Organisational benefits of a strong research culture in a health service: a systematic reviewKatherine Harding A B D , Lauren Lynch A , Judi Porter A C and Nicholas F. Taylor A B
B La Trobe University, Kingsbury Drive, Bundoora, Vic. 3086, Australia. Email: firstname.lastname@example.org
C Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia.
D Corresponding author. Email: email@example.com
Australian Health Review 41(1) 45-53 https://doi.org/10.1071/AH15180
Submitted: 28 September 2015 Accepted: 15 February 2016 Published: 14 April 2016
Objective The aim of the present study was to determine whether there is an association between having research culture in a health service and better organisational performance.
Methods Using systematic review methods, databases were searched, inclusion criteria applied and study quality appraised. Data were extracted from selected studies and the results were synthesised descriptively.
Results Eight studies were selected for review. Five studies compared health services with high versus low levels of research activity among the workforce. Three studies evaluated the effect of specific interventions focused on the health workforce. All studies reported a positive association between research activity and organisational performance. Improved organisational performance included lower patient mortality rates (two of two studies), higher levels of patient satisfaction (one of one study), reduced staff turnover (two of two studies), improved staff satisfaction (one of two studies) and improved organisational efficiency (four of five studies).
Conclusions A stronger research culture appears to be associated with benefits to patients, staff and the organisation.
What is known about this topic? Research investment in the health workforce can increase research productivity of the health workforce. In addition, investment in clinical research can lead to positive health outcomes. However, it is not known whether a positive research culture among the health workforce is associated with improved organisational performance.
What does this paper add? The present systematic review of the literature provides evidence that a positive research culture and interventions directed at the health workforce are associated with patient, staff and organisational benefits.
What are the implications for practitioners? For health service managers and policy makers, one interpretation of the results could be to provide support for initiatives directed at the health workforce to increase a research culture in health services. However, because association does not imply causation, managers need to interpret the results with caution and evaluate the effect of any initiatives to increase the research culture of the health workforce on the performance of their organisation.
References Patel VM, Ashrafian H, Ahmed K, Arora S, Jiwan S, Nicholson JK, alAthanasiou T. How has healthcare research performance been assessed? A systematic review. J R Soc Med 2011; 104 251–61.
| How has healthcare research performance been assessed? A systematic review.CrossRef | 21659400PubMed |
 Basu Ray I, Henry TL, Davis W, Alam J, Amedee RG, Pinsky WW, alPinsky WW. Consolidated academic and research exposition: a pilot study of an innovative education method to increase residents’ research involvement. Ochsner J 2012; 12 367–72.
| 23267266PubMed |
 Harding KE, Stephens D, Taylor NF, Chu E, Wilby A. Development and evaluation of an allied health research training scheme. J Allied Health 2010; 39 e143–8.
| 21184016PubMed |
 Lampman RM, Wolk SW, Fowler J, Cleary R, Pomerantz RA, Fry WJ, alHoshal VL. Resident research training conducted in a community hospital general surgery residency program. Curr Surg 2003; 60 304–9.
| Resident research training conducted in a community hospital general surgery residency program.CrossRef | 14972262PubMed |
 Lennon RP, Oberhofer AL, McNair V, Keck JW, Lennon RP, Oberhofer AL, alKeck JW. Curriculum changes to increase research in a family medicine residency program. Fam Med 2014; 46 294–8.
| 24788427PubMed |
 Access Economics. Exceptional returns: the value of investing in health R&D in Australia II. Canberra: The Australian Society for Medical Research; 2008.
 Hanney S, Boaz A, Jones T, Soper B. Engagement in research: an innovative three-stage review of the benefits for health-care performance. Southampton: NHS National Institute for Health Research; 2013.
 Skinner EH, Williams CM, Haines TP. Embedding research culture and productivity in hospital physiotherapy departments: challenges and opportunities. Aust Health Rev 2015; 39 312–14.
| Embedding research culture and productivity in hospital physiotherapy departments: challenges and opportunities.CrossRef | 25774754PubMed |
 Harding K, Porter J, Horne-Thompson A, Donley E, Taylor N. Not enough time or a low priority? Barriers to evidence-based practice for allied health clinicians. J Contin Educ Health Prof 2014; 34 224–31.
| Not enough time or a low priority? Barriers to evidence-based practice for allied health clinicians.CrossRef | 25530292PubMed |
 Perry L, Grange A, Heyman B, Noble P. Stakeholders’ perceptions of a research capacity development project for nurses, midwives and allied health professionals. J Nurs Manag 2008; 16 315–26.
| Stakeholders’ perceptions of a research capacity development project for nurses, midwives and allied health professionals.CrossRef | 18324991PubMed |
 Clarke M, Loudon K. Effects on patients of their healthcare practitioner’s or institution’s participation in clinical trials: a systematic review. Trials 2011; 12 16
| Effects on patients of their healthcare practitioner’s or institution’s participation in clinical trials: a systematic review.CrossRef | 21251306PubMed |
 Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Ann Intern Med 2009; 151 65–94.
 Reed DA, Beckman TJ, Wright SM, Levine RB, Kern DE, Cook DA. Predictive validity evidence for medical education research study quality instrument scores: quality of submissions to JGIM’s Medical Education Special Issue. J Gen Intern Med 2008; 23 903–7.
| Predictive validity evidence for medical education research study quality instrument scores: quality of submissions to JGIM’s Medical Education Special Issue.CrossRef | 18612715PubMed |
 Reed DA, Cook DA, Beckman TJ, Levine RB, Kern DE, Wright SM. Association between funding and quality of published medical education research. JAMA 2007; 298 1002–9.
| Association between funding and quality of published medical education research.CrossRef | 1:CAS:528:DC%2BD2sXhtVaisLzI&md5=a4b315e987c73e50f50ee748c03072b2CAS | 17785645PubMed |
 Aarons GA, Sommerfeld DH, Hecht DB, Silovsky JF, Chaffin MJ. The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: evidence for a protective effect. J Consult Clin Psychol 2009; 77 270–80.
| The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: evidence for a protective effect.CrossRef | 19309186PubMed |
 Brandt TL, Romme CR, LaRusso NF, Lindor KD. A novel incentive system for faculty in an academic medical center. Ann Intern Med 2002; 137 738–43.
| A novel incentive system for faculty in an academic medical center.CrossRef | 12416947PubMed |
 Brown A, Griffiss M. Effect of integrated research programs on health care systems and costs. Mil Med 1996; 161 691–5.
| 1:STN:280:DyaK2s7itFSmtQ%3D%3D&md5=5f7c6b4eba86d9fd62b337a82d5e9d63CAS | 8961726PubMed |
 Levin RF, Fineout-Overholt E, Melnyk BM, Barnes M, Vetter MJ. Fostering evidence-based practice to improve nurse and cost outcomes in a community health setting: a pilot test of the advancing research and clinical practice through close collaboration model. Nurs Adm Q 2011; 35 21–33.
| Fostering evidence-based practice to improve nurse and cost outcomes in a community health setting: a pilot test of the advancing research and clinical practice through close collaboration model.CrossRef | 21157261PubMed |
 Nayar P, Yu F, Apenteng B, Nayar P, Yu F, Apenteng B. Science-based and practice-based innovativeness and performance of substance abuse treatment facilities. Health Care Manage Rev 2014; 39 66–74.
| Science-based and practice-based innovativeness and performance of substance abuse treatment facilities.CrossRef | 23358133PubMed |
 Ozdemir BA, Karthikesalingam A, Sinha S, Poloniecki JD, Hinchliffe RJ, Thompson MM, alHolt PJ. Research activity and the association with mortality. PLoS One 2015; 10 e0118253
| Research activity and the association with mortality.CrossRef | 25719608PubMed |
 Salge TO, Vera A. Hospital innovativeness and organizational performance: evidence from English public acute care. Health Care Manage Rev 2009; 34 54–67.
| Hospital innovativeness and organizational performance: evidence from English public acute care.CrossRef | 19104264PubMed |
 Schreyögg J, von Reitzenstein C, Schreyogg J, von Reitzenstein C. Strategic groups and performance differences among academic medical centers. Health Care Manage Rev 2008; 33 225–33.
| Strategic groups and performance differences among academic medical centers.CrossRef | 18580302PubMed |
 Weiss AP. Measuring the impact of medical research: moving from outputs to outcomes. Am J Psychiatry 2007; 164 206–14.
| Measuring the impact of medical research: moving from outputs to outcomes.CrossRef | 17267781PubMed |
 Philip K. Allied health: untapped potential in the Australian health system. Aust Health Rev 2015; 39 244–7.
| Allied health: untapped potential in the Australian health system.CrossRef | 26629583PubMed |