Implementation and development of an embedded researcher program driven by rural health services: A qualitative exploratory case study.

Abstract

Background: Embedding researchers in healthcare settings is a strategy used to close the gap between research and practice. Existing research pays little attention to the factors related to the implementation, development, and outcomes of embedded researcher programs in rural healthcare settings. There are additional challenges to embedding research in rural health practice, including enduring workforce shortages and limited research resources. This case study aimed to describe the implementation, development, and the types of outcomes of a rural and regional embedded researcher program, comprising three research translation coordinator (RTC) roles implemented in rural health services by an academic health science centre (AHSC). Methods: This exploratory case study was informed by multiple data sources: the RTCs (n = 4; 100%); their employing health service chief executive officers (n = 3; 100%), and the implementing AHSC’s executive officers (n = 2; 100%). Data were gathered via semi-structured interviews, RTCs’ written activity reports, and impact case examples developed by the RTCs. Data were analysed using a team-based five stage framework approach. Results: Data collected included eight semi-structured interviews, fifteen activity reports and six impact case examples. Analysis of these data informed three themes and sub-themes: (1) Enabling and challenging implementation factors coded to two sub-themes (Rural health service ownership and Region-wide implementation) (2), Development of the rural embedded research translation coordinator role, comprising three sub-themes (Emerging and responsive to health service needs; Supporting translation of research, and Engaging strategic partners, and (3) Types of outcomes of the rural embedded research translation coordinator program at four levels (Rural clinician-researcher; Rural RTC; Organisation, and Region-wide or AHSC-levels). Conclusions: The rural embedded researcher program represents an evolving, yet ostensibly successful initiative implemented across a large rural and regional area. The RTCs were employed by and accountable to a rural health service, and worked as a team while simultaneously collaborating with partner regional health services and universities. This rural health-service driven embedded researcher program operated within a collectivist framework to produce different types of outcomes for clinicians and researchers, health services, and the region. These findings will inform policymakers and organisations concerned with improving research and practice in rural and other resource-constrained health settings.