mobilizing knowledge to improve health and social care - approaches and challenges
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Mobilizing Knowledge to Improve Health and Social Care - Approaches and Challenges by Jacky Swan, Professor in Organizational Behaviour, Director of the IKON Research Centre. Presented at "Using Research Evidence to Improve Health and Social Care". A NISCHR AHSC Workshop to Explore Strategies in Knowledge Transfer. 6th May 2014 – CardiffTRANSCRIPT
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Jacky Swan,
Professor in Organizational Behaviour, Director of the IKON Research Centre
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Outline
Why knowledge mobilization? Approaches to knowledge mobilization
Transfer, Translation, Transformation Examples from research
(Innovation, Knowledge and Organizational Networks)
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Why Knowledge Mobilization??The ability to move knowledge & evidence from one setting to another is seen as
critical: For NHS organizations:
Reducing costsDeveloping innovation
For policy makers 2006 Cooksey report – 2nd translational gap “between the producers & users of
research evidence” For patients
Improving quality & delivery of health care services
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Mind the Gap
Knowing Doing
Boundaries
OrganizationalProfessional DisciplinaryGeographical
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Bridging the Gap…
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Traditional Knowledge Transfer Approach
knowledge producers
knowledge users
PUSH PULL
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….The Reality
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Limits of Knowledge Transfer Science alone is not the way to effective decision-
making (Learmonth, 2008)Complex decisions require judgement that takes account also
of values, beliefs and social/political interests (Morrell, 2008) –e.g. individual needs vs population needs; cost and benefit…
(Nicolini, 2011) Transfer only works when people already speak the
same language & share ‘thought worlds’
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Knowledge Translation
Making the knowledge produced by one group meaningful to, and applicable by, another group.
transfer
translation
VS.
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Why is knowledge translation difficult?
Knowledge lives within ‘communities of practice’“groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly”& healthcare has multiple communities
Practice boundaries create boundaries to knowledge sharing (Carlile)
Need to develop social networks & boundary spanning roles to bridge communities
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Collaborations for Leadership in Applied Health Research & Care (CLAHRCs) in the NHS
Clinical researchers
Hospital doctors
Allied health practitioners
Social scientist researchers
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CLAHRC initiative in the NHS
Clinical researchers
Hospital doctors
Allied health practitioners
Social scientist researchers
KNOWLEDGE BROKERS
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Knowledge translation – role of brokers
Greentown network Greentown network: - connectivity with brokers removed
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Children’s Hospital of Eastern Ontario (CHEO) Children with complex health problems Problem – system not family focused, organizations
working in silos, fragmented care, loss/duplication of information, stress of parents
Coordination Pilot Project – CHEO + partner organizations (e.g., Champlain Community Care Access Centre and Ottawa Children’s Treatment Centre; families)
Objective: To provide family-centred, comprehensive care coordination
across the system while relieving burden on families https://www.youtube.com/watch?v=f1tOzsjd4L8
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The ‘SPOC’ solution Solution – Single Point of Care (SPOC) medical sheet
(“cheat-sheet”) + family binder‘Simple’ 2-3 page summary of up-to-date, information on
childMedical issues, allergies, directives, lists of people involved in
care, medications, test results, surgeries, technologies used Successful pilot on 23 children (20 in control group)
Satisfaction of patient & staff, ER visits/admissions avoided, streamlined admissions, better access to information…
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Developing the SPOC Intensive 3-month (min.) period of design with
involvement from multiple parties Ensured accuracy & engagement
Knowledge brokers – ensured the SPOC was actually used in medical encountersProject Manager (Lara) – leads overall project &
engages partner organizationsMedically responsible physician (Kathy) - signs &
circulates SPOC to CHEO doctors, Emergency Rooms community agencies and families
Nurse Coordinator – Beth updates (including deleting) SPOC by pulling information from network of carers
Parents – move SPOC from place to place
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Knowledge transformation
Mobilize knowledge by collectively generating new practice Simple solution but complex development process○ helped shift established practices & boundaries
between families & professionals Requires strong social network ties & leadership
to build trust & change politics/practice
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Transfer – supplying knowledge within communities
Challenge of sourcing information
Translation – sharing knowledge across communities
Challenge of understanding
Conclusion - Making KMob Work
Transformation – embedding knowledge in new practices
Challenge of politics
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