A tale of two silos

10 January 2014

Cindy Trytten is director of research and capacity building at Island Health (formerly Vancouver Island Health Authority). In this blog post, she describes her experience at the 2013 National Health Leadership Conference, where she witnessed firsthand that evidence-informed health care and health research may be on the same dance floor in Canada, but more practice is needed they are perfectly in step. Also included is a video clip describing one group’s efforts to get there.

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Health care and health research. Two silos separated by long-standing differences in organization, management, conduct, language, skills, regulations, oversight and funding.

Like two out of sync dance partners trying to master the steps to achieve the ultimate goal of “evidence-informed practice,” their divide has resulted in the aptly named “death valley” of knowledge translation.

Take, for example, the 2013 annual National Health Leadership Conference with its strong theme of health system improvement and a pressing need for innovation and change.

The largest gathering of health system decision makers in Canada included trustees, CEOs, directors, managers and department heads — an assembly of some of our country’s leading users of evidence.

The word “research,” the key engine that generates that evidence came up in a single presentation attended by a record-breaking audience of seven!

And what about BC?

All six health authorities share common goals of quality and excellence, but only half of them include research in their mission, purpose or values.

Is innovation needed? You bet. Maybe it’s time for BC to start transforming itself into a “learning health care system.” One “in which knowledge generation is so embedded into the core of the practice of medicine than it is a natural outgrowth and a product of the healthcare delivery process leading to continual improvement in care.” [1]

No one said it would be easy, but ultimately, this is the answer to the KT death valley. Take a look how leading ethicists in the US are already planning for this transition. What are we waiting for?



For the full article, click here.


  1. Faden, R et al. 2013. An Ethics Framework for a Learning Health Care System. A Departure from Traditional Research Ethics and Clinical Ethics. Hastings Centre Report. S16 to S27.