My research draws on the fields of organisational studies and organisational sociology, and incorporates the study of innovations in the organisation and delivery of health care services as well as quality improvement interventions. I have an overarching interest in organisation development and change management that spans all three domains of health care research, policy and practice. 

I have been a Principal Investigator or co-applicant on over 40 externally funded research grants since 1996 including 17 National Institute for Health Research (NIHR) grants (5 as Principal Investigator) as well as grants from the Economic & Social Research Council, Robert Wood Johnson Foundation, the European Union FP7 and H2020 programmes and the Health Foundation. 

Dissemination of findings arising from my research has often been via international public policy journals and those focusing specifically on the quality of health care. Amongst my peer-reviewed journal articles are publications in British Medical Journal, Milbank Quarterly, BMJ Quality & Safety, Medical Humanities and Implementation Science. 

Over the last 25 years of conducting research in the healthcare sector I have also co-authored/edited five books. One of these - which explored how innovations in health care delivery and organisation diffuse and are disseminated - was the 2006 winner of the Baxter Award for the most outstanding contribution to healthcare management in Europe. The associated journal publication has been cited over 5000 times becoming a seminal paper in the field.

The findings from a cross-cultural ethnographic study - with RAND in the United States - of high performing health care systems in America and Europe that focuses upon quality and service improvement as a dynamic process (as distinct from studying specific factors in isolation) were also published as a book entitled ‘Organizing for Quality. The improvement journeys of leading hospitals in Europe and the United States’. The ‘Organising for Quality’ framework formed the basis for a later three year EU-funded study with partners in five European countries exploring the relationships between the organisational and cultural characteristics of hospitals and how these impact upon clinical effectiveness, patient safety and patient experience in 10 hospital case studies. A resulting Board-level organisational development intervention (iQUASER) was later developed, implemented and evaluated in English acute hospitals.

Previous quality improvement research includes the first evaluations in the NHS of the Institute for Healthcare Improvement’s ‘Breakthrough’ Collaborative method (2000-2002) as well as bringing new perspectives on large-scale change. The latter most notably involved exploring and testing the value of bringing social movement thinking to healthcare quality improvement efforts. 

My current research interests include collaborating with product and service designers to identify and test any frameworks and methods that might have value in addressing some of the organisational design and development challenges facing the NHS. A particular focus of work since 2004 has been on developing and testing an ‘Experience-based Co-design' (EBCD) approach to quality improvement. EBCD combines (1) a user-centred orientation (by adopting a filmed narrative storytelling approach) and (2) a participatory, collaborative and creative change process. The approach has been applied and evaluated as an innovative approach in numerous healthcare services in the NHS and has subsequently been implemented internationally. 

Examples of ongoing quality improvement research projects include:

• a six year programme with colleagues at Jonkoping University in Sweden exploring, measuring and enhancing co-production at the national, regional and local levels,

• a 30 month study exploring the local operation and impact of Healthwatch in England to optimise patient and public voice in healthcare commissioning and service provision

• several EBCD projects either using the approach as part of local quality improvement work in different healthcare services or to develop complex interventions for improving the quality of care

Identifying, adapting and implementing frameworks that might have value in addressing the organisational development & change challenges facing healthcare organisations; designing and evaluating innovations in quality improvement and service delivery; participatory action research; design thinking; co-production