Table 4.

Operational issues highlighted by the case studies

Issue	Description of issue
Contracts and intellectual property	If it is a “user-pays” model the use of a contract can slow the process down. However, the impact can be minimized by operating in good faith and starting the review before the contract is signed (e.g. Cochrane Innovations, Sax Institute). Where a contract is used, the intellectual property is usually owned by the funder but there seems to be general acceptance of joint publication of completed reviews. However, this may not always be the case, for example, for the Sax Institute model not all reviews are made publicly available if confidentiality is requested by the funder.
External review of the rapid review	External review or “merit review” has the potential to slow the process down if reviewers don’t respond quickly but the different services all seem to have found ways to manage this well, e.g., approaching another reviewer if the first one can’t commit to a quick response.
Staffing	Recruiting staff with the right mix of skills and qualifications was noted as an issue for the REACH Policy Initiative model. The other three models used mentoring or internal training to address this issue, with the Sax Institute key informant noting that the Institute also had plans to develop a formal training program for researchers.
Evaluation	None of the models have formally evaluated the impact of the service on the uptake of research evidence for policy and/or practice—though there are plans to do this for the McMaster service [27].
Issues particular to developing countries	Having a fast and reliable internet connection was noted as an issue for the REACH Policy Initiative model. Access to databases and full text papers was noted as an issue for the REACH Policy Initiative model.