knowledge brokering comes to sick kids

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Knowledge BrokeringDemonstration Site

© Barwick / The Hospital for Sick Children

Knowledge Brokering Comes to Sick Kids

CHSRF Knowledge Brokering Workshop

October 24th, 2005

Melanie Barwick, Ph.D., C.Psych.Health Systems Scientist, Community Health Systems Resource

Group

Associate Scientist, Population Health Sciences

Assistant Professor, Psychiatry, Public Health Sciences, University of

Toronto

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Pediatric healthcare centres will be called upon to demonstrate that they are efficient producers of new knowledge and that they can apply and transfer that knowledge effectively to improve the health and well-being of children, contribute to research that is relevant to real-world issues, and inform policy and decision-making.

The Commonwealth Fund Task Force on Academic Health Centers (2003)

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Knowledge Translation and Our Mission

The Hospital for Sick Children will create, evaluate, apply and disseminate knowledge to improve the health of children.

We will lead in providing exemplary family-centered care, innovation and discovery, focusing on those areas in which we can make the greatest contribution.

Collaborating with others, we will become one of the best pediatric academic health science centre in the world.

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Our Knowledge Role

"Sick Kids' most important product is knowledge. We generate knowledge when we do research, we apply it when we treat children and we disseminate it when we teach others. Our greatest future potential, where we will see the greatest return on investment, depends on our ability – through research, education and advocacy – to influence child health outcomes outside our walls, in Canada and around the world"

(Hospital for Sick Children Trustee)

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Population Health Sciences Program

Population Health Sciences (PHS) is the largest and most diverse research program in The Hospital for Sick Children Research Institute.

The members of PHS study the characteristics of health and disease in children, with an emphasis on the determinants of health. Methods used include a broad range of qualitative and quantitative science methods. The program also evaluates the health outcomes and cost-effectiveness of hospital and community programs and interventions.

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Our team will evaluate the impact of our knowledge brokering (KB) and knowledge translation (KT) activities in transferring our research knowledge to those who are poised to change practice and policy and improve the health of children.

No other paediatric healthcare centre has taken on a similar challenge.

Knowledge Brokering in Pediatric Healthcare Research: From Science, To Linkage, To Impact

Canadian Health Services Research Foundation

2004-2007

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Research Team

Dr. Melanie Barwick, Principal Investigator, Sick Kids

Dr. Donna Lockett, Knowledge Broker, Sick Kids

Dr. Teresa To, Program Head Population Health Sciences Program, Sick Kids

Ms. Dale Butterill MSW, MPA, Manager, Knowledge Transfer, Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health

Ms. Elaine Orrbine, CEO Canadian Association of Pediatric Health Centers (CAPHC)

Ms. Laura Greer, Manager Public Affairs, Research Institute, Sick Kids

Ms. Allyson Hewitt, Executive Director, Safe Kids Canada

Members at Large

Ms. Adrienne Einarson, Assistant Director, Motherisk Clinic, Sick Kids

Dr. Beverley Antle, Academic & Clinical Specialist and Director of the PKU Program, Social Work, Sick Kids

Dr. Gail McVey, Psychologist, Community Health Systems Resource Group, Sick Kids

Dr. Alice Charach, Staff Psychiatrist, Psychiatry, Sick Kids

Dr. Lillian Sung, Staff Physician, Haematology / Oncology, Sick Kids

Project Team

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Two aims:

(1) Building knowledge transfer competencies (i.e., skills, knowledge) among health scientists, and

(2) Building exchange opportunities between scientists and decision-makers.

Knowledge Brokering in Paediatric Healthcare Research

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Relative Advantage of Knowledge Transfer for Scientists:

To ensure research actually has an impact on child health

Increasingly, funders and academic institutions will require it

Ultimately, the participation required with partners and stakeholders will strengthen the relevance of research for children

To distinguish Sick Kids as a leader in knowledge translation for paediatric health and mental health

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First Ever First Ever Knowledge Knowledge

Broker Hired at Broker Hired at Sick Kids!Sick Kids!

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Objectives

Target groups

Short-term outcomes

Med-term outcomes

Long-term outcomes

Components

Activities

Outputs

1. National dissemination and implementation support for Sick Kids’ Pediatric Healthcare Center KB/KT Program with support (financial, leadership, in-kind) from CAPHC and NCYHC.

1. Sustainability of KB position within Sickkids (investment and leadership support by management)

2. Growth of KTE activities within PHS Program and transfer/uptake to other Research Institute programs

3. Partnership with CAPHC and the NCYHC to develop multi-site replications, with financial, leadership and in-kind supports from CAPHC.

1. Interviews/surveys: # completed.

2. Off-line support: # requests; time devoted; description of activity; follow-up action.

3. Communication training: # training sessions, # participants, participant evaluation,

4. Scientist KT Training (RTTP): #workshops, content of workshops, # of participants, evaluation of training.

5. Formal Linkage and exchange workshops: # workshops; # policy & decision-makers; # PHS scientists, # research partnerships developed; participant evaluations.

PHS Scientists Policy & Decision-Makers

KTE Skill Building

Enhance KTE competencies

KTE Linkage & Exchange

Build exchange opportunities

Interviews & Surveys

RTTPTraining

Communications training

1. Improved use of KTE strategies and knowledge among PHS scientists (PHS survey, RTTP evaluation)

2. Improved attitudes and knowledge of KT among scientists (PHS survey, RTTP)

3. Increase in scientist-decision maker collaborations (PHS survey)

4. Increase in KTE activities KTE plans in research proposals (PHS survey)

5. Increased support for scientists’ KTE activities from management (Management survey/interviews)

Sick Kids Directors

Off-line support Linkage &

Exchange

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Ultimately, knowledge translation within healthcare requires that we demonstrate how our research directly affects patient outcomes and influences clinical practice. We need systems in place to track and report impact.

A model used by the Agency for Healthcare Research and Quality proposes how this can be operationalized.

Measuring Impact

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Impact on Healthcare Knowledge Baseand Future Research

(Level 1)

includes innovations around tools and methods of research, instruments, and techniques to assist in clinical decision-making, and studies that identify areas in which scientific knowledge is needed but absent.

Impact on Health Practices(Level 2)

requires demonstrating the impact of research on the creation of policies and / or programs in health, and other sectors including education and mental health

Impact on Clinical Practice

(Level 3)

how our research changes what clinicians or patients do; changes in a pattern of healthcare.

Impact on Health Outcomes

(Level 4)costs, wait time,

morbidity & mortality

Stryer et al 2000

New research collaborations developed through Liaison Program and other brokering opportunities that focus on real world issues

Impact of KTE activities on policies and/or programs reported by decision/makers and within hospital management

KTE activities among scientists that lead to change in practice and/or consumer behaviour

None at this time

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Baseline survey – Year 1 SickKids Knowledge Transfer Training for Scientists–

Year 1 Communications Training – Year 1 Liaison Program – Year 1

Accomplishments to Date

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KT Strategies Used in Past Year n=132, *81% RR

0

10

20

30

40

50

60

70

80

90

100

Journal Conference Workshop Present NA Informal NA Media Policy Summary Report MM

Perc

ent o

f Res

pond

ants

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Describe Your Understanding of KT

0

10

20

30

40

50

60

70

80

90

100

Never heard term before Don't know what it means Reasonably comfortable and

could apply with some support

Completely comfortable and

require little support

Perc

ent o

f Res

pond

ants

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Describe Your KT Practices

0

10

20

30

40

50

60

70

80

90

100

Discussed or

undertaken KT

Discussed

possibility of

including KT in a

project

Considered

including KT in

upcoming grant

Included KT in

proposal

Worked on a KT

piece

Actively engaged in

KT

Perc

ent o

f Res

pond

ants

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Describe Your KT Barriers

0102030405060708090

100

Competing priorities Lack of academic

currency

Lack of awareness of

WHO my audience is

Lack of knowledge of

HOW to do KT

Lack of access to

funding / resources

Perc

ent o

f Res

pond

ants

Not a barrier Minor barrier Significant barrier

Major barrier Insurmountable barrier

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In the end, the number of grants we get, the number of research studies we do or the proliferation of publications produced matters little to children if they do not improve practice. What we really want to get at is not how much research we have done, but how many children’s lives are improved as a result of what we have accomplished. SickKids can develop a user-driven or child-centered research agenda that is focused on making research discoveries for the people who need information to make better and informed decisions about children’s healthcare.

Barwick, 2003SickKids White Paper, Development of a Knowledge Translation Strategy

for Population Health Sciences

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Excellence in research is laudable,

but unless we can impact child health,

it presents an incomplete effort.

knowledge brokering comes to sick kids

Documents