Ann VosillaBC Liaison OfficerCADTH

Alison HoensPhysical Therapy Knowledge BrokerUBC Dept of PT (Faculty of Medicine), PABC, VCHRI, PHCRIClinical Associate ProfessorUBC Dept of PT

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� Why is mobilizing evidence to practice important?

� What is the KB role in mobilizing evidence to practice?

� What are the key contributors to successfully mobilizing evidence to practice?

� What can you do to support mobilizing evidence to practice?

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� 17 years for 14% of research findings to

reach clinical practice (Westfall et al, 2007)

� I had considerable freedom of clinical

choice of therapy: my trouble was that I did

not know which to use and when. I would

gladly have sacrificed my freedom for a

little knowledge.▪ Sir Archie Cochrane. Effectiveness and Efficiency: Random Reflections on Health

Services

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� Critique and Response:

� Cost cutting measure

� Cookbook medicine

� Evidence for EBM

� Uncertainty

� Context

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� “…the conscientious, explicit and judicious

use of current best evidence in making

decisions about the care of individual patients”

Sackett, 1996

� The integration of best research evidence with

clinical expertise and patient values

Sackett, 2000

Preferable term:

Evidence-informed practice5

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Preface

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� Challenges:

� Not enough time

� Not enough evidence

� Too much evidence

� Can’t acquire evidence

� Can’t appraise evidence

� Can’t synthesizing evidence

� Can’t apply evidence

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� Ranking of importance of factors

influencing current practice:

� Experience

� Continuing education (practical)

� Colleague influence

� Continuing education (theory)

� Professional literature *secondary sources

� Entry level training� Stevenson et al (2005)

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Figure 5. Knowledge Brokering: Exploring the process of transferring

knowledge into action. Ward et al, 2010 10

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� 1. Identify the partner(s)

� 2. Identify and meet the needs of the

partner

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� Identify the partner(s)

� Existing relationships

� Networking to build new relationships

� Need buy-in from key decision-makers first

Patients / residents / families

Educators

Researchers

Decision-makers & clinicians

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� Researchers

� Academics/instructors

� Policy makers

� Government

� Health care organizations

� Clinicians

� Professional associations

� E.g. PABC

� Patient organizations

� E.g. Heart & Stroke Association 14

Partnerships may be:

Overlapping

Unique

Fluid / dynamic

� engages potential users

� collaborative or participatory approach

� action oriented

� solution focused

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� Identify and meet the needs

� It’s all about THE QUESTION

▪ P - population

▪ I - Intervention

▪ C - comparison

▪ O – outcome

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� When the question is right ….

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When the team is right ….

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When the need is significant ….

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� When the question is not quite right ….

� “It didn’t answer my question”

� Keep it simple

� Context is important

� Let’s talk-direct dialogue

� Communicate 20

� Therefore, success is determined by:

1. The right partnerships

2. Meeting the specific needs

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� Success is amplified by:

1. The ripple effect

2. The snowball effect

3. Maximizing, not duplicating, roles

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