An Organizational Guide to Building Health Services Research Capacity

The first step in determining needs is to identify the current status of your organization's overall research infrastructure. This section will provide specific issues that you will want to examine to determine your organization's needs and capabilities.

The process of assessment will depend on the availability of resources — time, staff, and data. Data may come from existing documents and databases at your organization; population data from a national online resource; surveys of staff, faculty and/or students; interviews with faculty and administrators; and even from informal conversations with others.

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Health Services Seed and Fertilizer Organization

Assessment is important for setting up a successful initiative. In order to set achievable goals, it is vital that those goals are based on current information that shows where your organization is in relationship to where you want to be in developing a health services research infrastructure.

In this guide, we classify organizations in two ways: seed organizations and fertilizer organizations. A seed organization is one that may have established research capabilities but limited health services infrastructure support. Such an organization will want to initiate the development of a health services support infrastructure. For example, seed organizations may want to acquire access to health services research journals for their libraries or establish procedures for arranging release time for staff to conduct health services research. Fertilizer organizations, on the other hand, are organizations that have an infrastructure in place for conducting health services research, but there may be little support for it. A fertilizer organization might choose to retain consultants with specific research expertise to complement the skills of existing staff or to identify colleagues to review strategic plans or provide training.

To obtain perspective on where your organization is, we suggest five areas for assessment:

1. Contracts/grants infrastructure.
2. Research staff expertise and experience.
3. Research facilities and equipment.
4. Organizational research culture.
5. Partnerships within and outside the organization.

Contracts/Grants Infrastructure

It is important to review the resources available for both writing proposals and administering grants and contracts. Be sure to think about this information on both a departmental level and on an overall organizational level. In review of your contracts and grants infrastructure, you should consider the following questions:

1. Do you have an office that manages your department's or organization's proposals, grants and contracts?
2. Are staff available to:
   • Identify and disseminate information about funding opportunities.
   • Provide access to previous proposals.
   • Prepare budgets for grants and contracts.
   • Review proposals.
   • Review budgets for grants and contracts.
   • Legally commit the organization to perform the proposed work.
   • Coordinate grant and contract activities within the organization.
   • Keep track of funded project expenses and produce monthly expense reports .
   • Prepare invoices for funded projects.

Research Staff Expertise and Experience

It is invaluable to identify individuals at your organization who have the skills and interest to support the initiative. You should identify faculty and staff with the appropriate skills and abilities to help support the proposal or grant preparation process, and you should review information on faculty, staff, and students at your organization who can and will support your efforts.

1. How many faculty, staff, and students are at your organization?
2. What degrees are held by the faculty and staff?
3. What types of research staff (administrative/secretarial support, student workers, and graduate research assistants) are available? How many?

Review CVs, résumés and biographies of faculty and staff to find out about:

4. Current level of Federal research funding.
5. Amount of Federal research funding in the past 5 years.
6. Availability (release time) for conducting future research.
7. Area(s) of expertise – look at both research topics and methodologies.
8. Experience serving in the role of principal investigator.

Contact others at your institution to find out about:

9. Interest in getting involved with health services research (for both writing grants and proposals and also for conducting research).
10. Health services researchers with whom they have existing relationships.

Research Facilities and Equipment

In addition to staff, you will also need to consider the facilities and equipment available to conduct the work. Consider:

1. Office space.
   1. Do you have enough space to conduct your research?
   2. Is the space conducive to teamwork? Are all staff members able to be in the same area?
2. Information technology.
   1. Do you have the software for conducting data analyses and creating presentations and publications?
   2. Do you have the hardware—such as servers, computers, and printers—needed to conduct health services research?
   3. Are there existing data security protections and procedures to ensure privacy and prevent corruption? If not, what is necessary to develop and implement such procedures?
   4. Do you have means to access databases you need for your research? What about access to populations you plan to study?
3. Library facilities and relevant literature.
   1. Do you have access to online databases for literature searches?
   2. Does staff have the expertise to conduct these searches?
   3. Do you have access to the medical journals likely to be identified in these searches?

In the early stages of an initiative at a seed organization, the facilities and equipment currently available may limit the kinds of research that you pursue.

Organizational Research Culture

In assessing your needs and capabilities, it is important to address these additional aspects of your organizational culture. Consider the following questions when thinking about the research culture at your organization:

1. Research centers consist of a group of investigators who collaborate on research in a common topic area, operate as a formal entity within the structure of the organization, and generally share physical space. Do you have any research centers? How many? What is the focus of each center?
   1. Is there a potential for developing a synergy within an existing center to address health services research questions? Is it possible to form a new center to address health services/policy research questions?
2. What research focusing on or related to health services research has been funded at your organization in the last 5 years?
   1. From where was funding obtained? (Sources of funding including Federal, State, and local governments; foundations; your organization itself.)
   2. How much research funding did the organization receive?
3. How easily can staff access technical support in biostatistics, health services research methodologies (such as secondary data analyses, survey research, retrospective and prospective quasi-experimental observational studies, and qualitative methods), and research proposal and manuscript review within your organization? Outside of the organization?
4. How easily can staff obtain concrete support from the organization (staff labor or time, funding) to apply for and conduct health services research?

Institutional Policies

5. Does your organization have any formal documents (such as mission statements and strategic plans) or policies and practices that explicitly support or encourage research?
6. Does your organization have its own Institutional Review Board (IRB) or a formal agreement to use another organization's IRB?
7. Does your organization have staff or committees (such as a staff research council or vice president [VP] of research) that explicitly support or encourage research?
8. How supportive are your organization's leaders of research? How supportive is fellow staff?
9. What weight does obtaining support for, conducting, and disseminating research have in performance evaluations? What weight does research have on decisions about raises, promotions and tenure?

Personnel Policies

10. How difficult is it to get release time to conduct research (for example, a sabbatical, reduction in teaching responsibilities, or permission to consult)?
11. How much verbal support and encouragement does staff get from supervisors for conducting research?
12. What kind of tangible support does staff receive from supervisors for conducting research?

Partnerships

Existing partnerships can serve as important resources for helping to find out about potential funding opportunities, guiding and mentoring research activities, and providing access to research data. Examine what kind of relationships and partnerships exist within your organization and with other organizations. One of the most common and effective strategies we found in our research was developing partnerships with top-tier academic institutions and senior researchers. Consider developing partnerships with groups and organizations that will support your goals and activities. There are different types of partners listed below; please note that these categories are not mutually exclusive.

• Academic institutions or individuals (such as an experienced researcher at a university).
• Non-academic research partners (such as foundations, think tanks, associations, and not-for-profit organizations).
• Government partners (such as a State or local department of health).
• Community and clinical partners (such as a health care delivery system or a school).

As part of your assessment make a list of your current partners.

1. What partnerships do you already have in place?
   1. For each partner ask:
      What type of organization is the partnership with? (Use the categories above.)
      How long has the partnership been in place?
      What has the partnership already accomplished?
      How does your organization benefit from the partnership?
      How does your partner benefit from working with your organization?

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Preparing to Evaluate Your Project

It is important to monitor, evaluate, and update your organizational assessment on an ongoing basis. In this way, you will be able to revise your plans appropriately. It may be important to consider the following overall questions:

• What are the challenges or barriers to assessing your organization's infrastructure needs? How might you overcome these challenges?
• How will you define the success of an initiative? What data or information will you use to show that your strategies are moving you along the path to your goals?
• What information can be reassessed at a later time as part of an evaluation of your organization's infrastructure capacity-building?

For more details on designing and conducting evaluation activities, go to Step 5 (Evaluating the Infrastructure Support Initiative).

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Conducting and Using Your Assessment

Now that you have finished reading about assessing your needs and capabilities, prepare to conduct the assessment.

1. Create a variables list.
2. Construct data collection tools and storage for data.
3. Draft a summary of findings.
4. Incorporate findings in goal-setting exercises, proposals, and promotional activities.

Create a list of variables (things you wish to measure) in your assessment. Use the numbered questions in Step 1 as a guide. Include information on potential sources for the data. Figure 2 provides an example of a variables list.

Figure 2. Example of a variables list

Take a closer look at your list of variables and think about the costs — time, labor, and materials — to conduct this assessment. Revise your list of variables based on the resources and time you have available. Refine the variables on the list by prioritizing the five assessment area(s), selecting key variables in each of the five areas, or eliminating variables that are too costly to measure.

Once you've finalized your variables list, begin creating data collection tools and establish methods for storing the data. After completing the data collection, create a thorough, accessible summary of your findings. This summary can be used as a reference point for tracking your progress and as a resource in procuring support and funding. Figure 3 provides a framework and example for summarizing findings.

Figure 3. Example of a summary

Use this summary to highlight your organization's strengths and areas for improvement. Consider this to be a starting point for enhancing your current capabilities in health services research. Set goals and plan activities that will help you improve in weaker areas. The data can be used in proposals, marketing, and other reports.

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Maximizing Success

Assessment is a key component to infrastructure capacity development. It provides baseline information to track your progress. Further, it identifies opportunities for improvement that can be used to set achievable goals.

1. Create a list of variables that includes the potential source(s) of information.
2. Next, develop data collection questions for each variable and identify ways to collect these data. Use what is most readily available to you to collect data: publicly available web sites, discussions or emails with faculty and staff, email or online surveys, interviews, existing documents, and databases at your organization.
3. Once you've identified the variables, questions, and data collection strategies, consider involving other staff, such as a research assistant, to collect the data.

^a For more information about the Agency for Healthcare Research and Quality, visit the Agency's Web site at www.ahrq.gov.

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