title: Does the engagement of clinicians and organisations in research improve healthcare performance: a three-stage review.
abstract: OBJECTIVE
  There is a widely held assumption that engagement by clinicians and healthcare organisations in research improves healthcare performance at various levels, but little direct empirical evidence has previously been collated. The objective of this study was to address the question: Does research engagement (by clinicians and organisations) improve healthcare performance?
  
  
  METHODS
  An hourglass-shaped review was developed, consisting of three stages: (1) a planning and mapping stage; (2) a focused review concentrating on the core question of whether or not research engagement improves healthcare performance; and (3) a wider (but less systematic) review of papers identified during the two earlier stages, focusing on mechanisms.
  
  
  RESULTS
  Of the 33 papers included in the focused review, 28 identified improvements in health services performance. Seven out of these papers reported some improvement in health outcomes, with others reporting improved processes of care. The wider review demonstrated that mechanisms such as collaborative and action research can encourage some progress along the pathway from research engagement towards improved healthcare performance. Organisations that have deliberately integrated the research function into organisational structures demonstrate how research engagement can, among other factors, contribute to improved healthcare performance.
  
  
  CONCLUSIONS
  Current evidence suggests that there is an association between the engagement of individuals and healthcare organisations in research and improvements in healthcare performance. The mechanisms through which research engagement might improve healthcare performance overlap and rarely act in isolation, and their effectiveness often depends on the context in which they operate.
authors.affiliation: Faculty of Health, Social Care and Education, St George's, University of London and Kingston University, Grosvenor Wing, Cranmer Terrace, London, UK.
authors.forename: Annette
authors.initials: A
authors.lastname: Boaz
authors.affiliation: Health Economics Research Group, Brunel University London, London, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Hanney
authors.affiliation: Health Economics Research Group, Brunel University London, London, UK.
authors.forename: Teresa
authors.initials: T
authors.lastname: Jones
authors.affiliation: Health Economics Research Group, Brunel University London, London, UK.
authors.forename: Bryony
authors.initials: B
authors.lastname: Soper
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D006282:Health Personnel; D006296:Health Services / Q000592:standards*; D006302:Health Services Research; D006801:Humans; D009938:Organizations; D058996:Quality Improvement