Where Did CHSRF Come From?
In 1996, the federal budget announced funding for the establishment of a health services research fund. Formed to facilitate evidence-based decision-making in Canada's health sector, the origins of the Foundation were in the convergence of a Medical Research Council (MRC) concerned with applied research funding closer to health service delivery, and a federal government interested in better informing health services with research. Encouraged by the United Kingdom's "R & D Strategy" of the early 1990s, and responding to the recommendations of the 1996 National Forum on Health, federal sources agreed to invest an endowment for a foundation to improve the scientific basis for decisions made by those running health services.
One of the organizing principles underlying the creation of the fund was that it would be managed by a body at arm's length from the government – trustee guardians of a public foundation with long-term financial security and the mandate and capacity to innovate in achieving its mission. The Canada Foundation for Innovation was created at the same time to supply infrastructure funds to universities. The structure was created without the need for legislation through the assistance of the Canadian College of Health Service Executives (CCHSE), which agreed to have its own foundation transformed into the Canadian Health Services Research Foundation.
On November 28, 1996 the CCHSE's board of directors enacted a by-law to change the corporate name and the objects of the corporation. The changes were subsequently confirmed when, in December 1996, Industry Canada issued supplementary letters patent, changing the corporate name to "Canadian Health Services Research Foundation" and varying the objects of the corporation to read that the Foundation was established for the purposes of:
- identifying research gaps and needs in the field of health services research and defining priorities;
- the funding of peer-adjudicated research into the management, organization and effectiveness of health services, including research into the outcomes of health-affecting interventions as well as into the organization and management of institutional and non-institutional models of health services delivery; and
- the promotion of best practices of health services delivery and the communication of research outcomes.
The Canadian Health Services Research Foundation was subsequently incorporated as a not-for-profit national foundation with charitable status in the spring of 1997.
Funding, services and mission: 1997-2002
Since its formation in 1997, the Foundation has received $151.5 million from federal sources in three separate endowment contributions, for a variety of purposes.
In 1996-97, the Foundation received a $66.5 million establishment commitment from Health Canada, the (then) MRC and the Social Sciences and Humanities Research Council. This endowment was paid in five annual installments ending in 2001/02. It was used to support applied research projects and programs in an annual Open Grants Competition focused on priority themes elicited from consultations with managers and policymakers in the system. It also supported knowledge transfer help to investigators, exchanges to bring researchers and decision makers together, and products such as policy syntheses and Mythbusters summarizing research for the system.
In 1999, the Foundation received an additional $60 million from the federal government, consisting of a $35 million endowment to participate in the newly established Canadian Institutes of Health Research (the successor to the MRC), and a $25 million endowment to assume a special role with respect to nursing research in Canada. In response to the $35 million endowment for CIHR partnership, the Capacity for Applied and Developmental Research and Evaluation (CADRE) program was jointly developed to increase Canada's capacity to undertake applied health services and nursing research. Ten-year awards for education and mentoring Chairs, regional training centres, postdoctoral students, and career reorientation were introduced. The $25 million nursing endowment was used to create the Nursing Research Fund with a commitment to spend the equivalent of $2.5 million per year for 10 years for nursing research capacity development and research on nursing issues.
During this period, the Foundation's board of trustees identified managers and policymakers as the primary audience for its work. It also adopted an overall "linkage and exchange" strategy to achieve its ends, offering programs and activities that encouraged far greater interaction between those doing research on the health system and those who might use it.
This approach was reflected in the following overall 1997-2002 mission, consistent with the objects of the Foundation, and based on the results of an extensive national consultation with stakeholders:
- encouraging in its peer-reviewed funding a focus on issues of importance for decision makers, the regular sharing of results and issues between decision makers and researchers, the persuasive communication of research results and the training and support of health services and nursing researchers;
- funding syntheses of research and experience and encouraging user-friendly communication of research results and their implications for decision makers;
- working with health service organizations to increase their ability to acquire, appraise, adapt and apply research to policy-making and management; and
- developing relationships with partners and co-sponsors who uphold the Foundation's goals of generating and promoting the use of health services and nursing research that is relevant to decision-makers' needs.
The mission of the Canadian Health Services Research Foundation is to improve the health of Canadians by promoting and funding health services research and increasing its quality, relevance and usefulness for policy makers and managers by:
Funding, services and mission: 2000-2006
In 2003, the Foundation received its third and most recent federal contribution. This $25 million was to develop the capacity of health service executives and their organizations to use research. This was not made as a contribution to the endowment like previous funding, but as a segregated 13-year grant for the Executive Training for Research Application (EXTRA) program.
The EXTRA program signaled an increasing orientation of the Foundation to the needs of the decision-making community, partly in response to the recommendations of a 2002 international review panel that assessed the Foundation's first five years of progress. The Foundation also developed complementary programs to increase the health system's 'receptor capacity' for research, such as its knowledge brokering initiative, its inventory of promising practices in research use, or its regional Research Use Weeks.
Also in response to a recommendation of the 2002 international review panel, the Foundation negotiated the transfer to CIHR of its research project funding, and consolidated its annual research grant funding into four to six programs of research, capacity development and knowledge transfer spread across the Foundation's priority themes – the Research, Exchange and Impact for System Support (REISS) competition.
During this period the board of trustees continued its commitment to a linkage and exchange strategy. It also saw the need to not only encourage researchers to engage with decision makers, but also to bring the decision-making community more into the research process. By 2006 this was reflected in following statement of institutional purpose, now focused on evidence-informed rather than evidence-based decision-making:
To support evidence-informed decision-making in the organization, management, and delivery of health services through funding research, building capacity, and transferring knowledge.
