Knowledge Exchange From Concept to Implementation

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					Knowledge Exchange :
From Concept to Implementation
July 10, 2007 – National Summer Institute on Addictions

Mr. Peter Coleridge, Senior Advisor
Knowledge Exchange:
From Concept to Implementation

 Knowledge Transfer
                               Technology Transfer

             Knowledge Translation
                                                Research Utilization
   Dissemination
                         Research to Practice
Education
                                         Knowledge Application
                Knowledge Exchange

 Diffusion                       Knowledge Conveyance
Knowledge Exchange:
From Concept to Implementation

Outline

•   Knowledge Exchange – An Evolving Field
•   Definitions
•   Hierarchy of Evidence
•   Models
•   BCMHAS Knowledge Exchange Goal
•   BCMHAS Knowledge Exchange Process
•   Benefits
•   Summary
  Knowledge Exchange:
  From Concept to Implementation

  Knowledge Exchange – An Evolving Field




Canadian
Context
Knowledge Exchange:
From Concept to Implementation

Knowledge Exchange – An Evolving Field

•   No single model
•   Spans a number of different disciplines
•   Draws from a variety of different theoretical and practical
    approaches to behaviour and organizational change

                                   Communicating
      Disseminating
                                 new knowledge to
          research                                           Implementation
                                  broad audiences
       information to                                         and sustaining
                                    using multiple
        researchers                                          innovation/new
                                 vehicles (e.g. web,
           through                                            knowledge as
                                 policy documents,
         conference                                           ingredients of
                                  publications, best
    presentations and                                       practice or policy
                                       practice
      journal articles
                                     guidelines)
Knowledge Exchange:
From Concept to Implementation

Knowledge Exchange – An Evolving Field

Diffusion of Innovations Theory (Rogers)
Stages for adoption of innovations:
• Awareness
• Persuasion
• Decision
• Implementation
• Adoption

Elements that influence the diffusion process:
• The innovation
• Communication channels
• Time
• Social system
Knowledge Exchange:
From Concept to Implementation

Knowledge Exchange – An Evolving Field

Framework for the Dissemination and Utilization of Research for Health
Care Policy and Practice (Dobbins, 2004)
•   Knowledge – awareness of and interest in the innovation
•   Persuasion – attitudes toward the innovation are formed, and are strongly influenced
    by peers, as well as:
     •    Innovation characteristics
     •    Organizational characteristics
     •    Environmental characteristics
     •    Individual characteristics
•   Decision – conclusion to either adopt or reject the innovation (or something in-
    between)
•   Implementation – for those who adopt the innovation, integrating the research
    evidence into clinical and/or policy decisions
•   Confirmation – evaluation of the consequences of adopting
Knowledge Exchange:
From Concept to Implementation

Definitions

Knowledge Translation
The exchange, synthesis and ethically sound application of knowledge – within
a complex system of interactions among researchers and users – to accelerate
the capture of the benefits of research for Canadians through improved health,
more effective services and products, and a strengthened health care system.
(Canadian Institute of Health Research)
Knowledge Exchange:
From Concept to Implementation

Definitions (con’t)

Knowledge Exchange (formerly Knowledge Transfer)
Knowledge exchange is collaborative problem-solving between researchers
and decision-makers that happens through linkage and exchange. Effective
knowledge exchange involves interaction between decision-makers and
researchers and results in mutual learning through the process of planning,
producing, disseminating, and applying existing or new research in decision-
making. (Canadian Health Services Research Foundation)
Knowledge Exchange:
From Concept to Implementation

Definitions (con’t)
In other words …

  Knowledge exchange is about
        helping the right people have the right evidence-based
        information at the right time and in the right formats
  To promote the application of knowledge in
        health practice, policy, and public attitudes and behaviours

  With the ultimate goal to
        improve service delivery, strengthen the treatment system and reduce
        the burden of substance-related problems on Canadian society
Knowledge Exchange:
From Concept to Implementation

Definitions (con’t)

Knowledge Exchange
Knowledge exchange is the interactive and iterative process of imparting
meaningful knowledge between users and producers, such that users receive
information that they perceive as relevant to them and in easily usable formats,
and producers receive information about the knowledge needs of the users.
(Kiefer et al. 2006)

Knowledge Exchange is the translation and dissemination of evidence-based
information (or promising practice) and skills in a manner that facilitates
successful adoption and application by individuals, organizations and systems.
(BC Mental Health & Addiction Services)
Knowledge Exchange:
From Concept to Implementation

Hierachy of Evidence

Tier 1:         Strong evidence of effectiveness (evidence supportive of ‘best
                practices’)

Tier 2:     Evidence of effectiveness with general or similar populations
            (supportive of ‘better practices’)

Tier 3:     Evidence of logical and theoretical promise, but requiring more
            comprehensive assessment (supportive of ‘promising practices’)

Tier 4:         Evidence of ineffectiveness (supportive of ‘practice change’)


(NIH – NIAAA)
Knowledge Exchange:
From Concept to Implementation

In search of a KE formula …
Knowledge Exchange:
From Concept to Implementation

Models – Depiction of Knowledge Translation (KTK) within the Research Cycle




(CIHR)
 Knowledge Exchange:
 From Concept to Implementation

Models – Knowledge Management Cycle




(Netherlands Institute)
    Knowledge Exchange:
    From Concept to Implementation

        Models - Knowledge Synthesis, Transfer and Exchange Continuum
                                              POSSIBLE PHSA ENTRY POINTS



                SYNTHESIS                            TRANSFER                  EXCHANGE         EVALUATION

                                                                            Social Marketing
                                                                                                Conceptual use of
                                                      generation of key                        knowledge product:
                                                                            Media Campaign
           input from target audience                messages for public                          change public
       (public, policy and/or practitioner)
                                                         audience                              attitudes/behavior
                                                                            Print/Web info
             i.e. steering committee
                        +
                 research group                                                 Brokers

                                                                              Conferences
                                                                                                Instrumental use of
                                                                                                knowledge product:
                                                      generation of key       Workshops
       Knowledge Product                                messages for
                                                                                                  practice change
                                                    practitioner audience     Publications

                                                                                Toolkits


                                                                               Advocates

                                                                               Industry
                                                                                                  Symbolic use of
                                                      generation of key
                                                                                Toolkits        knowledge product:
                                                     messages for policy-
                                                       maker audience                          Policy and/or program
                                                                               Networks                change


                                                                            Communities of
                                                                               Practice




(Draft Conceptual and Operational Frameworks, PHSA Corporate Services)
  Knowledge Exchange:
  From Concept to Implementation

           Models – Knowledge ‘Exchange’: Information Flow Diagram




                                               Knowledge Conveyers
            Knowledge                            Networks, NGOs,            Policy-
             Product                            Advocates, Industry,       Decision
                                                  Communities of          Makers &
              Issue                              Practice, Brokers,      Practitioners
          Identification,                          Conferences,
           Evidence &                            Publication, Web
               Data                              Products, Media,
                                                 Social Marketing,
                                                Training, Education

                                                                           Society




(Draft Conceptual and Operational Frameworks, PHSA Corporate Services)
Knowledge Exchange:
From Concept to Implementation

Models - The Knowledge-Value Chain




(World Health Organization. August, 2006)
Knowledge Exchange:
From Concept to Implementation

Models - Health Research in Practice Framework




(Alberta Heritage Foundation for Medical Research. 2007)
Knowledge Exchange:
From Concept to Implementation

Models – A Model of Knowledge Exchange: National Substance Use
         Treatment Strategy


                                                       Knowledge
                                                       Knowledge
                                                       Generation
                                                       Generation




                                                                                      Knowledge
                                                                                       Knowledge
                         Evaluation
                         Evaluation                                                   Management
                                                                                      Management

                                                      Linkage and
                                                      Linkage and
                                                       Exchange
                                                        Exchange




                                      Implemen-
                                       Implemen-                          Knowledge
                                                                          Knowledge
                                        tation
                                         tation                           Movement
                                                                           Movement




(Draft Background Paper “Improving Practice in Substance Use Treatment through
 Knowledge Exchange: Promoting synergies between Research and Practice”)
Knowledge Exchange:
From Concept to Implementation

Models – BCMHAS Knowledge Exchange Process
Knowledge Exchange:
From Concept to Implementation

Models

Knowledge exchange includes:
• Employing multifaceted, active dissemination strategies.
• Building relationships, trust and communication between those who conduct
   and use research.
• Involving end-users at all stages of the knowledge cycle; utilizing
   collaborative and participatory research models.
• Supporting knowledge sharing structures such as communities of practice
   and social networks.
• Utilizing appropriately skilled knowledge-brokers and facilitators.
• Making (existing and new) evidence accessible through knowledge
   synthesis including actionable, evidence-based practices.
• Developing capacity and incentives for researchers to participate in
   knowledge exchange and research application.
Knowledge Exchange:
From Concept to Implementation

Models

Successful Implementation

“Successful implementation is a function of the relation between the
 nature of the evidence, the context in which the proposed change is
 to be implemented, and the mechanisms by which change is
 facilitated.” (Kitson et al. 1988)
Knowledge Exchange:
From Concept to Implementation

BCMHAS Knowledge Exchange Goal

•   To translate research findings and best practice into action
     – Professionals and Practitioners
         • Best practice development, dissemination and implementation (i.e. proactive
           support for change in practice through training/education, tools, and other
           support for uptake)
     – Decision / Policy Makers
         • Evidence based decision making and policy development related to services
           planning/delivery and system design
     – Public / Clients and Families
         • Evidence based information to improve awareness, attitudes, and behaviour
Knowledge Exchange:
From Concept to Implementation
Knowledge Exchange:
From Concept to Implementation

BCMHAS Knowledge Exchange Process

Knowledge                Knowledge      Diffusion &     Adoption/
                                                                    Evaluation
Creation                 Translation    Dissemination   Uptake


                                       Feedback loop

Can include:
   Performing basic or
   applied research
   Attaining expert
   consensus
   Gathering and
   documenting
   information/
   resources/evidence
Knowledge Exchange:
From Concept to Implementation

BCMHAS Knowledge Exchange Process – Adoption/Uptake
Knowledge Exchange:
From Concept to Implementation

Benefits

•   Outcome driven – positive health outcomes
•   Interactive and reciprocal process – collaboration among researchers,
    clinicians, policy makers, patients and families
•   Fosters culturally competent practice – develops and applies practices
    tailored to diverse, specific groups
•   Provides a scientific/evidence base for service planning and delivery to gain
    the maximum return on investment
•   Leads to adoption of a range of evidence-based health practices (i.e. health
    promotion, prevention, and treatment) ensuring resources are allocated in a
    cost effective manner and lead to optimal outcomes
•   Facilitates workforce development and retention/recruitment
Knowledge Exchange:
From Concept to Implementation

Summary

•   Knowledge exchange belongs within the larger context of innovation and
    organizational change.

•   Establish priorities and establish appropriate leadership.

•   Develop and evaluate proactive knowledge exchange plans for targeted
    change in practice, policy and/or attitudes and behaviour.

•   Diffusion and dissemination of research information/new knowledge does
    not usually lead to action (i.e. practice, policy, attitude or behaviour change).

•   Training, education, and skill development is important, but not sufficient.

•   Assess and develop readiness for change.

•   Align policies, practices, and other structural supports.
Knowledge Exchange:
From Concept to Implementation

				
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