CDPAC Building it Together

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A Knowledge Transfer Story
.circa 1747
Time Elapsed from Lancaster to Adoption 264 years
1497 Vasco da Gama Rounds Cape of Good Hope to
find sea route to India. Of the 160 crew, 100 die
of scurvy
1747 Dr. James Lind conducts random trial of six
treatments for scorbutic sailors
1795 British Navy orders citrus fruit in diet
for sailors
1601 Captain Lancaster sails with 4 ships Crew
1 given 3tsps lemon juice daily
1865 British Board of Trade orders citrus on
merchant marine vessels
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Evolving Story

• Consistent evidence of failure to translate
  research findings into clinical practice
• 30-40 patients do not get treatments of proven
  effectiveness
• 2025 patients get care that is not needed or
  potentially harmful
• Schuster, McGlynn, Brook (1998). Milbank Memorial
  Quarterly
• Grol R (2001). Med Care

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symbiosis living togethermutualism -(both
organisms benefit)commensalism -(one benefits,
one unaffected)parasitism (one benefits, one is
harmed)competition (neither species
benefits)neutralism (both species are
unaffected)
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impala and other savannah animals let oxpeckers
clean them up
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Knowledge Transfer and Exchange Framework
Knowledge
Persuasion
Decision
Implementation
Confirmation
Knowledge transfer strategies
Evidence-informed Decision-making
Knowledge Uptake
Outcomes
Adopt
Reject
Dissemination strategies
Innovation characteristics
Decision-making efforts
Implementation strategies
Pt outcomes resource allocation expenditures organ
izational performance
Organizational characteristics
Individual characteristics
Environmental characteristics
(Dobbins et al, 2002)
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A Framework for Knowledge Transfer and Uptake
Knowledge
Persuasion
Decision
Implementation
Confirmation
Did the search for evidence identify the most
highly synthesized current information? (apply
appropriate quality assessment criteria)
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A Framework for Knowledge Transfer and Uptake
Persuasion
Knowledge
Decision
Implementation
Confirmation
What characteristics of the 1) innovation, 2)
organization, 3) environment and 4) individual
are likely to influence the adoption of a new
program/policy
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A Framework for Knowledge Transfer and Uptake
Persuasion
Knowledge
Decision
Implementation
Confirmation
Who are the key stakeholders who should
be involved in the decision to adopt the
innovation? What factors need to be considered
to make an evidence-informed decision?
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A Framework for Knowledge Transfer and Uptake
Persuasion
Knowledge
Decision
Implementation
Confirmation
What strategies will promote behavioral change
and implementation of research findings among my
colleagues?
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A Framework for Knowledge Transfer and Uptake
Knowledge
Persuasion
Decision
Implementation
Confirmation
What indicators should I measure to evaluate the
success of implementing an evidence-informed
decision?
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Organizational Context

• how can you increase the value your organization
  places on using research evidence in
  decision-making

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Organizational Context (contd)

• How do you assist your staff/colleagues to become
  critical consumers of information sources and
  maintain critical appraisal skills

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Organizational Context (contd)

• What mechanisms would you put in place to assist
  staff/colleagues to identify, access, assess,
  interpret, and apply research evidence within the
  local context