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Journal cover: Journal of Health Organization and Management

Journal of Health Organization and Management

ISSN: 1477-7266
Previously published as: Journal of Management in Medicine

Online from: 2003

Subject Area: Health Care Management/Healthcare

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Mind the gap: Understanding utilisation of evidence and policy in health care management practice


Document Information:
Title:Mind the gap: Understanding utilisation of evidence and policy in health care management practice
Author(s):Emmanouil Gkeredakis, (Warwick Business School, University of Warwick, Coventry, UK), Jacky Swan, (Warwick Business School, University of Warwick, Coventry, UK), John Powell, (Warwick Medical School, University of Warwick, Coventry, UK), Davide Nicolini, (Warwick Business School, University of Warwick, Coventry, UK), Harry Scarbrough, (Warwick Business School, University of Warwick, Coventry, UK), Claudia Roginski, (Coventry Teaching Primary Care Trust, Coventry, UK), Sian Taylor-Phillips, (Warwick Medical School, University of Warwick, Coventry, UK), Aileen Clarke, (Warwick Medical School, University of Warwick, Coventry, UK)
Citation:Emmanouil Gkeredakis, Jacky Swan, John Powell, Davide Nicolini, Harry Scarbrough, Claudia Roginski, Sian Taylor-Phillips, Aileen Clarke, (2011) "Mind the gap: Understanding utilisation of evidence and policy in health care management practice", Journal of Health Organization and Management, Vol. 25 Iss: 3, pp.298 - 314
Keywords:Evidence, Evidence-based practice, Health care, Knowledge sharing, National Health Service, Primary care, Public policy
Article type:Research paper
DOI:10.1108/14777261111143545 (Permanent URL)
Publisher:Emerald Group Publishing Limited
Acknowledgements:© This work is Crown copyright protected material. An earlier version of this paper was presented at the 7th Biennial International Conference in Organisational Behaviour in Health Care (OBHC), 11-14 April 2010, University of Birmingham, UK. The authors also gratefully acknowledge the generous funding from the NIHR SDO programme on “Management Practice” (SDO project 08/1808/244). Neither the NIHR SDO nor the UK Department of Health are responsible for the content of, and the ideas expressed in, this paper. Special thanks are due also to Dawn Coton for her ongoing support to this project.
Abstract:

Purpose – The paper aims to take a reflective stance on the relationship between policy/evidence and practice, which, the authors argue, is conceptually under-developed. The paper aims to show that current research perspectives fail to frame evidence and policy in relation to practice.

Design/methodology/approach – A qualitative study was conducted in the English NHS in four Primary Care Trusts (PCTs). Seventy-five observations of meetings and 52 semi-structured interviews were completed. The approach to data analysis was to explore and reconstruct narratives of PCT managers' real practices.

Findings – The exploratory findings are presented through two kinds of narratives. The first narrative vividly illustrates the significance of the active involvement, skills and creativity of health care practitioners for policy implementation. The second narrative elucidates how problems of collaboration among different experts in PCTs might emerge and affect evidence utilisation in practice.

Practical implications – The findings exemplify that policies are made workable in practice and, hence, policy makers may also need to be mindful of practical intricacies and conceive policy implementation as an iterative process.

Originality/value – The contribution of this paper lies in offering an alternative and important perspective to the debate of utilisation of policy/evidence in health care management and in advancing existing understanding of health care management practice. The paper's rich empirical examples demonstrate some important dimensions of the complexity of practice.



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