (EQUIPT) are described in Box 1. flag up the importance of continuous involvement and using in-person contact to build relationships [30]. Ovretveit J, Hempel S, Magnabosco JL, Mittman BS, Rubenstein LV, Ganz DA. A recent supplement of this journal edited by Paina et al. Stakeholders represent organizations and individuals that have an interest in the health system. There are also a growing number of reviews of such studies [21,22,23,24,25,26,27]. 2012;7:39. How we consult and engage Our Stakeholder Engagement Framework sets out the principles and standards that apply when we consult and engage with our stakeholders. Springer Nature. concluded that approximately 20% of their study participants “reported that stakeholder engagement improved the relevance of research, increased stakeholder trust... enhanced mutual learning by stakeholders, and researchers about each other, or improved research adoption” ([13], p. 1697), whereas 6% reported improved transparency and 9% increased understanding of research processes. SEE-Impact data included observational data, interviews and document analysis. © 2020 BioMed Central Ltd unless otherwise stated. http://www.cmtpnet.org/our-work/stakeholder-engagement/. GRIPP2 reporting checklists: tools to improve reporting of patient and public involvement in research. Ultimately, building a culture of health within a community is going to require engaging all relevant stakeholders. Gagliardi AR, Berta W, Kothari A, Boyko J, Urquhart R. Integrated knowledge translation (IKT) in health care: a scoping review. They also point out the importance of having a model of collaborative research with clear guidelines of how to conduct partnership research projects in order to further facilitate the use of research by practitioners. Similarly, there is a large and currently distinct literature on PPI in research [9], including the development of reporting guidelines such as GRIPP2 [10]. Forsythe et al. Engaging stakeholders, taking into account their needs and inputs and adjusting elements of the research project based on their feedback takes time and can slow down the research process, 10) Generate a shared commitment to sustained and continuous stakeholder engagement, Project teams and stakeholders see the value of links between research producers and research users to build ongoing collaborations in order to meet the objectives, 11) Plan stakeholder engagement activity as part of the research programme of work, This should be built into the project protocol or plan (see Pokhrel et al. For example, the Hungarian team talked about their pragmatic approach to research and the need to conduct useful and usable research, with stakeholder engagement being a key component. Deverka et al. Health Res Policy Sys 16, 60 (2018). PubMed Google Scholar. This means engaging all actors, by means of a broad consultation, in meaningful policy dialogue to build consensus on the current situation and on the values, goals and overall policy directions that will guide health policy. Our analysis of the complex and nuanced process of stakeholder engagement has resulted not in a list of indicators, but in a set of design principles. health research, with protocols for engaging multiple stakeholder groups becoming normative in patient-centered outcomes research. Correspondence to Nyström ME, Karltun J, Keller C, Andersson Gäre B. Collaborative and partnership research for improvement of health and social services: researcher’s experiences from 20 projects. Papers on the full findings are being finalised. Pokhrel S, Evers S, Leidl R, Trapero-Bertran M, Kalo Z, De Vries H, et al. Paina L, Ekirapa-Kiracho E, Ghaffar A, Bennett S. Engaging stakeholders in implementation research: tools, approaches, and lessons learned from application. In that case, evaluation findings might be ignored, criticized, or resisted because your evaluation did not consider stakeholder concerns or priorities. Kramer D, Wells R, Bigelow P, Carlan N, Cole D, Hepburn CG. This opinion piece provides a short conceptualisation of stakeholder engagement, followed by ‘design principles’ that we put forward based on a combination of existing literature and new empirical insights from our recently completed longitudinal study of stakeholder engagement in research. https://doi.org/10.2217/cer.14.79. A next step will be to address the remaining gap in the stakeholder engagement literature concerned with how we assess the impact of stakeholder engagement on research use. In this paper, we discuss two participatory methods for engaging with stakeholders – participatory social network analysis (PSNA) and participatory … A compelling reason to engage stakeholders is that it can enhance the implementation of your guideline (Grol, Dalhuijsen et al. The evaluation of this initiative revealed many positive changes in the delivery of care, and patients improved their goal-setting. 2017;358:j3453. Innvær S, Vist G, Trommald M, Oxman A. volume 16, Article number: 60 (2018) Health Res Policy Syst. In this study, the following stakeholders were identified: National and European stakeholders consisting of policy-makers, academics, health authorities, insurance companies, advocacy groups, ministries of finance, national committees, clinicians and health technology assessment (HTA) professionals, and experts on smoking cessation and HTA. Article  (DOCX 17 kb). The pioneering study by Kogan and Henkel [12] analysed both the importance of engaging policy-makers in setting research agendas to meet their needs, and the obstacles to making the process work well. PubMed  An initial draft of the paper was produced by AB, with all authors contributing significantly to its development and revision. PubMed  The concept of stakeholder analysis is covered in Section 7 Theories of strategic planning. Powerful stakeholders in other situations might include tax payers through their political representatives, patient care advocacy groups and … Stakeholders should be representative of the community to ensure that all voices are heard. Engaging stakeholders. Developing a NeSF begins first by documenting a country’s representative health stories. https://doi.org/10.1186/s12961-016-0107-2, https://doi.org/10.1016/j.jenvman.2011.10.005, https://doi.org/10.1007/s11606-012-2037-1, https://doi.org/10.1007/s11606-014-2878-x, https://doi.org/10.1002/9781118413555.ch02, https://doi.org/10.1186/s13012-016-0399-1, https://doi.org/10.1258/135581902320432778, https://doi.org/10.1186/s12961-017-0191-y. Stakeholder involvement in research and implementing its findings is complex and time consuming, and the authors recommend an advocacy role where funders support a range of activities to address barriers to effective KT. The results of the EQUIPT study have now been published [32, 33] and a full account of the main methods from SEE-Impact have been submitted for publication. They favoured a particular, individualised approach to stakeholders and, over time, partially reshaped the stakeholder engagement activities to something more akin to research participation (that is, taking part in a research study as a means of generating specific data as determined by researchers, rather than as co-producers of research). To do this we use 5 principles to help our engagement. Consider the case of a collaborative improvement initiative in 29 primary care centres in the USA.5 The project aimed to increase patient and family support for self-management of chronic conditions. We are purposeful, inclusive, timely, transparent and respectful. Oliver K, Innvar S, Lorenc T, Woodman J, Thomas J. Health policy-makers’ perceptions of their use of evidence: a systematic review. Moving past the hospital and community organization partnerships, healthcare organizations must tap into their patients and other residents to build excitement for improving community health. 2017;15:26. https://doi.org/10.1186/s12961-017-0191-y. The SEE-Impact study (Stakeholder Engagement in EQUIPT for Impact), received funding from the United Kingdom Medical Research Council to explore the engagement of stakeholders in the EQUIPT project. We have designed this guide to help State officials and other program administrators engage and partner with stakeholders in initiatives to improve the quality of child health care.1Stakeholders can include a wide range of individuals and organizations, such as caregivers, clinicians, advocacy groups, and policymakers.By engaging stakeholders in your quality improvement (QI) initiatives, you can help ensure that the initiatives are implemented effectively, achieve intended outcomes, and contribute to sustainabl… Further, current implementation science models provide little clarity about what engagement means, despite its importance. Higher Education Funding Council for England (HEFCE). Holmes B, Scarrow G, Schellenberger M. Translating evidence into practice: the role of health researcher funders. In this paper, we discuss two participatory methods for engaging with stakeholders – participatory social network analysis (PSNA) and participatory … In the primary care example, the obvious stakeholders for QI evaluation were the healthcare organisations’ patients, front-line practitioners and line managers. The authors would like to acknowledge the contribution of the EQUIPT team, in particular, the Principal Investigator Subhash Pokhrel. [18] examined the literature on multi-stakeholder health services research collaborations in an attempt to address the question of whether it was worth investing in them. Hanney SR, Gonzalez-Block MA, Buxton MJ, Kogan M. The utilisation of health research in policy-making: concepts, examples and methods of assessment. 2012;1(2):181–94. They found that, if bi-directional relationships are sustained over time, stakeholders can serve as ambassadors for high-integrity evidence even where the findings are contrary to generally accepted beliefs. Various studies have attempted to assess a range of impacts of research (especially health research) and/or attempted to identify facilitators and barriers of research use in policy-making. 1994;7(4):13–33. In public health, community engagement refers to efforts that promote a mutual exchange of information, ideas and resources between community members and the health department. https://doi.org/10.1136/bmjopen-2014-%20006945, https://doi.org/10.1108/JHOM-08-2013-0164, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s12961-018-0337-6. Guide for Engaging Stakeholders 3 . Finally, in terms of practices, the principles suggest that it is important to plan stakeholder engagement activity as part of the research programme of work; build flexibility within the research process to accommodate engagement and the outcomes of engagement; consider how input from stakeholders can be gathered systematically to meet objectives; consider how input from stakeholders can be collated, analysed and used; and to recognise that identification and involvement of stakeholders is an iterative and ongoing process. Boaz A, Fitzpatrick S, Shaw B. Assessing the impact of research on policy: a literature review. 2014;29:1692–701. 2002;7:239–44. https://doi.org/10.1093/intqhc/mzu009. Kramer et al. Concannon et al. Knowl Policy. The final version has been approved by all authors. It is unclear how to engage a wide range of knowledge users in research. The successful stakeholder engagement in the United Kingdom work encouraged the research team to fully integrate stakeholder engagement into the European study. Between November 2014 and August 2015, REACHnet convened advisory groups regularly to generate, refine, and prioritize research topics. recommend continuing to build trust with stakeholders “throughout the engagement process” ([5], p. 27). The quality of the Healthcare systems depends heavily on how mobilized and concerned these professional groups are in ensuring quality health services. The principles relating to values are to foster shared commitment to the values and objectives of stakeholder engagement in the project team; share understanding that stakeholder engagement is often about more than individuals; encourage individual stakeholders and their organisations to value engagement; recognise potential tension between productivity and inclusion; and to generate a shared commitment to sustained and continuous stakeholder engagement. These stakeholders include patients, providers, payers, and policymakers. 2009;36:255–70. To develop patient-centered research agendas for obesity and diabetes, the Research Action for Health Network conducted topic generation and prioritization activities with multistakeholder research advisory groups. 2. It also provided experience of practical elements of working with stakeholders, but perhaps most importantly lived experience of the practical benefits of engagement. Outcomes to be synthesized are methods for (1) identifying stakeholders, (2) engaging stakeholders at different stages of the guideline development process, and (3) resolving differences in opinions/perspectives. 2005;10 Suppl 1:35–48. Implement Sci. This includes frameworks or processes that address the implementation or evaluation of stakeholder engagement in guideline development. [36] identify a range of complexities which, they argue, need to be taken into account by funding schemes in order to meet funders’ and stakeholders’ expected ROI. Objectives Stakeholder engagement and public involvement are considered as integral to developing effective public health interventions and is encouraged across all phases of the research cycle. [37] looked at the involvement of intermediary organisations as research partners on three interventions across four sectors, namely manufacturing, transportation, service and electrical utilities sectors. Boaz, A., Hanney, S., Borst, R. et al. Google Scholar. As part of evidence and experience-based guidance to researchers and practice personnel about forming and carrying out effective research partnerships, Ovretveit et al. These principles, rooted in both the existing literature and in the findings from our prospective study of stakeholder engagement, are intended to inform the planning and delivery of stakeholder engagement activities. This paper provides a short conceptualisation of stakeholder engagement, followed by ‘design principles’ that we put forward based on a combination of existing literature and new empirical insights from our recently completed longitudinal study of stakeholder engagement. The key aims of stakeholder engagement activity were to access the knowledge and skills (described in the protocol as co-creation innovation in the working space) and to increase influence and impact (described in the protocol as dissemination innovation in the transfer space through stakeholder engagement). The first stakeholder is the policymakers, ministers, or jurisdictional authorities for deciding the healthcare policies. 2016;31:13–21. Article  Center for Medical Technology Policy. Given the diversity of stakeholder engagement and the thin evidence base for its impact, our study set out to identify a set of indicators that might be used to identify stakeholder engagement with potential for impact. J Health Serv Res Policy. 2016;120(1):46–54. PubMed Central  To do this we use 5 principles to help our engagement. Faculty of Health, Social Care and Education, a partnership between Kingston University and St George’s, University of London, London, United Kingdom, Health Economics Research Group, Brunel University London, Uxbridge, United Kingdom, Erasmus School of Health Policy & Management, Rotterdam, The Netherlands, VU University Amsterdam, Amsterdam, The Netherlands, You can also search for this author in Guide for Setting a Shared Strategic Direction 4 . also stress the importance of “establishing ‘parameters and expectations for roles’, giving stakeholders guidance, and allowing time for stakeholders to ‘get comfortable with their roles’ as important tasks” ([30], p. 19). The review of methods of stakeholder engagement conducted by Mallery et al. Article  There are additional issues about the definition of stakeholder engagement when the nature of the engagement activities is considered. argue that evaluations of stakeholder engagement should be “designed a priori as an embedded component of the research process” ([35], p. 142). The lack of flexibility came in part from the funder. Back a couple years or so ago, I was at the conference of a well-known group in enterprise-architecture and the like. However, herein, we conceptualise PPI as a subset of stakeholder engagement in-line with most of the literature, including Concannon et al. The project team (comprising members of the SEE-Impact research team and collaborators from EQUIPT) met for a 2 day analysis workshop. J Gen Intern Med. Understanding the stakeholders’ intention to use economic decision-support tools: a cross-sectional study with the tobacco return on investment tool. J Gen Intern Med. The literature is diverse, with a rapidly expanding but still relatively small number of papers specifically referring to ‘stakeholder engagement’, and a larger number of publications discussing issues that at least partly overlap with stakeholder engagement. Hering et al.’s [39] global study of water science and technology used stakeholder involvement in the objectives and approaches of the research for the co-production of knowledge as part of transdisciplinary research. The impact on healthcare, policy and practice from 36 multi-project research programmes: findings from two reviews. We present the findings of an … A final consideration about the nature of the body of literature specifically on stakeholder engagement is that not only is it still quite limited in total, but there are also notable areas where authors claim it is particularly sparse. Google Scholar. CAS  Yet other stakeholders had power over the situation, both for the improvement and for sustainability. J Comp Eff Res. Based on the literature and the application of initial principles to our study, we have developed the elaborated design principles presented in Box 2. There is a growing interest in stakeholder engagement as a potentially promising approach to promoting research impact. Many advocates for patient-centered outcomes research (PCOR) and comparative effectiveness research (CER) see collaboration between researchers and stakeholders … This opinion piece draws on a study of stakeholder engagement in research and a systematic literature search conducted as part of the study. ENGAGING STAKEHOLDERS IN HEALTH SYSTEM ASSESSMENTS: A GUIDE FOR HSA TEAMS . Huberman M. Research utilization: the state of the art. Health Res Policy Syst. A participatory approach combines systematic inquiry with the collaboration of diverse stakeholders to meet specific needs and to contend with broad issues of equity and justice. 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