From Evidence to Action:

Addressing Challenges to Knowledge Translation in RHAs

The Need to Know Team Meeting

May 30, 2005

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The Need to Know Project: Levels of impact

Personal learning– All partners

“How I do my job”– All partners

How RHAs make decisions– Less evidence

Provincial networks– Expectations, how business conducted

National impact– “CIHR model program”– National consultations

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Challenges identified through evaluation Organizational vs. Individual “capacity building”

– N.B. to RHA Team Members 1 or 2 people from each RHA Focus on workshops vs. RHA activity Limited change in RHA decision – making “We need to build organizational capacity, not just one

person”

Sustainability – Dependent on relationships?– Funding

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Organizational barriers identified

Failure to institutionalize NTK activities– Lack of formal reporting requirements– Little communication initiated by CEOs

Time constraints, work demands of staff– Not protected time

Organizational priorities– “there is always time for the important things”

Lack of awareness/skills– Importance of research, benefits

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Organizational barriers, con’t

Organizational Culture– Crises bump research off the agenda

Leadership commitment to change– I’m not sure there is the will to change– (EBDM is) more rhetoric – I’m not sure people

want to change

Structural barriers to communication– I’m not allowed to talk to the Board, and the CEO

chose not to invite them

Larger political context

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Response: “From Evidence to Action”

Proposal to CIHR (KT)– submitted May 2004, accepted Feb. 2005

Purpose: identify and develop strategies to address organizational barriers to EB planning and decision-making within RHAs

Participants: All RHAs (including WRHA) + MCHP

Timeline: 3 years

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Key Activities– Interviews & focus groups – Development & application of organizational

assessment instrument– Identification and piloting interventions to address

barriers

Builds on NTK project– Team meetings– RHA Team members as “KT experts”

BUT separate from it (objectives, activities, participants, funding)

Specifics

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Key points

Focus: Organizational planning & decision making

Methodology: Qualitative, collaborative– Input from RHA team at all stages (planning,

implementation, evaluation)

– Project will adapt to issues emerging

Participants: RHA Board, Executive, Staff Location of activities: In RHAs vs. Team

Meetings

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Objectives

Develop collaboratively designed tool

Apply tool in all MB RHAs

Evaluate effectiveness of tool – RHAs of varying characteristics

Collaboratively develop & implement strategies to address identified barriers

Assess effectiveness of strategies

Produce user friendly resources

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Research questions

What are the greatest barriers to increased use of research in planning?– Are barriers similar across RHAs?– What RHA characteristics are associated with

specific barriers? – Which barriers require the participation of other

stakeholders?

What are strengths and weaknesses of RHAs in addressing these barriers?– Are there differences based on size, structure,

leadership, resource availability, remoteness?

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Does a collaborative approach result in unique characteristics of an assessment tool?

– Does it promote acceptance of assessment results, and willingness to engage in strategies to address identified barriers?

– Is it feasible to develop one tool that is appropriate for RHAs with diverse characteristics?

What strategies are proposed by RHA decision-makers? – What similarities and differences are found between urban/rural/remote, and

large, medium and small RHAs? – Does linkage with other RHAs with similar challenges assist in developing

effective strategies for addressing identified barriers?

What strategies are most effective in a) increasing awareness & commitment to research utilization? b) addressing specific planning issues facing RHAs? What difficulties are found in implementing these strategies?

 

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Expected outcomes

Understanding of barriers/solutions from perspective of RHAs themselves

Assessment instrument developed in collaboration with RHAs

Similarities and differences – RHAs with varying characteristics– E.g., size, organizational structure, leadership

characteristics

User friendly resources

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Comparison – The Need to Know & From Evidence to Action

Similarities Collaborative,

community – university partnership

CIHR KT funding Key role of RHA Need

to Know team members Response to issue

identified by regions

Differences Includes WRHA, not MB

Health Practical focus on

barriers to use of research in RHAs

Key activities take place in regions

Greater role for RHA board & management

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Opportunities and Challenges

Opportunities Issue identified by

Team Members “Cutting edge” of KT

research Opportunities for

organizational growth Further opportunities

for networking, MB leadership, high profile project

But… Organizational change

always painful Varying support,

readiness among RHAs?

Need to convince RHA leadership to make time, resources available

Demands on NTK team members

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Activities to date

RHAM meeting launch April 14

Staffing

Ethics

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Phases

1. Consultation Phase (months 1-6)

2. Development and Implementation of Assessment Instrument (2-12)

3. Analysis, Feedback and Prioritization of Strategies (8-18)

4. Selection and Implementation of Intervention Strategies (16-30)

5. Evaluation of Interventions (16-34)

6. Institutionalizing Change (32-36)

7. Reporting and Dissemination (18-36)

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Consultation phase (1)

Essential to rest of project Establish framework for consultation and

communication, & methods used– Advisory (Working) Group established

Communication strategy for each RHA– Visits by research staff to each RHA

Project understanding Effective strategies for RHA input Clarification of roles and expectations Ethics/confidentiality

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Consultation phase (2)

Generate assessment by stakeholders of– Perceived NB of EBDM– Regional KT to date– Barriers to EBDM– Suggested indicators of barriers/facilitators– Project evaluation

Combined with consultation phase 1? (North) Timed to coincide with Board/Exec meetings Methods: Key informant interviews, discussion

at board/exec meetings, focus groups

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Communication from CEOs?

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What we need to decide today:

Major adaptations, issues that would affect project planning and implementation?– Key events and timelines

Advisory Committee – who, T of R?– Role of NTK team

Communication plan – recommendations Recommendations re: next steps:

– MCHP to do…..– Each Team Member to Do……

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Questions for Manitoba Health Team

What communication should occur within the Ministry? – Communication plan

What role do MB Health team members see for themselves in the FEA project?

How can MB Health support the project, and its activities?