Scale

This page provides further information on the design framework ‘Scale’ theme, including the background and supporting material, and the development process.

Background and supporting material

The variable scales at which embedded research initiatives were operating was a notable structural feature across our data. Such variation was found in relation to the scale of the work undertaken, the timescale of the initiative and the size and composition of the embedded research team.

The work undertaken in early published examples of healthcare-related initiatives was relatively tightly-bounded, mainly comprising individual projects (i.e. evaluations of localised services) (Marshall et al 2014; Eyre et al 2015). As well as being bounded in terms of the scope of the work, such initiatives also tended to take place across a well-defined time period with a specific end-date. Data from our scoped examples, however, showed that around half (N=25) had fixed end-dates, and less than a third (N=13) were examples of single projects. Instead, many comprised a portfolio of projects and activities with no fixed end-date. Indeed, many of these initiatives were deliberately emergent in nature.

Much of the literature focuses on the challenges associated with performing the role of an embedded researcher and the need for ongoing support and mentoring (Duggan 2014, M Marshall et al 2016, Rowley 2014). These observations reflect the nature of many of the early published examples of embedded research initiatives which tend to comprise a lone researcher working outside their usual setting. Whilst we found similar examples, we also identified more recent examples that comprised teams of embedded researchers (Crowe et al 2017, Wye et al 2019). As well as having the potential to address some of the emotional and practical challenges facing individuals performing an embedded researcher role, our workshop participants suggested that multidisciplinary embedded research teams could also be important for addressing the complex issues that face healthcare organisations.

References

Crowe, S., Grieco, L., Vindrola-Padros, C. and Elkhodair, S. (2017) ‘Multidisciplinary Embedded Research to Identify Solutions to Emergency Department Overcrowding’, International Journal for Quality in Health Care, 29: 55-56.

Duggan, J. R. (2014) ‘Critical friendship and critical orphanship: Embedded research of an English local authority initiative’, Management in Education, 28(1): 12-18.

Eyre, L., George, B. and Marshall, M. (2015) ‘Protocol for a process-oriented qualitative evaluation of the Waltham Forest and East London Collaborative (WELC) integrated care pioneer programme using the Researcher-in-Residence model’, Bmj Open, 5(11).

Marshall, M., Pagel, C., French, C., Utley, M., Allwood, D., Fulop, N., Pope, C., Banks, V. and Goldmann, A. (2014) ‘Moving improvement research closer to practice: the Researcher-in-Residence model’, BMJ Quality & Safety, 10.1136/bmjqs-2013-002779.

Marshall, M., Eyre, L., Lalani, M., Khan, S., Mann, S., de Silva, D. and Shapiro, J. (2016) ‘Increasing the impact of health services research on service improvement: the researcher-in-residence model’, Journal of the Royal Society of Medicine, 109(6): 220-25.

Rowley, H. (2014) ‘Going beyond procedure: Engaging with the ethical complexities of being an embedded researcher’, Management in Education, 28(1): 19-24.

Wye, L., Cramer, H., Beckett, K., Farr, M., le May, A., Carey, J., Robinson, R., Anthwal, R., Rooney, J. and Baxter, H. (2019) ‘Collective knowledge brokering: the model and impact of an embedded team’, Evidence & Policy.

Development and adaptation process

This theme originally had two sub-themes – scale of work and size of team. Scale of work encompassed both the number of projects and the duration of the initiative whilst the team aspect only focused on the size of the team. During the workshop participants spoke of the multi-disciplinary nature of their work and the teams which they were part of, how and where their work fitted into large organisations with multiple needs and priorities and the emergent and varied nature of their work. The metaphor of a pond and ripples was used as a way of exploring and explaining the potential impact of an embedded research initiative on different actors and parts of the organisation.

On reflection we decided to divide the scale of work theme into its component parts (number of projects and timescale/duration) to ensure that both aspects were clear. We also adapted the ‘size of team’ theme to focus on both size and composition, taking into account the comments about multi-disciplinary teams. In our description we also highlighted the overarching insight about the emergent nature of embedded research initiatives.