Knowledge Translation in Health Care E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 665

Veröffentlichungsjahr: 2013

Beschreibung

Knowledge Translation in Health Care is a practical introduction to knowledge translation for everyone working and learning within health policy and funding agencies, and as researchers, clinicians and trainees. Using everyday examples, it explains how to use research findings to improve health care in real life.

This new second edition defines the principles and practice of knowledge translation and outlines strategies for successful knowledge translation in practice and policy making. It includes relevant real world examples and cases of knowledge translation in action that are accessible and relevant for all stakeholders including clinicians, health policy makers, administrators, managers, researchers, clinicians and trainees. 

From an international expert editor and contributor team, and fully revised to reflect current practice and latest developments within the field, Knowledge Translation in Health Care is the practical guide for all health policy makers and researchers, clinicians, trainee clinicians, medical students and other healthcare professionals seeking to improve healthcare practice.

Leseprobe

Contents

Cover

Title Page

Copyright

List of Contributors

Section 1: Introduction

Chapter 1.1: Introduction: Knowledge Translation: What it is and what it isn't

What is Knowledge Translation?

What is End of Grant KT?

What is Integrated KT Research?

Why is KT Important?

What are the Determinants of KT?

What is KT Research?

What is the Practice of KT?

The Knowledge to Action Framework: A Model for Knowledge Translation

The Action Cycle

References

Chapter 1.2: Integrated Knowledge Translation

The KTA Gap as a “Knowledge Transfer” (Dissemination) Problem

The KTA Gap as a “Knowledge Production” Problem

Integration of the Two Paradigms

Implications for Practice

Summary

Future Research

References

Section 2: Knowledge Creation

Chapter 2.0: Introduction: The K in KT: Knowledge Creation

References

Chapter 2.1: Knowledge Synthesis

Groups that Conduct Systematic Reviews

The Review Team

How do we Formulate the Question, Eligibility Criteria and Protocol?

How do we Find Relevant Studies?

How do we Select Studies for Inclusion?

How do we Assess the Risk of Bias of Included Studies?

How do we Extract Data from the Individual Studies?

How do we Analyze the Data?

How can we Present the Results of the Review?

How can we Interpret the Results?

How do we Update Systematic Reviews Prior to Publication?

How do we Disseminate the Results of our Review?

How do we Increase the Uptake of our Review Results?

Future Research

References

Chapter 2.2: Knowledge Translation Tools

Knowledge Translation Using Clinical Practice Guidelines

Translating Knowledge for Patients Using Decision Aids

Future Research

Summary

References

Chapter 2.3: Searching for Research Findings and KT Literature

Getting Started: How do we Find Knowledge Syntheses?

What should we do Next: How do we Search Large Databases?

Should we Search the Internet?

What are Some Existing Collections of KT material?

How do we Search the Grey Literature?

Searching for Literature About Knowledge Translation

Summary

References

Chapter 2.4: Knowledge Dissemination: End of Grant Knowledge Translation

When is Knowledge Ready for Dissemination?

What is Knowledge Dissemination?

What are the Fundamentals of end of Project KT/Dissemination?

What is Known About Effective Dissemination Strategies?

What is an Integrated KT approach to Dissemination?

Future Research

Summary

References

Section 3: The Action Cycle

Chapter 3.0: Introduction

References

Chapter 3.1: Identifying Knowledge to Action Gaps

What is a “Gap?”

How can we Measure the Gap?

Why do Gaps Exist?

Future Research

Summary

References

Chapter 3.2: Adapting Knowledge to Local Context

Why should we Adapt Clinical Practice Guidelines for Local use?

How do we Adapt Clinical Practice Guidelines for Local Use?

What is the Adaptation Process?

Summary

Future Research

References

Subsection 3.3 Barriers

Chapter 3.3a: Barriers and Facilitators: Strategies for Identification and Measurement

Introduction

Why are Barriers and Facilitators to Knowledge Use Important?

What are Some of the Conceptual Models for Assessing Barriers and Facilitators to Knowledge Use?

What are Some Methods and Tools for Assessing Barriers and Facilitators to Knowledge Use?

Future Research

Summary

References

Chapter 3.3b: Mapping KT Interventions to Barriers and Facilitators

What are the Key Concepts for Mapping Interventions to Barriers and Facilitators?

Common Sense Approaches

Theory-Based Approaches

What are the Challenges of Intervention Design?

Future Research

References

Subsection 3.4 Selecting KT Interventions

Chapter 3.4a: Developing and Selecting Knowledge Translation interventions

Getting Started: What are the Objectives for Knowledge Translation?

What are the Indicators That can be Used to Measure Implementation?

What are Potential Determinants of Practice?

How can we Link KT Interventions to these Determinants?

What Factors should we Consider When Deciding to Use a Single or Multi-component KT intervention?

Research That is Needed to Advance the Field

Summary

References

Chapter 3.4b: Formal Educational Interventions

What is the Role of Education?

What is the Process for Education?

What Educational Interventions can we Use to Effect Knowledge Translation?

Self-Directed Learning

What are Some Current and Future Trends in CE?

Future Research

References

Chapter 3.4c: Linkage and Exchange Interventions

What Linkage and Exchange Interventions can be Used to Positively Influence Knowledge Use?

Linkage and Exchange Interventions

Future Research

Summary

References

Chapter 3.4d: Audit and Feedback Interventions

Chart Audits

Audit and Feedback

Future Research

Summary

References

Chapter 3.4e: Informatics Interventions

What Sources of Data can be Used for Planning and Evaluating KT projects?

What Informatics Interventions Might be Effective in Achieving KT?

Summary

Future Research

References

Chapter 3.4f: Patient-Direct and Patient-Mediated KT Interventions

Patient-Direct Interventions

Do Patient-Direct Interventions Work?

Patient-Mediated Interventions

Do Patient-Mediated Interventions Work?

Future Research

Summary

References

Chapter 3.4g: Organizational Interventions

Perspective 1: Resource Based View (RBV) of the Firm

Perspective 2: Critical Management Studies

Perspective 3: Organizational Form

Summary

References

Chapter 3.4h: Shared Decision Making

Future Research

Summary

References

Chapter 3.4i: Financial Incentive Interventions

What Different Types of Financial Incentives are There?

What is the Behavioral Response to Financial Incentives?

How can Financial Incentives Affect Professional Practice?

What is the Evidence for the Effectiveness of Financial Incentives?

Future Research

Summary

References

Chapter 3.5: Monitoring Knowledge Use and Evaluating Outcomes

Monitoring Knowledge Use

Evaluating the Impact of Knowledge Use

Future Research

References

Chapter 3.6: Sustaining Knowledge Use

What is Sustainability?

What Sustainability Models are Available to Inform Knowledge Translation?

How can Sustainability-Oriented Action Plans be Developed?

Sustainability Tensions

How should KT Interventions be Scaled Up and Spread?

What Models Exist for Spreading and Scaling up KT Strategies?

How should KT Interventions be Adapted and Sustained?

Sustainability: Not an all or Nothing Phenomenon

Future Research

Summary

References

Subsection 3.7 Case Examples

Chapter 3.7a: Ilustrating the Knowledge to Action Cycle: An Integrated Knowledge Translation Research Approach in Wound Care

Context for the Case Study

Knowledge Creation: A Brief History of the Evidence for Compression Therapy

The Action Cycle

Adapting Knowledge to Local Context

Assessing Barriers to Knowledge Use

Selecting, Tailoring, and Implementing Interventions to Promote the Use of the Guideline

Monitoring Knowledge Use (i.e. Guideline Recommendations Adherence)

Evaluating Outcomes

Sustaining Knowledge Use

Summary

References

Chapter 3.7b: Tips on Implementation

Introduction

Where do we Start?

How Far can we go in Adapting the Knowledge to the Local Context?

How do we Organize an Assessment of Barriers and Facilitators?

How do we “Connect” the Phases and Choose Implementation Strategies?

What If the Implementation Plan Does Not Work?

We have Taken Actions to Select, Tailor and Implement Change Strategies: Now what?

References

Section 4: Theories and Models of Knowledge to Action

Chapter 4.1: Planned Action Theories

Future Research

Summary

References

Chapter 4.2: Cognitive psychology theories of Change in Provider Behavior

Theories Related to Motivation

Theories Related to Action

Theories Related to Stages of Change

Theories Related to Decision Making

Constructs Common to Psychological Theories

Future Research

Summary

References

Chapter 4.3: Educational Theories

Learning Domains

Learning Styles

Motivation to Learn

Learning Theories

Evidence for Educational Theories and Interventions

Future Research

Summary

References

Chapter 4.4: Organizational Theories

The Problem of Knowledge Use in Health Care Organizations and Systems

Key Concepts of Knowledge Use

Future Research

Summary

References

Chapter 4.5: Quality Improvement Theories

Defining Quality Improvement

Relating Quality Improvement to Knowledge Translation Research

Frameworks for Quality Improvement

Assessments of Quality Improvement as a Means of Knowledge Translation or Implementing Evidence-Based Practice

Issues and Concerns in Quality Improvement as a Means of Knowledge Translation

Future Research

References

Section 5: Evaluation of Knowledge to Action

Chapter 5.1: Methodologies to Evaluate Effectiveness of Knowledge Translation Interventions

How can Theory Inform the Evaluation of a KT Intervention?

How can Internal Validity of a Study be Established?

How can External Validity be Established?

Summary

References

Chapter 5.2: Economic Evaluation of Knowledge Translation Interventions

Why should Health Economics be Included in KT?

What Health Economic Principles can Guide Decision Making in Health Care?

What Types of Health Economic Evidence can be Used in Decision Making?

What Economic Issues should be Considered When Embarking on a KT Activity?

Identifying the Knowledge Gaps

Adapting Knowledge to a Local Context

Assessing Barriers or Enablers to Knowledge Use

Select, Tailor and Implement Knowledge Translation Activity

Monitor and Evaluate Knowledge Use

Sustain Knowledge Use

Conclusions

Further Research

References

Section 6: Ethics

Chapter 6.1: Ethics in the Science Lifecycle: Broadening the Scope of Ethical Analysis

Introduction

What Ethics for the Science Lifecycle?

A Critical Analysis of Relations of Power and Context

The Knowledge-to-Action Ethics Framework (KTA–E)

Applying the KTA-E Framework: Sample Case Scenarios and Analyses

Summary and Future Directions

References

Chapter 6.2: Ethical Issues in Cluster-Randomized Trials in Knowledge Translation

General Ethical Principles

Justification for the CRT Design

Is Research Ethics Review Required?

How should Research Participants be Identified?

From Whom Must Informed Consent be Obtained?

Consent for What?

What if Informed Consent is not Feasible?

When should Informed Consent be Sought?

Considerations in Health Professional Consent Procedures

What is the Role of Cluster Gatekeepers?

Future Research

Summary

References

Index

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Library of Congress Cataloging-in-Publication Data

Knowledge translation in health care : moving from evidence to practice / edited by Sharon E. Straus, Jacqueline Tetroe, Ian D. Graham. – 2nd ed.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-1-118-41354-8 (pbk.)

I. Straus, Sharon E. II. Tetroe, Jacqueline. III. Graham, Ian D.

[DNLM: 1. Evidence-Based Medicine. 2. Diffusion of Innovation. 3. Information Dissemination. WB 102.5]

R723.7

610–dc23

2013011462

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover design by Rob Sawkins for Opta Design

List of Contributors

Kristiann Allen, MA

University of Auckland

Auckland

New Zealand

Onil Bhattacharryya, MD

Li Ka Shing Knowledge Institute

St. Michael's Hospital

Department of Family and Community Medicine

University of Toronto

Toronto, ON

Canada

Marije Bosch, MSc

Scientific Institute for Quality of Healthcare

Radboud University Nijmegen Medical Center

Nijmegen

The Netherlands

Sarah Bowen, PhD

School of Public Health

University of Alberta

Edmonton

Alberta

Melissa Brouwers, PhD

Department of Oncology

McMaster University

Hamilton, ON

Canada

Heather Colquhoun

Ottawa Hospital Research Institute

Centre for Practice Changing Research

Ottawa, ON

Canada

Barbara Davies, RN, PhD

University of Ottawa School of Nursing

Ottawa, ON

Canada

Dave Davis, MD

Association of American Medical Colleges

Washington, DC

USA

Nancy Davis, PhD

Association of American Medical Colleges

Washington, DC

USA

Jean-Louis Denis, PhD

École nationale d'administration publique

Montreal, QuÉbec, QC

Canada

Martin P. Eccles, MD

Institute of Health & Society

Newcastle University

Newcastle upon Tyne

UK

Nancy Edwards, MSc, PhD

University of Ottawa School of Nursing

Ottawa, ON

Canada

Carole A. Estabrooks, PhD

Faculty of Nursing, University of Alberta

Edmonton, ALB

Canada

Ewan B. Ferlie, MA, MSc, PhD

King's College London

London

UK

Beatrice Fervers, PhD

UniversitÉ Lyon 1

Lyon

France

Jaime Flamenbaum, MD, MSc

University of Ottawa Research Ethics Board

Gerd Flodgren, PhD

Department of Public Health

University of Oxford;

Managing Editor

Cochrane EPOC Group UK Satellite

Oxford

UK

Robbie Foy, MBChB, PhD

University of Leeds Leeds

UK

Michelle Gagnon, MBA, PhD

Norlien Foundation

Alberta

Canada

Ian D. Graham, PhD, FCAHS

School of Nursing

University of Ottawa;

Ottawa Hospital Research Institute

Clinical Epidemiology Program

Ottawa, ON

Canada

Jeremy Grimshaw

Ottawa Hospital Research Institute

Centre for Practice Changing Research

Ottawa, ON

Canada

Richard Grol, PhD

Scientific Institute for Quality of Healthcare

Radboud University Nijmegen Medical Centre

Nijmegen

The Netherlands

Samir Gupta, MSc, MD

University of Toronto

Toronto, ON

Canada

Margaret B. Harrison, RN, PhD

School of Nursing, Community Health and Epidemiology

Senior Scientist Practice and Research in Nursing (PRN) Group

Queen's University

Kingston, ON

Canada

Leigh Hayden, PhD

Li Ka Shing Knowledge Institute

St. Michael's Hospital

University of Toronto

Toronto, ON

Canada

Sophie Hill, BA (Hons), MA, PhD

Centre for Health Communication and Participation

Australian Institute for Primary Care and Ageing

La Trobe University

Melbourne

Australia

Alison M. Hutchinson, RN, BASci (Adv Nsg), MBioeth, PhD

School of Nursing and Midwifery

Deakin University

Melbourne, VIC

Australia

Nathan Johnson, BSc

Association of American Medical Colleges

Washington, DC

USA

Alison L. Kitson

Faculty of Nursing

University of Adelaide

Adelaide

Australia

France LÉgarÉ, BSc Arch, MD, MSc, PhD, CCMF, FCMF

Faculty of Medicine

Department of Family Medicine and Emergency Medicine;

Tier 2, Canada Research Chair in Implementation of Shared Decision Making in Primary Care

UniversitÉ Laval

Quebec, QC

Canada

Pascale Lehoux

Department of Health Administration

University of Montreal

Montreal, QC

Canada

Cynthia Lokker, PhD

Department of Clinical Epidemiology and Biostatistics

McMaster University

Hamilton, ON

Canada

Ann C. Macaulay, CM, MD, FCFP

Department of Family Medicine

McGill University

MontrÉal, Quebec

Canada

K. Ann McKibbon, MLS, PhD

McMaster University

Hamilton, ON

Canada

Craig Mitton, PhD

School of Population and Public Health, University of British Columba

Centre for Clinical Epidemiology and Evaluation

Vancouver, BC

Canada

David Moher, PhD

Department of Epidemiology & Community Medicine

Faculty of Medicine

University of Ottawa

Ottawa, ON

Canada

Annette O'Connor, RN, PhD, FCAHS

Department of Epidemiology

University of Ottawa School of Nursing;

Ottawa Health Research Institute

Ottawa, ON

Canada

Emma Quinn, MPH

Centre for Epidemiology and Evidence

Population Health Division

NSW Ministry of Health

North Sydney, NSW

Australia

Judith A. Ritchie, RN, BN, MN, PhD

McGill University Health Centre and Ingram

School of Nursing

McGill University

Anne Sales, PhD, RN

Center for Clinical Management Research

VA Ann Arbor Healthcare System;

School of Nursing

University of Michigan

Ann Arbor, MI

USA

Jon Salsberg, MA, PhD (c.)

Department of Family Medicine

McGill University

MontrÉal, Quebec

Canada

Anthony Scott

Melbourne Institute of Applied Economic and Social Research

Faculty of Business and Economics

University of Melbourne

Melbourne

Australia

Sasha Shepperd, MSc, DPhil

Department of Public Health

University of Oxford

Oxford

UK

Dawn Stacey, RN, PhD

Faculty of Health Sciences

University of Ottawa and Patient Decision Aids Research Group

Ottawa Hospital Research Institute

Ottawa, ON

Canada

Sharon E. Straus, MD, FRCPC, MSc

Li Ka Shing Knowledge Institute

St. Michael's Hospital;

Department of Medicine

University of Toronto

Toronto, ON

Canada

Monica Taljaard

Ottawa Hospital Research Institute, Clinical Epidemiology Program Ottawa, ON;

Department of Epidemiology and Community Medicine, University of Ottawa, ON;

Rotman Institute of Philosophy, Department of Philosophy, Western University, London, ON

Canada

Jacqueline Tetroe, MA

Knowledge Translation Portfolio

Canadian Institutes of Health Research

Ottawa, ON

Canada

Jennifer Tetzlaff, BSc

Ottawa Methods Centre

Ottawa Hospital Research Institute

Ottawa, ON

Canada

Andrea C. Tricco, PhD, MSc

Li Ka Shing Knowledge Institute of St. Michael's Hospital

Toronto, ON

Canada

Joan van den Hoek, BNSc

Practice and Research in Nursing (PRN) Group

Queen's University

Kingston, ON

Canada

Jeanette Ward, PhD

Health Perspectives Sydney

NSW, Australia;

Department of Epidemiology and Community Medicine

University of Ottawa

Ottawa

Canada

Charles Weijer

Rotman Institute of Philosophy, Department of Philosophy;

Department of Medicine;

Department of Epidemiology and Biostatistics

Western University, London, ON

Canada

Michel Wensing, PhD

Scientific Institute for Quality of Healthcare

Radboud University Nijmegen Medical Centre

Nijmegen

The Netherlands

Peng Zhang, MD, PhD

Knowledge Transfer and Health Technology Assessment Research Group of the CHUQ Research Centre (CRCHUQ)

Quebec, QC

Canada

Merrick Zwarenstein, MB, BCh(Med), MSc(CHDC)

Centre for Studies in Family Medicine

Department of Family Medicine

Schulich School of Medicine and Dentistry

Western University London, ON

Canada;

Institute for Clinical Evaluative Sciences

Toronto, ON

Canada

Section 1

Introduction

Chapter 1.1

Introduction

Knowledge Translation: What it is and what it isn't

Sharon E. Straus,1 Jacqueline Tetroe,2 and Ian D. Graham3

1 Li Ka Shing Knowledge Institute, St. Michael's Hospital, Department of Medicine, University of Toronto, Toronto, ON, Canada

2 Knowledge Translation Portfolio, Canadian Institutes of Health Research, Ottawa, ON, Canada

3 School of Nursing, University of Ottawa, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada

Key Learning Points

Gaps between evidence and decision making occur across all decision makers including patients, health care professionals, managers, and policy makers.Knowledge translation is the synthesis, dissemination, exchange, and ethically sound application of knowledge to improve health, provide more effective health services and products, and strengthen the health care system.

Globally health care systems are experiencing the challenges of improving the quality of care and decreasing the risk of adverse events [1]. Health systems fail to optimally use evidence (i.e. underuse, overuse, misuse of therapies, system failures) with resulting inefficiencies and reduced quantity and quality of life [2, 3]. For example, McGlynn and colleagues found that US adults received less than 55% of recommended care [4]. Simply providing evidence from clinical research (such as through publication in journals or presentation at scientific meetings) is necessary but not sufficient for the provision of optimal care or decision making. Indeed, the “know–do” gap in health care practice and health systems management creates an “ethical urgency” for both the practice and science of knowledge translation (KT) to answer these challenges and to optimize the return on investment in research. The growing emphasis on KT (and recognition that our knowledge about how to achieve KT is incomplete) has created interest in KT which we define as the methods for closing the knowledge-to-action gaps.

What is Knowledge Translation?

There have been many terms used to describe the process of putting knowledge into action [5]. In their work to create a KT search filter, McKibbon and colleagues have so far identified more than 100 terms for research use which may contribute to confusion about what KT is and thus, hinder its advance [6]. In the UK and Europe, the terms implementation science or research utilization are commonly seen in this context. In the USA, the terms dissemination and implementation, research use, knowledge transfer and uptake are often used. In Canada, the terms knowledge transfer and exchange and knowledge translation are commonly used. The term knowledge translation has largely been adopted in Canada because the Canadian Institutes of Health Research (the federal health research funding agency) has translation of research embedded in its mandate. In this book we use the terms knowledge translation and knowledge to action interchangeably.

For those wanting a formal definition of KT, the Canadian Institutes of Health Research (CIHR) defines KT as “a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products and strengthen the healthcare system” [7]. This definition has been adapted by the US National Center for Dissemination of Disability Research and the World Health Organization. The common element to these different terms is the move beyond simple dissemination of knowledge and into actual use of knowledge. It is clear that knowledge creation (first generation research), distillation (creation of systematic reviews or second generation research), and dissemination (appearance in journals) are not usually sufficient on their own to ensure appropriate knowledge use in decision making.