New ways of seeing: Health social work leadership and research capacity building.

Social Work in Health Care

ISSN: 0098-1389 (Print) 1541-034X (Online) Journal homepage: http://www.tandfonline.com/loi/wshc20

New ways of seeing: Health social work leadership and research capacity building Fiona McDermott PhD & Glenda Bawden MSW To cite this article: Fiona McDermott PhD & Glenda Bawden MSW (2017): New ways of seeing: Health social work leadership and research capacity building, Social Work in Health Care, DOI: 10.1080/00981389.2017.1367349 To link to this article: http://dx.doi.org/10.1080/00981389.2017.1367349

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Date: 09 September 2017, At: 01:27

SOCIAL WORK IN HEALTH CARE https://doi.org/10.1080/00981389.2017.1367349

New ways of seeing: Health social work leadership and research capacity building Fiona McDermott, PhDa and Glenda Bawden, MSWb a

Faculty of Medicine, Nursing & Health Sciences, Monash University, Caulfield East, Victoria Australia; Social Work Department, Monash Health, Clayton, Victoria Australia

Downloaded by [Australian Catholic University] at 01:27 09 September 2017

b

ABSTRACT

ARTICLE HISTORY

Building research capacity amongst social work practitioners is critically important for leaders in the social work profession. To reverse an apparent reluctance to use evidence and engage in research, strong social work leadership in practice organisations is needed. The literature on leadership in health social work is relatively silent regarding research capacity building as a leadership attribute but it is argued in this paper that leadership is crucial. A programme of research capacity building and its outcomes in a health social work department is described, identifying key principles guiding its establishment and tasks undertaken. A transformational leadership style characterised this approach to research capacity building which delivered benefits to the staff and the service.

Received 13 February 2017 Revised 5 July 2017 Accepted 8 August 2017 KEYWORDS

Health social work; leadership; practice research; research capacity building

Introduction The building of research capacity amongst social work practitioners in health settings requires leadership. The literature on developing practitioners’ research capacity is minimal. Focusing on the role of leadership in building research capacity opens up new territory for analysis. Health settings are key sites where the importance of research and evidence in clinical decision-making and practice amongst all health professionals is emphasised. Indeed, evidence-based practice (EBP), beginning in medicine (Sackett, Straus, Richardson, Rosenberg, & Haynes, 1997), has since expanded to include most health and allied health professionals. Health service managers and service users increasingly place emphasis on service providers working from an evidence base. In addition, health practitioners themselves are required to be involved in research. Social workers (Tischler, Webster, Wittman, Wade, 2016) and other allied health practitioners (McCrystal & Wilson, 2009) are expected to have the skills and knowledge to be able to both analyse research evidence, as well as to carry out research into their own practice.

CONTACT Fiona McDermott [email protected] Faculty of Medicine, Nursing & Health Sciences, Monash University, PO Box 197, Caulfield East, Victoria 3145, Australia. New ways of seeing: Health Social Work leadership and Research Capacity Building © 2017 Taylor & Francis

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F. MCDERMOTT AND G. BAWDEN

In Australia, the introduction of activity-based funding (where hospitals receive payment based on the number and complexity of the patients they treat) emphasises the importance of health social workers working from an evidence base, evidence being required to be cited for all service delivery, policy, procedure development and funding bids. Literature review


Research capacity building

Research capacity building (RCB) refers to advancing a service or individual’s ability to understand, utilise and undertake research. It includes the development of research skills, as well as understanding of organisational strategy, policy and systems (Cooke, 2009). Social work practitioners and students have been noted as expressing disinterest in engaging in research, perhaps due to a self-perception that they lack the skills, including the capacities to read and understand it and incorporate it into their practice (Bellamy, Bledsoe, Mullen, Fang, & Manuel, 2008; Caldwell, Coleman, Copp, Bell, & Ghazi, 2007; Edmond, Megivern, Williams, Rochman, & Howard, 2006; Harder, 2010; Unrau & Grinnell, 2005). Several studies have identified factors which limit social workers undertaking of research as well as their adoption of EBP. Lack of time, constant client demands, limited agency resources as well as organisational cultures perceived as being unsympathetic to research, combined with disinterest from practitioners create an inhospitable research environment (see for example, Cheung, Ma, Thyer, & Webb, 2014; Gira, Kessler, & Poertner, 2014; Gray, Joy, Plath, & Webb, 2012; Bender, Altschul, Yoder, Parrish, & Nicke, 2014; Harding, Porter, Horne-Thompson, Donley, & Taylor, 2014; Parrish & Rubin, 2011; Van der Zwet, Beneken genaamd Kolmer, & Schalk, 2014; Webber 2015). Despite social workers’ apparent reluctance regarding research and the barriers impeding their research capacity, it is increasingly important that health social work departments become familiar with research, using research findings in instrumental ways (for example, making changes to practice where research indicates that this is warranted), symbolically (for example, as support for decisions they have made) and conceptually (for example, enabling them to reframe or think differently about practice (Weiss, 1979). It is here that social work leadership has a key role to play. Evidence-based practice

EBP refers to the systematic gathering and appraisal of relevant research evidence and the integration of that evidence with client preferences and practitioner


SOCIAL WORK IN HEALTH CARE

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knowledge (Adams, Matto, & LeCroy, 2009; Berger, 2010; Edmond et al., 2006; McCracken & Marsh, 2008; Rubin & Parrish, 2007; Sackett et al., 1997). Within social work itself over the past 10 years, there has been argument and disagreement over the place of EBP (Adams et al., 2009; Berger, 2010; Edmond et al., 2006; Shlonsky, Noonan, Littell, & Montgomery, 2010). However, it is recognised as central to the development of social work’s professional credibility (Berger, 2010; Edmond et al., 2006; Pack & Cargill, 2015; Tischler et al., 2016; Webber, 2015). For social workers to work from an evidence base means that they have the research capacity, the skill-set to read research, to undertake practice-driven research and to incorporate relevant theoretical developments and research findings into their practice (Adams et al., 2009, p. 168; Edmond et al., 2006, p. 380). Utilising evidence alongside practice wisdom, knowledge of client values and wishes enhances expertise and skilled service delivery (Rubin and Parrish (2007). Leadership in health social work

Within social work, leadership has been studied with increasing interest (Lawler, 2007; McDonald & Chenoweth, 2009). Definitions of leadership are as varied as the people who write about it, reflecting a diversity of understandings and interpretations of the role (Lawler, 2007, p. 125). However, consensus exists that management and leadership are distinct roles, referring to different attributes and capacities (Kotter, 1996; Lawler, 2007). To be considered a manager might refer to those who accept current organisational practices, favouring efficiency and regulation, while a leader might demonstrate the capacity to hold a reflective orientation, combined with an ability to articulate and envision different ways of engaging in social work (Beckert, 1999, p. 786; Lawler, 2007, p. 126). Two types of leadership in social work have received increasing attention – transactional and transformational leadership. As McDonald and Chenoweth argue (2009, p. 105, transformational leadership is highly congruent with social work. Drawing on the work of Burns (1978) (see also Tafvelin, Hyvonen, & Westerberg, 2014, p. 887), they note that transformational leaders advance goals that are mutually or independently held amongst organisational members and directed towards an end value. The meeting of such goals involves transformational leaders in a reciprocal process in which they must work in contexts of conflict and competition. McDonald and Chenoweth (2009) argue that social work has paid relatively little attention to the training of leaders, with the exception of the health field. They concur with Mizrahi and Berger’s (2005) view that in health settings, constant demands for organisational restructuring have highlighted the need for leadership, in part because of the leader’s need to find a balance between the range of competing demands from a range of stakeholders and service users.


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Both management and leadership skills are paramount in navigating this potentially conflictual and always competitive environment. Such professional leadership in the contemporary health environment is crucial in ensuring that social work health services can respond to institutional, organisational, technological and biomedical changes. Mizrahi and Berger (2005, p. 156) noted that ‘(t)he health care system needs leaders willing to make bold decisions, while figuring out strategically with others, when to accommodate and acquiesce, when to negotiate and compromise, and when to hold on and resist destructive forces’. Rank and Hutchinson (2000) studied the leadership skills recognised and valued by health social work managers, surveying a random sample of 75 social work leaders about their understanding of leadership. Respondents identified proaction, values and ethics, empowerment, vision and communication as key characteristics (p. 492). Similarly, Holosko (2009, p. 455) identified five core attributes of social work leadership: vision, influencing others to act, team work, collaboration, problem solving capacity and creating positive change. These five core attributes share ground with work on change management and leadership by Kotter (1996), whose identification of an eight-stage framework for bringing about change in organisations has been highly influential. It is noteworthy that the leadership attributes noted by Holosko (2009) parallel those considered to characterise transformational leadership (Tafvelin et al., 2014). Gellis (2001, p. 18), in her study of 234 hospital social workers’ perceptions of transformational leadership, found that such leaders focused on promoting organisational change through their ability to develop and transmit a vision of the future which moved beyond the status quo. Gellis (2001, p. 18) considered that transformational leaders worked to advance and develop their followers into becoming leaders themselves, thereby influencing the culture of the organisation. She noted that the more highly the manager was rated by workers as a transformational leader, the greater the desire of workers to participate in the activities requested by the leader, even when that went beyond what was expected (p. 24). It is noteworthy that both the National Association of Social Workers (2016) and the Australian Association of Social Workers (2016) have drawn on these attributes of transformational leadership in describing desired leadership characteristics for social workers, emphasising that social work leaders must be visionaries, forward thinkers and innovators who can adapt to change while respecting traditional methods. Above all, they must thrive in uncertainty. Holosko (2009) asserted that such high level functions characteristic of transformational leaders contribute to patient outcomes, organisational success and worker effectiveness and satisfaction. However, the relationship between these leadership attributes and outcomes for service users and organisations remains difficult to ascertain (Cerullo & Cooney, 2011; Poertner, 2006).


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Research capacity building

In the last 20 years, a number of initiatives for building research capacity (RCB) amongst social workers and other health professionals have been described in the literature. Since the early work of Christ, Siegal and Weinstein (1995), several other initiatives have been described: Randall (2002); Joubert (2006); Perry, Grange, Heyman, and Noble (2008); Wong (2009); Lunt, Ramian, Shaw, Fouche, and Mitchell (2012); Bawden and McDermott (2012); Marshall (2014). The majority of these refer to various approaches to establishing linkages and partnerships between academia and the field whereby practitioners benefit from the availability of research expertise. The majority of these papers describe rather than analyse the important role which organisations and leadership play in achieving this outcome. For example, Tischler et al. (2016) note the challenge that an absence of organisational support poses to the task of building a sustainable research culture. As Orme and Powell (2007, p. 989) point out, systems and cultures in organisations are very important to the development of RCB. They highlight two approaches, the first on developing ‘communities of practice’, and the second relating to the development of a research culture as strategies to strengthen organisational support. As Cooke (2005) and others (Orme & Powell, 2007; Pickstone et al., 2008) note, RCB is an approach to developing sustainable research skills on both an individual and an organisational level. RCB establishes a cycle whereby the production of useful research which informs practice prompts the acquisition of higher levels of research skills and an increased ability to perform useful research. As such, its sustainability will be evident in the extent to which such a cycle of activity prevails. Importantly, as Pickstone et al. (2008) comment, establishing research capacity might require a time frame approaching 10 years. Critical to building research capacity is developing an organisational culture characterised by research mindedness. Indeed it is likely that these two elements operate in tandem. Research mindedness is an orientation towards the social world characterised by curiosity, critique and a reluctance to take the status quo of everyday social and political life for granted. Everything observed and undertaken by social actors is subject to scrutiny and analysis, whether this be an apparently simple request for a social worker to assess an elderly patient for hospital discharge, or the routine use of the descriptor ‘complex’ in relation to client presentations. Orme and Powell (2007) suggest that research mindedness is as much about a practitioner identifying as a researcher as it is about having research competence. Orme and Powell (2007, p. 1003) concluded that, to create the optimum conditions for RCB, change has to occur in the culture of practice at an organisational level. The question then arises what kind of leadership style might be most effective in creating such change.

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Leadership and EBP Guerrero, Padwa, Fenwick, Harris and Aarons (2016) studied the attributes of leadership style which assisted the implementation of EBP in a community-based addiction treatment programme in the US. This study found that transformational leadership strategies whereby leaders developed staff talents and promoted staff growth were important to the implementation of behaviour change amongst practitioners. Importantly, such a leadership style was found to improve staff attitudes towards the use of EBP, a point also noted by Gellis (2001, p. 18). The literature on social work leadership in RCB and in implementing practitioner behaviour change in health settings is meagre. One exception is the recent paper by Tischler et al. (2016). These researchers described the development of a practice-based research programme in a health social work department in the US, noting that ‘. . .social work leadership (played a) pivotal role in helping staff transition from a solely care delivery model to a research-informed intervention model’ (p. 1). While the strategies developed and processes engaged in are described and the importance of leadership in this process emphasised, the particular attributes of that leadership are not specified. However, it would appear that the emphasis placed on the adoption of a vision and the encouragement of practitioners to help create that vision are suggestive of a transformational style of leadership. Evaluation and sustainability

Transformational leadership is demonstrated through the development of structures and processes which enable the vision to materialise. Synonymous with realising the vision, in this case that of creating an environment characterised by research mindedness and RCB, is importance given to evaluation. The primary test of the success of RCB is the results produced and the impact it has on practice, demonstrable through such things as changes to practice, and utilisation of a range of methods for dissemination of findings such as publications, protocols and seminars. Cooke (2005) contributes a framework which comprises one of very few attempts to measure progress in RCB and build an understanding of what works in health settings. Of particular value to social workers is its usefulness in capturing changes occurring in and across structural levels, i.e. at the micro, meso and macro. Summary

In reviewing the literature on health social work leadership in establishing and building research capacity and EBP amongst practitioners, it is evident that little attention has been paid to this aspect of the role. What has been described in the literature are a range of models for RCB, none of which specifically address


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leadership requirements. The literature on leadership has however extended understanding of transformational leadership as comprising attributes which would seem to contribute significantly to bringing about the cultural and behavioural changes necessary to establishing research mindedness, a prerequisite to practitioner engagement with research and the development and utilisation of EBP.


The project: Building an RCB programme in a large health service

A programme of RCB in a large health service in Victoria, Australia is now presented. The processes through which this programme developed are analysed through the lens of transformational leadership, adopting an interpretive perspective, noting various transformational leadership attributes and strategies as identified by Kotter (1996) and Holosko (2009). In 2009, a programme of stimulating and developing practitioner research was introduced into a large health service, employing almost 300 social workers across four hospital sites. It began with the creation of a full-time senior academic position appointed to work 50% at the health service and 50% at the university for an initial 3-year contract, later extended for two further periods of 2 years. Funds from within existing budgets supported the establishment of the position. Importantly, it was structured in order to exemplify a view of practitioner research as ‘contextualised’ research (Bawden & McDermott, 2012), with focus on changing the context of practice by introducing an academic to build a practice culture characterised by research mindedness. At the outset, seven guidelines were laid down by the leaders as the foundation of this initiative which we will name The Project (see Table 1). Table 1. Seven guidelines for establishing The Project. Guidelines for establishing The Project Indicators Inclusiveness All social workers interested in learning about researching their own practice can participate Purposefulness Social workers encouraged to begin with asking questions of their own practice, identifying contradictions, gaps, inconsistencies, unknowns which confront them in day-to-day practice encounters Developmental Begin by discovering their own questions as starting points for seeking out and developing the necessary skills and research techniques for answering these questions Collaborative Partnership with colleagues across the health service and across disciplines which share similar questions Supported Training in research methods and approaches relevant to the research Questions made available; opportunities for individual and group supervision of projects; opportunities for higher degree enrolments Reflexive Focus on taking the research findings back into practice as a part of the research cycle Shared Communicate findings through presentations to colleagues and community forums, attendance at conferences, publications of papers

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An organisational partnership model

The joint academic appointment sat between the academic and the practice world, being neither a full time academic nor a full time health practitioner. Structures needed to be put in place across both organisations to support and sustain the role in order to prevent the incumbent falling between organisations or becoming isolated. Different organisations have different criteria for excellence and different expectations and demands on employees. These areas of difference required management by both organisations. In the health service, a formal memorandum of understanding, an agreed position description and agreed key performance indicators (KPIs) were negotiated, reflecting the leadership tasks discussed by Guerrero et al. (2016, p. 6). A steering committee with representatives of both organisations continued to meet twice-yearly to review and advise on processes and the handling of emerging issues (such as the RCB programme responding to the strategic directions of each partner organisation). An innovation was the establishment of twice-yearly public demonstration forums held at both partner locations to showcase achievements and give broader access to the work undertaken. The academic needed regular meetings and engagement with the social work department leader to gather inside knowledge, identify concerns and develop solutions which helped to establish RCB strategies. Evaluating the development of RCB was an essential part of The Project. Both process and outcome evaluation measures were adopted, drawing on the work of Cooke (2008). During the next seven years (October 2009–June 2016), from a baseline of almost no research, the following outcomes were achieved: ● ● ● ● ● ● ● ● ● ●

50 practitioner research projects completed Six competitive small grants received 61 conference papers and posters presented Three BSW honours theses supervised by practitioners Seven articles published in peer reviewed journals Four resources/materials developed Eight identified clinical changes made in practice settings/interventions resulting from practice research One replication of research in another health service (McAlinden, McDermott, & Morris, 2013) Seven practitioners completed postgraduate coursework Masters study One PhD enrolment

During this seven year period, the social work department moved from a situation in which only experienced staff presented occasionally at conferences,


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to a situation where there were clear expectations of research engagement by both experienced and inexperienced practitioners, all students and their social work educators. An outcome of this was the creation of further change, for example, staff enrolments in postgraduate study, practitioners taking the initiative to build on and undertake further practice research. What was beginning to emerge was the ‘institutionalisation’ of practice research in this setting as noted by Orme and Powell (2007), in which a cultural change was becoming increasingly evident. For example, the practitioners who were engaged in research rather than the academic appointee, on occasions became the local champion for colleagues wanting to do research.

The leadership challenge

In order to tease out the leadership skills employed to initiate The Project as a response to the challenge of building research capacity amongst health social workers, the work of Kotter (1996) and Holosko (2009) was drawn upon. Holosko (2009, p. 455), as noted earlier, highlighted five core attributes of social work leadership. These are discussed below and illustrated with reference to The Project. 1. Vision: The social work leader had long held the view that the absence of practice research was the missing component preventing excellence in the large health social work department. Her vision was that of grounding practice research as part of the everyday tasks of practitioners, anticipating that routine consulting of the literature, growing innovation and testing out hypotheses and hunches would come to characterise ‘taken for granted’ practice. Her vision encompassed an academic and scientific approach. To bring this about, she envisioned a joint senior academic position located half-time both in social work academia and in the field. This idea emerged out of consultation with experts both locally and internationally and from the literature on different models of using evidence and advancing practitioner-driven research. The intention was to avoid replicating models that either used the field as a ‘laboratory’ or relied solely upon the goodwill and personal investment of academics. 2. Influencing others to act: To bring this vision to reality, both organisations (health service and university) needed to understand that it was important to act at this time. Timing, as Kotter (1996) emphasised, was crucial. Both the university and the health service needed to have the determination and the financial capacity to act to establish a position, and at this time it appeared that ‘the stars were aligned’. In 2001, the University Social Work Department elected to join the Medical Faculty and in 2002, joined the School of Primary Health Care. Thus, the University Social Work Department needed to develop closer links with a health environment. The health service for its part was placing increasing emphasis on EBP and the need to demonstrate innovation and excellence.


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Extensive ongoing discussions established agreed common goals, honed the model, sought broader support and reach principled and operational agreement. The shared vision encompassed a senior academic position with responsibilities to support and upskill health practitioners, and at the university to provide teaching, supervision of research higher degrees, publishing and researching. Funding this required a sacrifice of resources for the health service from direct service to infrastructure. Both organisations needed to share this vision of closer collaboration for research, teaching and training. This major investment by both partners needed agreement at high levels in both organisations. 3. Team work and collaboration: Kotter (1996) refers to this as coalition building, the task being to identify leaders and seek their commitment. A negotiated agreement from areas with common interests towards an agreed outcome was required. In the health service, the leader decided to establish a steering committee which included representation from the university and the health service in order to provide a regular forum to discuss and agree on goals, and to communicate the ideas widely, especially to the health service departments which were to contribute financially. 4. Problem solving capacity: An academic institution and a health service delivery organisation do not have common goals, only common interests. Thus, once the vision and principles were agreed, the practicalities needed to be negotiated. The steering committee provided a place to address and remove any identified or hidden barriers obstructing or threatening the realisation of the vision (see Kotter, 1996), as well as normalising the fact that differences were to be expected. 5. Creating positive change: As Kotter (1996, p. 24) noted, evidence of achievements are vital to record, measure and publicise, ensuring that, for the risk takers, initiating the project was worthwhile. A process needed to evolve in which these small wins were built on and change consolidated. Very importantly, strategies needed to be in place to communicate with stakeholders about the evolution of the change process as well as its achievements (Kotter, 1996, p. 24). One way of doing this was to ensure that each achievement was regularly noted, nurtured and celebrated. These small ‘wins’ were part of a process of consolidating the change that was taking place, of integrating that change within the existing culture, and an insurance against its de-establishment. To this end, over the years of The Project, frequent seminars and numerous conference presentations were delivered, as well as articles accepted for publications.


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Actualising the vision

Putting these five core leadership skills into operation required the development of two key documents. (1) Operationalising the vision:


A position description was developed by the steering committee and advertised (see Table 2). The initial KPIs for the position are noted in Table 3. These reflected the demands and interests of both university and health service in equal measure. (2) Establishment: Once agreed, these two documents became the cornerstones of The Project, establishing the role of building staff research capacity and developing practitioners’ skills in doing and using research to advance their practice. Simultaneously, opportunities for the university to employ practitioners in teaching, to access and incorporate field based research and practice knowledge into curricula were created. (3) Development: Table 2. Position description. Position description The Department of Social Work, XY University and Social Work, ZW Health have developed a joint position of Associate Professor Social Work to foster collaboration and research in health-related areas and strengthen their joint commitment to health social work. There will be an even division of time between the two organisations and the incumbent will be familiar with and meet the expectations of both organisations. The position will: facilitate closer collaboration between the academic and practice settings; provide leadership in developing a research culture; foster evidence-based practice and continuous improvement; encourage and actively engage staff in practice research, presentations and publications about social work practice in health; foster student placements and teaching; foster and support honours and higher degree research projects at the health service; develop organisational initiatives around multidisciplinary research; undertake teaching, administrative and supervision duties at the University.

Table 3. Key performance indicators for joint appointment. Key performance indicators Submit at least one journal publication in the first year, two in the second and three in the third Give at least three presentations to staff per year Submit at least five significant grant applications over the course of the 3 years Supervise at least three higher degree students commencing within the first year of the appointment Conduct at least one public seminar per year Teach at least one subject at the university per semester Establish at least three significant research collaborations within the period of the appointment

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Table 4. Model for developing research capacity building. Participants Students and new graduates

Early career

Experienced


Senior clinicians

Focus of Research Capacity Building *Understanding relevance of research to practice; *Understanding evidence-based practice (EBP); *Doing research *Increase familiarity with EBP; *Understanding of Practice Research (PR) *Doing PR *Collaborating with other health professionals in research *Supervising SW students: supporting their involvement in research *Undertaking research to improve services for their clients *Enrolling in postgraduate studies *Collaborating with other health professionals in research *Supervising SW students: supporting their involvement in research *Familiarity with EBP *Understanding PR *Doing and supervising PR *Enrolling in postgraduate studies

The RCB project relied on an ‘embedded’ model of academic/practice partnership, characterised by activities which were action-oriented and small scale. It took a multi-directional focus, comprising efforts to engage social workers in research at every point in the study/work cycle: into the profession (social work students on placement); into the social work workforce (early-career and experienced practitioners) and into senior positions (as part of their role, and/or as part of postgraduate studies). It was a strategy aimed at building a research culture within a practice-focused context. As it evolved, a model for RCB in the health service emerged. As can be seen on Table 4, this was not a linear process.

Sustainability RCB projects falter if the essential work to make them sustainable is absent, or the RCB programmes developed were intended to be no more than ‘model’ programmes of short-term duration. The leader was aware that to sustain the RCB programme, she needed to ensure that participating practitioners could generate outcomes, such as research projects, practice changes and publications. These have earlier been noted. Their increase over time demonstrated a growing research mindedness, evident, for example, in the degree to which practitioners began to initiate and build on their own research activities. To further ensure sustainability, RCB was connected to a large student field programme. Two student cohorts participated annually in a project to build an online bank of evidence for practice interventions. Being done in collaboration with field educators has ensured ongoing practitioner engagement, satisfying the health service’s emphasis on research and practice productivity.


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Discussion: RCB: A key task for social work leadership in health

Establishing a RCB programme in a health social work department is both a risky step as well as an essential one within an environment where health systems are under pressure both to deliver more services to an increasingly aged and chronically ill population and to do so without overstretching already restricted budgets. Skilled transformational leadership provided the vision, determination and persistence to bring this about, echoing Bracht’s (1978, p. 30) comment that ‘. . .. . .(Professional) social work autonomy develops. . . from a strong research and demonstration base. . ..(it) is achieved and can be strengthened by effective social work leadership’. High on the leader’s agenda was recognition that practitioner research can enhance critical thinking, enabling greater understanding and awareness of how and in what ways research may lead to improved services to patients and families. There is also a ‘trickle-down’ effect. Learning research skills and undertaking research encourages practitioners to assume leadership in practice, contributing their knowledge and expertise to their multidisciplinary teams. An organisational environment which sustains the growth and development, characterising RCB will be one which operates within a long time frame, perhaps 10 years or so, (Pickstone et al., 2008), and which provides support such as allocated time for research, funding for conference attendance and so on. The ongoing strong partnership between two large organisations was crucial in ensuring guidance and evaluation of the processes and outcomes of The Project, and the quarantining of project funds on an ongoing basis. From the experience generated by The Project, several guidelines for leadership approaches and strategies can be distilled. Leadership needs to: ● ● ● ● ● ● ● ● ● ●

Establish a vision of what is desired Negotiate with key actors towards agreeing on the nature of its establishment, funding and expenditure Be clear about the potential benefits to partners Emphasise that bringing this vision to reality is urgent Identify and specify outcomes – in this case, evidence of RCB Identify steps and pathways to doing this, for example, consider different models for RCB and assess their ‘goodness of fit’ for the organisation Select a model: For example, a university/field partnership, being cognisant of what such a partnership might deliver for each stakeholder Adopt a long-term time frame that fits the vision and goals, setting in place agreed review processes Build a coalition within and across both organisations Develop KPIs: what are the goals? What skills & knowledge are desirable? What outputs are required? How often will they be reviewed?

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Table 5. RCB evaluation focus. Research capacity building – focus of evaluation (adapted from Cooke, 2005) 1. Building of practitioners’ skills and confidence 2. Development of linkages and partnerships within and across organisations 3. Ensuring that research is close to practice 4. Development of appropriate means of disseminating outcomes and impacts 5. Investment in infrastructure 6. Building strategies to sustain and ensure continuity

●


●

Establish legal agreement Agree on a staged evaluation process from the outset

To establish a sustainable programme of RCB, the leader needs to account for and measure the various outcomes and processes underpinning RCB. Cooke (2005) has identified six areas within which RCB should be focused and its impact measured (see Table 5). Developments in each of these areas may be identified and measured at individual, team, organisation and supra organisation levels. Conclusion It has been argued that RCB is of critical importance to leaders in health social work, requiring development of strategies and initiatives. The experience gained from The Project suggests that transformational leadership is necessary, requiring: ● ●

● ● ● ●

A vision of research capacity as essential for practitioners if the profession is to prosper and meet contemporary demands An ability to see the leadership skills required in bringing this about in structural and principled terms, including how to work within an organisational context, how to build linkages, establish partnerships, shape infrastructure Capacity to engage others in this vision, managing conflict and competing demands An understanding of and access to the financial and systems resources necessary A strategy to implement RCB A framework for evaluating RCB

Where social workers lack research capacity, their services run the risk of delivering less than optimal interventions to patients and families. Leading developments in RCB provide one way of equipping staff to develop and challenge themselves and be confident in the value and effectiveness of their work. The establishment of RCB within the health service created waves of change. It did not just mean that practice research was done; rather it meant that the social


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work department and its staff changed their way of thinking and operating, became more confident and competent about seeking out relevant evidence for practice. More students were accepted on placement, more practitioners taught at the university and took higher degrees. The social work department was increasingly recognised both inside the health service and externally in the industry as engaged in ongoing review and development of both its staff and its services. These positive changes underscore the importance of social work leadership developing staff research capacity. The experience from The Project has indicated that where this is embedded in an academic/practice alliance, it is of clear benefit to both organisations.

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