An operational researcher (lead author of this article, SC) supported knowledge production within a 2-year multidisciplinary grant-funded research project focusing on services following discharge from infant cardiac surgery . That research project had two objectives: firstly, to understand the challenges encountered in accessing and providing services and to identify patient risk factors for adverse outcomes through qualitative and quantitative strands of research, and secondly, for an advisory group to develop recommendations for improving services. The operational researcher joined the project in order to bridge these two objectives by providing an explicit process for translating the research findings into practical recommendations of relevance to policymakers.|
A combination of problem structuring (soft systems methodology ) and quantitative OR methods (classification and regression tree (CART) analysis  and data visualisation) were deployed. The technical details are described elsewhere [45, 49], but for the purposes of this article, we highlight four key aspects:
- Developing a Rich Picture (a device used in soft systems methodology) to explore the key features of services following infant cardiac surgery, perceived problems and possible improvements (see Additional file 1) .
- Facilitating a workshop with the project’s advisory group, who were tasked with agreeing a set of recommendations for service improvement . This included a patient representative from the charitable sector and representatives from tertiary, secondary, primary and community care.
- Creating a visual representation of data analysis to inform the advisory group’s consideration of the prioritisation of service improvements (the CART diagram, see Additional file 2) .
- Using a systematic process to integrate findings from the different strands of research and recommendations from the advisory group and a parent workshop (using a hyper-framework ).
Outputs from the applied health research project included published academic articles reporting findings from the quantitative  and qualitative [51,52,53,54,54] strands of research, as well as the final evidence-informed recommendations for service improvement . These recommendations fed into National Health Service (NHS) England’s national review and public consultation on the care standards and specifications for commissioning specialist services for congenital heart disease . Given the rapid uptake of the research outputs by national policymakers, we considered this to be a successful example of producing readily implementable knowledge within an applied health research context. We therefore sought to identify aspects of the OR approach to knowledge production that contributed to this success.