Abstract
This Dissertation in Practice proposal introduces the topic of implementing centralized clinical research programs in safety-net health systems. Specifically, the subsequent documentation and examples explain the gap in knowledge on how to properly implement a clinical research unit in Federally Qualified Health Systems by focusing on the roadblocks experienced by stratified levels of leadership. Preliminary text outlines the history and literature regarding clinical research in health systems, healthcare delivery for marginalized populations in specialized healthcare systems, and the research that is conducted within those systems. Additionally, insight is given into the ideas of organizational change readiness and polycentric governance, and how theories within those fields of study can be applied along with an understanding of tangible barriers to enact a centralized research unit. Finally, after addressing the disparity of these systems to conduct research, a qualitative methodology utilizing semi-structured interviews and snowball sampling is presented to outline how to identify said barriers to enacting research units in these systems. This is presented with specific insights from various system leaders and then subsequently outlines a proposal for how to overcome issues of both perceived barriers through outsourcing and links this plan to utilize organizational change readiness techniques.