Foundations of KT program helps teams turn knowledge into action

26 May 2014

One of the greatest challenges facing health researchers is the timely application of evidence to inform and improve health care practice.

Studies have shown that it can take as long as 20 years for new discoveries to enter day-to-day practice. Remarkably, only an estimated 14 percent of research findings are introduced clinically.

To help address this challenge, a new program is working to build capacity for effective knowledge translation (KT) among health care providers. The Foundations of Knowledge Translation Project is a partnership between MSFHR, Toronto’s St. Michael’s Hospital, and the Vancouver Coastal Health Research Institute that helps research and practice teams build the necessary skills to implement evidence relevant to their particular clinical setting.

Launched in spring 2013, the year-long program aims to increase the application of health care evidence by supporting partnerships between researchers and knowledge users, including clinicians, patients, policy-makers, and managers.

The program features a series of three in-person workshops, as well as access to online resources and mentorship. Participating teams undertake projects in collaboration with knowledge user partners to address identified evidence gaps in their clinical areas.

The program’s first cohort recently completed its one-year term, and a second cohort was launched in spring 2014. Following the second cohort’s completion in early 2015, the program will be evaluated to assess its impact on enhancing KT capacity. The evaluation will be led by University of Toronto researcher Dr. Sharon Straus and supported by a CIHR Knowledge-to-Action Grant.

Case study: Increasing awareness of self-management support

For Karen Anzai, Caroline Marcoux, Kelly Sharp, and Helena Jung – educators at Vancouver’s GF Strong Rehabilitation Centre – the Foundations program offered a unique and valuable opportunity to increase awareness and adoption of self-management support strategies among clinicians.

Self-management support is the provision of education and supportive interventions, by health care staff, to increase clients’ skills and confidence in managing their health problems. “It is more of a partnership,” says Anzai. “Clinicians are only present in clients’ lives for a short time – self-management support helps instil knowledge and confidence to better prepare clients to manage their medical condition in the long-term.

Despite its well-established benefits, self-management support remains under-used in acute rehabilitation settings. Among the barriers to its implementation is a lack of awareness and understanding among front-line staff.

To overcome this barrier, the team of Anzai, Marcoux, Sharp and Jung devised a KT strategy to be implemented through their participation in the Foundations program.

“I’ve been practicing a long time, and this is one of the richest projects I’ve been involved with.”

— Karen Anzai

Initial consultation with a range of stakeholders suggested a need for training opportunities related to self-management support. Working with University of Victoria self-management expert Dr. Patrick McGowan, the team organized two three-hour workshops for clinicians. Fifty-eight participants attended these sessions, which focused on general concepts and approaches in self-management support.

Next, the team conducted a needs assessment survey. The survey results revealed that following the workshop, clinicians had a good understanding of self-management support and felt it could be valuable to integrate self-management support principles into their practice. However, the majority were only somewhat confident in their ability to support clients to become self-managers and in their ability to use self-management support strategies in their practice.

Based on this feedback, the GF Strong team launched a self-management community of practice in early 2014 to help support clinicians to develop their confidence around self-management support. The group consists of 16 clinicians from different disciplines and programs across the continuum, and one client representative. The group meets monthly to further learn about self-management support, discuss how it can be applied in an acute rehab setting, and practice using self-management support strategies.

Three sessions into its schedule, the community of practice participants have demonstrated their engagement by starting to integrate self-management support strategies into their practice.

Iterative evaluation and continuous improvement

According to Anzai, clinicians have found the community of practice approach helps them receive knowledge about self-management support and apply it. The session-based approach also allows iterative evaluation and continuous improvement. At each session, clinicians have the opportunity to share their experiences with tools introduced previously and are asked to complete tool evaluation forms.  The feedback received will be used to modify the tools included in the GF Strong self-management toolkit being created in parallel.

“By the end of the year, we hope to have a set of tools clinicians have tried and found to be most useful,” says Anzai. “We’ll have something we can offer to a broader group of clinicians and share with other rehab centres.”

The team is also investigating the possibility of using its experience as the basis for a research study to evaluate the community of practice as a learning tool.

Anzai says the Foundations program has been highly valuable in facilitating her team’s work. The three workshops allowed the team to receive feedback from other participants, while the program’s structured approach provided accountability and goal setting opportunity.

“Kelly, Caroline, Helena and I are very appreciative to be given the resources to embark on this journey,” Anzai says. “I’ve been practicing a long time, and this is one of the richest projects I’ve been involved in.”