Experiences and perceptions of evidence use among senior health service decision makers in Ireland: a qualitative study

Abstract

Background: To support evidence-informed decision making in a health service context, there is a need to better understand the contextual challenges regarding evidence use.

Aims and objectives: To examine experiences of evidence use and perceived barriers, facilitators and recommended strategies to increase research use among senior decision makers in the national health service in Ireland.

Methods: We conducted semi-structured interviews with decision makers in Ireland's national health service (n= 17) from August 2021 to January 2022. Criterion sampling was used (division in the organisation and grade of position), and interviews were analysed using thematic analysis. Barriers and facilitators were mapped according to multiple-level categories (individual, organisational, research, social, economic, political) identified in the literature.

Findings: Health service decision makers described a blended and often reactive approach to using evidence; the type and source of evidence used depended on the issue at hand. Barriers and facilitators to research use manifested at multiple levels, including the individual (time); organisational (culture, access to research, resources, skills); research (relevance, quality); and social, economic and political levels (external links with universities, funding, political will). Strategies recommended by participants to enhance evidence-informed decision making included synthesising key messages from the research, strengthening links with universities, and fostering more embedded research.

Discussion and conclusion: Evidence use in health service contexts is a dynamic process with multiple drivers. This study underlines the need for a multilevel approach to support research use in health services, including strategies targeted at less tangible elements such as the organisational culture regarding research.

Keywords: barriers; decision making; evidence use; facilitators; health service; strategies.