Building Capacity for Implementation – The KT Challenge

BackgroundResearch funders, educators, investigators and decision makers worldwide have identified the need to improve the quality of health care by building capacity for knowledge translation (KT) research and practice. Peer-based mentorship represents a vehicle to foster KT capacity. The purpose of this exploratory study is to identify mentoring models that could be used to build KT capacity, consult with putative mentee stakeholders to understand their KT mentorship needs and preferences, and generate recommendations for the content and format of KT mentorship strategies or programs, and how they could be tested through future research.MethodsA conceptual framework was derived based on mentoring goals, processes and outcomes identified in the management and social sciences literature, and our research on barriers and facilitators of academic mentorship. These concepts will inform data collection and analysis. To identify useful models by which to design, implement and evaluate KT mentorship, we will review the social sciences, management, and nursing literature from 1990 to current, browse tables of contents of relevant journals, and scan the references of all eligible studies. Eligibility screening and data extraction will be performed independently by two investigators. Semi-structured interviews will be used to collect information about KT needs, views on mentorship as a knowledge sharing strategy, preferred KT mentoring program elements, and perceived barriers from clinician health services researchers representing different disciplines. Qualitative analysis of transcripts will be performed independently by two investigators, who will meet to compare findings and resolve differences through discussion. Data will be shared and discussed with the research team, and their feedback incorporated into final reports.DiscussionThese findings could be used by universities, research institutes, funding agencies, and professional organizations in Canada and elsewhere to develop, implement, and evaluate mentorship for KT research and practice. This research will establish a theoretical basis upon which we and others can compare the cost-effectiveness of interventions that enhance KT mentorship. If successful, this program of research may increase knowledge about, confidence in, and greater utilization of KT processes, and the quality and quantity of KT research, perhaps ultimately leading to better implementation and adoption of recommended health care services.

Knowledge translation (KT) refers to the process of moving knowledge into healthcare practice and policy. The practice of KT is about helping decision-makers become aware of knowledge and facilitating their use of it in their day-to-day work. The science of KT is about studying the determinants of knowledge use and investigating strategies to support the adoption, implementation, and sustained use of knowledge in healthcare practice and policy. An increasing number of trainees are developing careers in KT practice and/or KT research. Given the infancy of this field, there may be unique challenges that trainees face as they develop their careers in KT. This paper is one of two from a study about KT trainees’ perspectives on KT research and practice. The purpose of this paper was to identify challenges that KT trainees face in their KT practice or research

Knowledge translation (KT) in healthcare is a complex process. Building the KT capacity of the workforce is fundamental to closing the gaps between research and evidence-based practice. This evaluation aimed to describe the impact of a KT capacity building program (Allied Health Translating Research into Practice, AH-TRIP) on allied health professionals and health services and systems, with the secondary aim of identifying barriers and enablers to program impact. Multi methods evaluation using online surveys and semi-structured interviews with 20 program participants and their managers. The interview guide was underpinned by the Framework to Assess the Impact from Translational health research (FAIT). Deductive content analysis was used to categorise impact against FAIT, with barriers and enablers mapped to an implementation framework. Six domains of impact were identified: Individual Capacity Building, Workforce Capacity Building, Enhanced Networks, Clinical Practice Change, Patient/Community Benefits, and Economic Benefits. Enablers of impact were program design (flexibility, access to mentors, funding opportunities), local contexts supporting research (manager support, access to local experts), and previous exposure to KT. Consistent barriers included a lack of clinician time and confidence in KT, staff turnover (particularly in regional/rural areas), lack of organisational research culture, and short-term funding cycles. Using FAIT methodology, we have demonstrated significant impact achieved by a KT capacity building program for individual health professionals and the broader allied health workforce and health services and systems. Impact could be further optimised by strategies targeted at managers to create supportive contexts for KT through improving research literacy in health decision and policy contexts and innovative workforce planning.

The workshop that this paper reports, held in Iran in May of 2011, at the 1st Inter-national and 4th National Congress on Health Education and Promotion, had three main objec-tives: 1) to introduce participants to the knowledge translation (KT) concept, along with its mod-els and methods; 2) to enhance participants' knowledge of how KT could apply to public health education and promotion ; and 3) to learn from different participating stakeholder groups about the factors that facilitate or impede effective KT in public health education and promotion in Iran. The workshop consisted of three components: introducing the KT concept, assessing the KT capacity of participants, and facilitating a discussion of the important contextual factors that promote and impede effective KT. Of the 26 individuals from across the country participat-ing in the workshop, 17 took part in a KT capacity assessment activity. They classified them-selves into one of the following three stakeholder groups: administrators and policymakers (n=6), practitioners (n=2), and researchers (n=9). There were different capacities for KT across the three stakeholder groups. The re-ported challenges for effective KT include "lack of resources and funding"; "lack of time"; "poor quality of relationships and lack of trust between health policymakers, administrators, re-searchers, and clinicians"; "inadequate skills possessed by healthcare professionals and adminis-trators for assessment and adaptation of research findings"; and "poor involvement of commu-nity partners in the research process." There is a great need to develop effective strategies to overcome the reported barri-ers for effective KT.

Background In 2003, the Registered Nurses’ Association of Ontario (RNAO) established the Best Practice Spotlight Organization® (BPSO ®) designation, a pivotal knowledge translation strategy. This initiative aimed to support the Best Practice Guidelines (BPGs) implementation, enable rapid learning and sustainability of evidence-based practice changes. Evaluating the sustainability of evidence-based practice changes is crucial for fidelity of the BPG implementation. Despite existing strategies to acknowledge sustained improvements in practices, there are currently no clear criteria or guidelines available for evaluating sustainability. This article introduces a systematic approach to evaluate the sustainability of BPG implementation outcomes. Methods A mixed methods approach is used to develop criteria to evaluate the sustainability of practice changes and outcomes associated with BPG implementation. This process aims to guide future data reporting frequencies by BPSOs. This approach includes collecting and analyzing qualitative and quantitative data from BPSOs; conducting an environmental scan to determine any existing methods to assess sustainability; and facilitating internal and external expert discussions to provide feedback on the proposed criteria. Results A numerical measure is developed to estimate the number of observations or data submission months required for achieving data saturation and stability or sample size adequacy. A case study is conducted to illustrate the application of the proposed method based on data collected during the implementation of the Assessment and Management of Pain (2013) BPG at an acute care hospital in Ontario, Canada illustrates sustainability of the following practice change and related outcome: consistent pain assessments by healthcare providers and improved patient satisfaction with pain management. Conclusions Monitoring sustainability is a crucial step in BPG implementation. Optimized reporting informs resource allocation and changes to implementation activities. The case study underscores the benefits of using control charts for evaluating practice sustainability and facilitating meaningful data collection by BPSOs for quality improvement.

To document the outcomes of a dedicated Science Communication Community of Practice (CoP) for increasing prevention-focused knowledge translation (KT) and evidence uptake. Type of program: Shared priorities and a united vision to communicate the value of prevention research led to the formation of a dedicated Science Communication CoP within an Australian public health prevention-focused research collaboration. Members of the CoP included science communication experts and early- and mid-career researchers (EMCRs) with KT-focused roles. The CoP met monthly, with semi-structured meetings led by an experienced science communication professional. A priority of the CoP was to develop resources that could help members and external parties to communicate their findings, especially EMCRs and those working on low-resourced projects. Insights from CoP members were synthesised to document if, and how, the CoP increased communication and KT capacity. CoP members found that participatory dialogue - dialogue that involves sharing perspectives and listening to others in order to develop a shared understanding - helped promote a greater understanding of science communication techniques and led to KT being embedded within projects. The CoP itself resulted in shared narratives and communication outputs that could not have been produced by individual members, primarily due to a lack of dedicated resourcing. Members found that engaging in the CoP increased their use of a range of science communication skills, tactics, and methods (e.g., targeted messaging for policy and practice, use of media and social media, and event management to engage audiences and build trust). The CoP helped build a greater working knowledge of science communication among its members, leading to increased KT activities. Within an environment of low resourcing for science communication, bringing researchers together with science communication experts can help promote the communication of synthesised evidence and unified messaging on 'what works for prevention'.

BackgroundEnacting knowledge translation (KT) in healthcare settings is a complex process that requires organizational facilitation. In addition to addressing organizational-level barriers, targeting individual-level factors such as KT competencies are a necessary component of this aim. While literature on KT competency training is rapidly growing, there has been little exploration of the potential benefits of training initiatives delivered from an intra-organizational perspective. Addressing this gap, we developed the Knowledge Translation Facilitator Network (KTFN) to meet the KT needs of individuals expected to use and produce knowledge (e.g., healthcare providers, research staff, managers, family advisors) within an academic health sciences center. The aim of this study is to describe the development, implementation, and evaluation of the KTFN curriculum.MethodsAn educational framework was used to guide creation of the KTFN curriculum. Stakeholder interviews, a literature review of KT competency, and environmental scan of capacity building initiatives plus adult learning principles were combined with in-house experience of KT practitioners to inform content and delivery. An evaluation strategy consisting of pre/post-test curriculum and post-session satisfaction surveys, as well as post-curriculum interviews assessed impact on participant knowledge and skills and captured perceived value of KFTN.ResultsThe curriculum has been delivered three times over 3 years, with 30 individuals trained, representing healthcare providers, graduate level research trainees, managers, and family advisors. Using the New World Kirkpatrick Model as an analysis framework, we found that the KTFN curriculum was highly valued and shifted learners’ perceptions of KT. Participants identified enhanced knowledge and skills that could be applied to different facets of their work; increased confidence in their ability to execute KT tasks; and intention to use the content in future projects. Barriers to future use included time to plan and conduct KT activities.ConclusionKTFN was developed to enhance KT competency among organizational members. This initiative shows promise as a highly valued training program that meets both individual and organizational KT needs and speaks to the importance of investing in tailored KT competency initiatives as an essential building block to support moving evidence into practice.

This study explored factors that affect the adoption or rejection of evidence-based practice (EBP) changes and differences in nurse manager and staff nurse perceptions about those factors. Roger's Diffusion of Innovations Theory explains relevant organizational strategies for guiding practice change. The primary author developed the Evidence-Based Practice Changes Survey consisting of 12 items, completed by 92 nurses at a level 1 trauma center. Top barriers to EBP were insufficient time, lack of staff, and not having the right equipment and supplies. Top reasons to adopt EBP were having personal interest in the practice change, avoiding risk of negative consequences to the patient, and personally valuing the evidence. Several statistically significant differences emerged for demographic variables. Planning for EBP change must address barriers and facilitators to practice change and emphasize the benefit for patients and value of the practice change to nurses.

BackgroundThe Knowledge Translation Innovation Incubator (KTII) initiative, launched by the Knowledge Translation program of the CHILD-BRIGHT Strategy for Patient-Oriented Research Network, provided funding support for researchers and partners to experiment with various approaches and strategies to support the development of innovative knowledge translation (KT) research in the context of neurodevelopmental disabilities.ObjectiveWe aimed to describe the process and contexts of innovation development in integrated knowledge translation (iKT) practices in patient-oriented research.MethodsWe applied an iKT practice to conduct the collective case study of 7 KTII-funded projects. We interviewed 10 researchers, 4 research trainees, 2 clinicians, 2 parentpartners, 2 patient-partners (1 adult and 1 youth), 1 community partner, 1 KT specialist, 1 designer, and 1 research program manager at the middle and the end of the project period. We conducted qualitative content analysis using the Consolidated Framework for Implementation Research to identify and assess patterns of determinants of (1) drivers of innovation, (2) facilitators and barriers to innovation development, and (3) enablers for sustainability of KT products.ResultsInnovative KT was majorly driven by the identified know-do gap to meet the needs of people with lived experience. Outer setting constructs, such as funding and partnerships and connections, were not only drivers but also facilitators to innovation development. iKT practices presented in this case study were fostered by researchers’ approach to participatory design, involving iterations of listening to emerging ideas and feedback of patient-partners and other partners, and researchers’ continuous reflections on their roles in knowledge creation. Despite the challenges in building consensus and the limited time of the fluid process, researchers’ strong passion for engagement and value placed on lived experience led to flexible engagement and open communication to create KT products. Intangible outcomes included further relationships at individual and organizational levels, capacity building of young people, and a collective voice to influence communities. Sustainment of the KT products requires not only accessibility and adaptability of the product itself but also mechanisms at inner settings, such as training, continued interest of patient-partners and the community, and institutional partnerships to support the further uptake of the product.ConclusionsThis study illustrates the critical roles of researchers in addressing power dynamics and making the research partners’ tacit knowledge visible for successful innovative KT. The research landscape should also change in terms of funding and timeline in order to foster researchers’ mental models in designing thinking and actions on collaborative research engagement.

Pain is inadequately managed in pediatric populations across health care settings. Although training programs to improve health care provider knowledge and skills have been developed and evaluated, clinical practices have not always kept pace with advancing knowledge. Consequently, the goal of this review was to systematically examine the pediatric pain literature of knowledge translation (KT) programs targeting health care providers. Systematic searches of PubMed, Web of Science, CINAHL, and PsycINFO were undertaken. KT initiatives directed toward health care providers and in which the primary focus was on pediatric pain were included. Primary outcomes, intervention characteristics, and risk of bias were examined across studies. Study outcomes were conceptually organized and a narrative synthesis of results was conducted. A total of 15,191 abstracts were screened for inclusion with 98 articles retained on the basis of predetermined criteria. Across studies, KT approaches varied widely in format and focus. Knowledge-level changes and self-reported increases in comfort or confidence in skills/knowledge were consistently achieved. Practice-level changes were achieved in many areas with varying success. Design and reporting issues were identified in the majority of studies. Examination of patient-related outcomes and of the long-term impact of pediatric pain KT programs was limited across studies. KT programs vary in quality and impact. Although several successful programs have been developed, many studies include a high risk of bias due to study quality. Evidence-based KT program implementation and a focus on sustainability of outcomes must be given greater consideration in the field of pediatric pain.

BackgroundNurses are increasingly expected to engage in evidence-informed decision-making (EIDM) to improve client and system outcomes. Despite an improved awareness about EIDM, there is a lack of use of research evidence and understanding about the effectiveness of interventions to promote EIDM. This project aimed to discover if knowledge translation (KT) interventions directed to nurses in tertiary care are effective for improving EIDM knowledge, skills, behaviours, and, as a result, client outcomes. It also sought to understand contextual factors that affect the impact of such interventions.MethodsA systematic review funded by the Canadian Institutes of Health Research (PROSPERO registration: CRD42013003319) was conducted. Included studies examined the implementation of any KT intervention involving nurses in tertiary care to promote EIDM knowledge, skills, behaviours, and client outcomes or studies that examined contextual factors. Study designs included systematic reviews, quantitative, qualitative, and mixed method studies. The search included electronic databases and manual searching of published and unpublished literature to November 2012; key databases included MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Excerpta Medica (EMBASE). Two reviewers independently performed study selection, risk of bias assessment, and data extraction. Studies with quantitative data determined to be clinically homogeneous were synthesized using meta-analytic methods. Studies with quantitative data not appropriate for meta-analysis were synthesized narratively by outcome. Studies with qualitative data were synthesized by theme.ResultsOf the 44,648 citations screened, 30 citations met the inclusion criteria (18 quantitative, 10 qualitative, and 2 mixed methods studies). The quality of studies with quantitative data ranged from very low to high, and quality criteria was generally met for studies with qualitative data. No studies evaluated the impact on knowledge and skills; they primarily investigated the effectiveness of multifaceted KT strategies for promoting EIDM behaviours and improving client outcomes. Almost all studies included an educational component. A meta-analysis of two studies determined that a multifaceted intervention (educational meetings and use of a mentor) did not increase engagement in a range of EIDM behaviours [mean difference 2.7, 95 % CI (−1.7 to 7.1), I2 = 0 %]. Among the remaining studies, no definitive conclusions could be made about the relative effectiveness of the KT interventions due to variation of interventions and outcomes, as well as study limitations. Findings from studies with qualitative data identified the organizational, individual, and interpersonal factors, as well as characteristics of the innovation, that influence the success of implementation.ConclusionsKT interventions are being implemented and evaluated on nurses’ behaviour and client outcomes. This systematic review may inform the selection of KT interventions and outcomes among nurses in tertiary care and decisions about further research.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0286-1) contains supplementary material, which is available to authorized users.

Knowledge translation (KT) was traditionally framed as a problem of moving research results into policy and practice. The impetus for the flow of knowledge originated with researchers constructing new knowledge and seeing its utility, or with policymakers and administrators seeing problems in practice and looking to researchers for solutions. In the 1970s, a shift in focus away from knowledge use was exemplified by Caplan’s (1979) two-communities theory, which posits that researchers and policymakers comprise two different communities with two different languages (Jacobson, Butterill, & Goering, 2003). A shift back to knowledge use with a new focus on user-centered design is evident in more recent KT models that provide frameworks for researcher and user interaction in order to build better understanding between diverse groups. The flow of knowledge from its construction in one context to its use in another context has been variously termed knowledge translation, knowledge exchange, knowledge transfer, research transfer, technology transfer, knowledge transformation, knowledge dissemination, knowledge mobilization, knowledge utilization, and research utilization. The terms are often used synonymously, but a specific term is sometimes used because it highlights a particular component of the knowledge flow process. For example, knowledge exchange implies a sharing of information between partners of equal value and focuses on the movement of knowledge between them, whereas research utilization implies the transformation of research results into usable knowledge and focuses on embedding the usable knowledge in practice. Information technologies have the potential to support knowledge translation in powerful ways. Key processes in the translation of knowledge include: (1) knowledge creation, management, and dissemination; (2) recognition of links between existing knowledge and its potential application to problems or practice; (3) translation into usable knowledge in practice; and (4) change in practice. Information technologies are a natural solution for these knowledge translation processes. For example, group and social software such as blogs and wikis support collaborative construction and sharing of knowledge; knowledge management systems support capture, storage, accessibility, and maintenance of constructed knowledge; and most Internet-based technologies support dissemination of information. Well-designed virtual communities provide online environments for the kinds of human interaction that enable collaborative exploration of ideas, that foster recognition of potential links between existing knowledge and its application to solve problems or change practice, and that inspire people to transform their practice. Data mining and artificial intelligence techniques can be used to enhance identification of potential links between knowledge in one context and problems in another context.

OBJECTIVE Since 1996 three, meanwhile eight, psychiatric hospitals have been working closely together in a multidisciplinary team aiming at improving quality management and reducing the frequency and duration of coercive measures, respectively. METHODS Development, aims, and functioning of the cooperation are described, and selected data of comparisons of documented restraints and of coercive measures in one of the hospitals (1998-2004) are presented. RESULTS This way of cooperation was conductive to changes in organizational policies and practices of coercive measures and, in parts, resulted in reducing coercive measures. CONCLUSIONS The cooperation was effective in improving quality management and implementation of changes in practice of coercive measures.

Translational research: The ingredients are only the start of the recipe for better dietetic practice

Research leadership in health care settings is increasingly recognized as a pivotal factor influencing institutional effectiveness, innovation, and development. However, the way people perceive and respond to this concept is unclear mainly because of the difficulties in merging the various definitions that have developed across different fields, especially in healthcare settings. Hence, it is vital to clarify the meaning of “research leadership” and formulate its defining attributes, antecedents, consequences, and practical applications. Using the eight-stage concept analysis framework by Walker and Avant (2019) along with a conversational search engine that uses Large Language Models (LLMs) Perplexity AI, a robust tool for its real- time web search capabilities and ability to provide comprehensive answers, "research leadership" was explored. A thorough literature search was completed covering peer-reviewed, full-text, and English-language publications from the last decade (2014–2025) from four online sources- EBSCOhost and PubMed databases; via Google Scholar search engine; and the Mendeley article access as well as three English dictionaries. After applying the eligibility criteria, a total of 24 articles were reviewed, and analyzed after until saturation was reached. The review revealed key characteristics that emphasized the most frequently used terms associated with the concept. Following Walker and Avant’s methodology (2014; 2019), five defining attributes emerged as significant themes: 1. Strategic Vision and System Improvement; 2. Contextual Adaptation and Implementation; 3. Collaborative and Relational Leadership; 4. Workforce Support and Development; 5. Knowledge Translation and Evidence- Based Practice. Meanwhile, antecedents included: Core research competencies and skills; Supportive environment and adaptive and Ethical leadership styles. Meanwhile, four consequences were: 1. Performance Improvement;2. Stakeholder Success; 3. Adaptable Frameworks; and 4. Knowledge Translation. Lastly, a clearer definition was identified as the ability to empower individuals to spearhead research initiatives that demonstrably improve healthcare delivery and patient outcomes. This leadership is characterized by a strategic vision for system-wide enhancements, a commitment to sustained operational support for effective interventions, collaborative practices that foster team cohesion and engagement, targeted workforce training to develop research capacity, and effective knowledge translation to integrate evidence-based practices into clinical settings.