Elizabeth M Morrow

Research Support NI

Background UK equality law and National Health Service (NHS) policy requires racial equality in job appointments and career opportunities. However, recent national workforce race equality standard (WRES) data show that nearly all NHS organisations in the UK are failing to appoint ethnically diverse candidates with equivalent training and qualificat...

Background: In the UK National Health Service (NHS) provider organisations are mandated to assure racial equality in job appointments and career opportunities. However, recruitment continues to discriminate against ethnically diverse candidates (British and overseas) and NHS providers are failing to attain the many benefits associated with an ethni...

Background Machine-learning algorithms and big data analytics, popularly known as ‘artificial intelligence’ (AI), are being developed and taken up globally. Patient and public involvement (PPI) in the transition to AI-assisted health care is essential for design justice based on diverse patient needs. Objective To inform the future development of...

Within higher education, inclusion of students from diverse nations, socioeconomic, ethnic and cultural backgrounds is vital for social mobility and economic development. Despite some international successes in widening participation, inequalities in student experiences and differentials in degree attainment for traditionally underrepresented group...

Participation and involvement of publics in the provision of health care is gaining traction as people are encouraged to become “discerning consumers” in seeking care and wellness from an increasingly diverse range of providers. In order to meet the demands of consumers, health care providers seek feedback from service users. It can be argued that...

Background and Rationale: Internationally, the idea of “co-production' has become more popular in health research because of the promise of partnership between researchers and patients to create research that focuses on patients' needs. Patient and public involvement (PPI) at an early stage in deciding what research should be funded, can improve th...

This toolkit is for higher education institutions to develop an embedded approach to research impact. It covers a broad spectrum of impact areas to enable different staff groups and stakeholders to coordinate the leadership and management of impact. With the support of the UK higher education funding councils this toolkit was developed by the Lead...

Orientating to impact is essential for understanding what impact means for an Higher education institution, its departments, research teams and staff. Investing time in orientating to the issues can inform strategy development and support effective leadership and management of research through understanding the opportunities and challenges impact p...

Visioning impact is vital for understanding how to support impact with leadership, governance and management. Visioning is the process of exploring possibilities, generating ideas and deciding targets. It brings benefits for the whole organisation, through identifying focus and direction for impact as part of the organisation’s mission.

Mobilising for impact is an essential prerequisite for developing capacity to achieve impact. It involves understanding the present situation, knowing what changes are needed at different levels in the organisation, and directing resources accordingly.

Evaluation is crucial for evidencing the impact of research, particularly for the purpose of research assessment. Evaluating impact is also important for understanding and developing impact. For example, evaluation of the processes involved in generating impact can inform future impact practices.

Communicating is essential for evidencing the impact of research but it is also fundamental to an embedded approach to research impact. Communication about impact can bring benefits for the whole organisation through raising awareness within an higher education institution and building a reputation for research impact beyond academia.

Engagement of academic and professional services staff within an higher education institution is important for embedding impact in organisational structures and systems. Senior organisational leaders, research managers and impact leads need to engage staff to ensure that developing impact is seen as an essential part of the research endeavour.

Integrating impact in research is essential for developing a higher education institution’s capabilities to deliver impact. Integration of strategies and support for impact brings benefits for the whole organisation through improvements in research design and research practice. Integrating impact spans into other types of impact such as the impact...

Capturing impact is imperative for informing evaluations of impact and for creating case studies, reports or accounts that communicate impact effectively. Focusing on capturing impact can also lead to better management of research data and more accessible research information.

Embedding impact refers to the development of supportive organisational cultures, structures and systems for research impact. This toolkit emphasises an embedded approach to research impact by encouraging leaders and managers to reflect on the organisational conditions that enable staff to maximise research impact.

Guidance for impact assessment and measurement. A synthesis of five key principles for measuring the impact of research. The principles are transferable to measurement of impact in a wide range of organisational impact assessment or transformation work.

Guidance for researchers about what makes a robust claim to research impact. Twenty points drawn from an analysis of REF2014 impact case studies. The full version is available in section 7 'Evaluating' of The Research Leader's Impact Toolkit from the Leadership Foundation for Higher Education (2017).

Research is increasingly under the spotlight to demonstrate impact as well as ‘World Class’ quality. Impact measures were introduced into the United Kingdom’s Research Excellence Framework in 2014, and are being adopted in other countries. However, impact is a concept that is both loosely applied and often contested. It needs unpacking to build und...

Background: Growing numbers of older people living with frailty and chronic health conditions are being referred to hospitals with acute care needs. Supportive care is a potentially highly relevant and clinically important approach which could bridge the practice gap between curative models of care and palliative care. However, future intervention...

The impact agenda is moving at pace through higher education. Impact is increasingly central to universities’ research strategies. Whilst the term ‘impact’ is bandied about and we think we know what it means, there is little consensus in the sector about how impact is achieved, what kind of organisational conditions support and nurture it, or what...

There are many important reasons to try to maximise the impact of our research. All of the major research funders are talking about pathways to impact. In this study we have tried to pin point what exactly universities and researchers can do to build their own diverse routes to impact, not only at project level but across departments and universiti...

Aim: The aim of this review was to explore the concept of carer engagement in the hospital care of older people and to build theory to inform future research and practice. Background: Carer engagement can help to improve the delivery and continuity of care provided to older people in hospital. However, definitions, guidance and structures for ca...

It is not new, but it continues to be an uncomfortable fact that the ethnic composition of higher education institutions (HEIs) in the UK reflects a history of racial inequality. While the proportion of Black and Minority Ethnic (BME1) staff and students has increased through widening participation2 and employment3 policies, there remain very few l...

Purpose – The purpose of this paper is to explore the nature and impact of leadership in relation to the local implementation of quality improvement interventions in health care organisations. Design/methodology/approach – Using empirical data from two studies of the implementation of The Productive Ward: Releasing Time to Caret in English hospital...

To identify and examine mechanisms through which patients' experiences of chronic disease can be accessed, understood, and used to improve outcomes, health care costs, and quality of life for individual patients. Interpretive synthesis of the research literature on chronic disease and associated areas of clinical practice and service development. S...

There is strong evidence to show that lower nurse staffing levels in hospitals are associated with worse patient outcomes. One hypothesised mechanism is the omission of necessary nursing care caused by time pressure-'missed care'. To examine the nature and prevalence of care left undone by nurses in English National Health Service hospitals and to...

Objective: To identify and examine mechanisms through which patients’ experiences of chronic disease can be accessed, understood, and used to improve outcomes, health care costs, and quality of life for individual patients. Study Design and Setting: Interpretive synthesis of the research literature on chronic disease and associated areas of clinica...

Cowley S, Whittaker K.A, Grigulis A, Malone M, Donetto S, Wood H, Morrow E, Maben J. (2013) This literature review was commissioned to support the Health Visitor Implementation Plan 2011-2015: A Call to Action (Department of Health 2011). That document sets out plans increase the number of health visitors employed by around 50% (4200 additional he...

This literature review was commissioned to support the health visitor implementation plan 2011-2015. It aimed to ascertain the key components of health visitor interventions, as well as relationships between the current health visiting service and its processes, and outcomes for children and families.

Objectives To first, validate in English hospitals the internal structure of the ‘Patient Evaluation of Emotional Care during Hospitalisation’ (PEECH) survey tool which was developed in Australia and, second, to examine how it may deepen the understanding of patient experience through comparison with results from the Picker Patient Experience Quest...

Background: Understanding and improving 'patient experience' is essential to delivering high quality healthcare. However, little is known about the provision of education and training to healthcare staff in this increasingly important area. Objectives: This study aims to ascertain the extent and nature of such provision in England and to identif...

Purpose: This paper aims to focus on facilitating large-scale quality improvement in health care, and specifically understanding more about the known challenges associated with implementation of lean innovations: receptivity, the complexity of adoption processes, evidence of the innovation, and embedding change. Lessons are drawn from the implemen...

This book fills an important niche in the market providing practical expert advice on the involvement of service users - patients, carers and the public - in nursing and healthcare research. An invaluable guide for anyone working or involved in nursing and healthcare research, this book provides a step-by-step guide to the principles and process of...

EuropeThe USACanadaAustralia and New ZealandDeveloping countries

Personal health researchVolunteer networksService user-led organisationsCharities and not-for-profit organisationsExperienced service user representativesAcademic service user researchers

Indicators of successful involvementDocumenting service user involvement workUsing reflective techniquesReflexivity and service user involvementQuality experiences of involvementQuality environments for involvement

Service usersInvolvementRepresentationExperiential knowledgeEmpowermentParticipationModels of involvementA theoretical framework for approaching service userinvolvement in research

Children and their parentsSchool-age childrenYoung peopleAdultsOlder people

Approaching service user involvementPolitical and research contexts of involvementHistorical roots and social movementsPerspectives of service user involvementWhat is known about the impact of involvement?Current challenges

Why we need to know about impactDesigning an assessment of impactRecognising impactRecording impactReporting impact

Involving seldom-heard groupsPeople with physical disabilitiesThe deaf and people who are hard of hearingPeople who are blind or partially sightedPeople with learning disabilitiesPeople with degenerative cognitive impairmentPeople with mental health problemsBlack and minority ethnic groups

Making connectionsWorking environmentsRoles and responsibilitiesLegal and ethical issuesTraining and supportCommunicationFeedback and reflectionEmbedding service user involvement

Patients who are receiving health carePeople who are very sickPeople with rare clinical conditionsPeople who find it difficult to access servicesPeople who do not have the capacity to consentCarers

Summary conclusionsService user involvement enhancing evidence-based practiceEnriching professional educationTeaching service user involvement in researchDeveloping professional rolesSecuring service user's commitment to involvementFurther readingWeb-based resources

Deciding who to involveBuilding in opportunities for involvementResearch methods and approaches to involvementPlanning involvementPaymentsResearch ethics and governance

Background: meticillin-resistant Staphylococcus aureus (MRSA) is endemic within the United Kingdom health care sector. Recent campaigns to reduce health care-associated infection have rested on increasing staff accountability and ownership of the problem and its solutions. However, the existence of reservoirs of colonization in the community now cr...

Despite long-standing commitment to the notion of critical reflection across the healthcare professions it is unusual for critical theory and practice to be taught as explicit subjects in healthcare higher education. There is evidence to show that reflective techniques such as critical portfolios and reflective diaries can help students to consolid...

We examine problems resulting from the narrow empirical focus associated with evidence-based nursing, including the deleterious influence of vested interests, disattention to patients' experiences, underestimation of the importance of social processes, lack of an individualized research perspective, marginalization of other forms of knowledge, and...

Aim and objective: To explore why innovations in service and delivery are adopted and how they are then successfully implemented and eventually assimilated into routine nursing practice. Background: The 'Productive Ward' is a national quality improvement programme that aims to engage nursing staff in the implementation of change at ward level....

The NHS Institute for Innovation and Improvement’s (NHS Institute) Productive Ward: Releasing time to care™ (The Productive Ward) programme aims to empower ward teams to identify areas for improvement by giving staff the information, skills and time they need to regain control of their ward and the care they provide. This research builds on the ins...

BACKGROUND: Meticillin-resistant Staphylococcus aureus (MRSA) is endemic within the United Kingdom health care sector. Recent campaigns to reduce health care-associated infection have rested on increasing staff accountability and ownership of the problem and its solutions. However, the existence of reservoirs of colonization in the community now c...

Meticillin-resistant Staphylococcus aureus (MRSA) is endemic within the United Kingdom health care sector. Recent campaigns to reduce health care-associated infection have rested on increasing staff accountability and ownership of the problem and its solutions. However, the existence of reservoirs of colonization in the community now creates ambigu...

In the UK, researchers across the health professions are increasingly being encouraged by policymakers and research commissioners to ‘involve’ service users in research. A recent review shows there is some evidence that involving patients, carers, relatives, social or community groups directly and actively as part of the research process can improv...

The Productive Ward: Releasing time to care™ programme aims to empower ward teams to identify areas for improvement by giving staff the information, skills and time they need to regain control of their ward and the care they provide. The NHS Institute for Innovation and Improvement commissioned Kings College London to undertake a review of the Prod...

This paper aims to support the critical development of user involvement in systematic reviews by explaining some of the theoretical, ethical and practical issues entailed in 'getting ready' for user involvement. Relatively few health or social care systematic reviews have actively involved service users. Evidence from other research contexts shows...

Teaching reflexivity Elizabeth Morrow (née Smith) National Nursing Research Unit, King’s College London Abstract The ability to critically reflect is held as an important professional skill across a wide range of health and social care disciplines. Taking time to reflect on our views and actions is important for making sense of what we think and...

A research base should be of sufficient quality and quantity to inform nursing practice. It must allow nurses to access information about clients' needs and to identify effective strategies for meeting those needs. This paper presents the findings of a scoping review of 'learning disability nursing research'. The review aimed to determine whether t...

In the UK policy recommends that service users (patients, carers and the public) should be involved in all publicly funded health and social care research. However, little is known about which approaches work best in different research contexts and why. The purpose of this paper is to explain some of the theoretical limitations to current understan...

Abstract Service user (patients, carers and the public) involvement is an important issue for health and social care services, professional education and research in the United Kingdom and other Westernized nations. New policy requirements create challenges and opportunities for the development of professional practice in all of these contexts. In...

Understanding patients' experiences of their interactions with health services is an important step in building quality from within. The purpose of this article is to look at the possibilities for involving service users in the development of the National Health Service in England through the structure of integrated care pathways (ICPs). A systemat...

In the UK, strategies to improve retention of the mental health workforce feature prominently in health policy. This paper reports on a longitudinal national study into the careers of mental health nurses in the UK. The findings reveal little attrition during the first 6 months after qualification. Investigation of career experiences showed that th...

Increasing numbers of healthcare researchers in the UK are using telephone interviews in their research. In this paper, Elizabeth Smith summarises the context in which the method is used to target purposive samples of service users or patient, carers, clinicians and other staff, or key individuals in the field of inquiry. The aim is to gain detaile...