From Individuals to Organizations: Brokering at CHSRF

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From Individuals to Organizations Brokering at
CHSRF

• David Clements, MPA
• Vice-President, Knowledge Exchange

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Objectives

• To share the experience knowledge brokering at
  the Canadian Health Services Research Foundation
• To share knowledge from scanning and survey work
  on knowledge brokering in Canada
• To reflect on the recent experience of CHSRFs
  knowledge brokering demonstration sites.

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What is Knowledge Brokering?

• Knowledge brokering offers a perspective on
  innovation and innovators that recognizes the
  value not of invention but of inventive
  combination.
• - Andrew Hargadon

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Why Knowledge Brokering?

• Interpersonal links, spread through the life of
  a given study, are the key to research use. They
  allow non-researchers to find their niche and
  their voice while a study is still young There
  are reciprocal effects, such that we are no
  longer in a conventional research-to-practice
  paradigm, but in more of a conversation among
  professionals, each bringing different expertise
  to bear on the same topic
• Huberman, M Research Utilization The State of
  the Art. Knowledge and Policy 1994722

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Why Knowledge Brokering?

• Systematic review of 24 studies that asked over
  2000 policymakers what facilitated or prevented
  their use of research evidence
• 1 facilitator of research use personal contact
  between researchers between researchers and
  policy-makers (13/24)
• 1 barrier to research use absence of personal
  contact between researchers and policy-makers
  (11/24)
• Innvaer et al. J Hlth Serv Res Pol 20027241

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Our Journey

• 1997 CHSRF created, with research and KE
  mandate
• 1998 Policy syntheses
• 1999 Plain-language workshops
• 2000 Self-assessment tool
• 2001 Research summaries (Mythbusters)
• 2002 Cross-country KB focus groups review of
  KB literature
• 2003 The Theory and Practice of Knowledge
  Brokering
• 2004 Knowledge Brokering Demonstration sites
  Evaluation
• 2006 - Shift to tools and strategies for
  research use

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Knowledge Brokering Survey and Scanning

• Regional consultations across Canada in which we
  met with close to 200 knowledge brokers working
  in Canadas health system
• National meeting to confirm findings, create
  consensus and check assumptions
• Extensive literature review on brokering in a
  variety of disciplines
• Canadian Health Services Research Foundation.
• The Theory and Practice of Knowledge Brokering in
  Canadas Health System. Ottawa CHSRF, 2003.

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What do knowledge brokers do?

• Find and link people
• Work with both parties to scan the literature,
  summarize what exists, identify gaps
• Work with researchers and users of research to
  create researchable questions from
  policy/management issues
• Ensure that both researchers and users of
  research are engaged throughout the research
  process

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What do brokers do?

• Collaboratively set agendas
• Facilitate interactions
• Communicate different realities
• Create a common language and frame of reference
• Help to establish realistic expectations, roles
  and responsibilities

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Brokering Competencies

• Understanding of both the research and decision
  making environments
• Ability to find and assess relevant research
• Entrepreneurial skills (networking,
  problem-solving skills, innovative solutions,
  etc)
• Mediation and negotiation
• Understanding of the principles of adult learning
• Communication skills
• Credibility

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Gladwell

• Connectors are the people who "link us up with
  the world ... people with a special gift for
  bringing the world together.
• Mavens are "information specialists", or "people
  we rely upon to connect us with new
  information."They accumulate knowledge,
  especially about the marketplace, and know how to
  share it with others.
• Salesmen are "persuaders", charismatic people
  with powerful negotiation skills. They tend to
  have an indefinable trait that goes beyond what
  they say, that makes others want to agree with
  them.
• (Wikipedia)

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Where does brokering happen?

• Brokering can be done in a variety of settings
• Knowledge brokering organizations
• Individuals or teams in research organizations
• Individuals or teams in decision-making
  organizations

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The State of Brokering

• A significant amount of brokering is happening in
  the Canadian health system
• Brokering is rarely called brokering, and a great
  deal of what is now being called brokering is not
  really brokering
• Very little brokering is formal
• Much brokering goes completely unrecognized and
  unrewarded
• Little brokering is done by full-time workers
• Few resources are attached to these people /
  roles
• Virtually no evaluation has been done on the
  importance of brokering

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There is no one-size-fits-all

• What brokering entails (skills and activities)
  will be dependant on the context in which it
  occurs
• Research vs. decision-making environment
• Organizations with rich KT strategies vs...
• Existing research (recombinant?) vs
• But if the true goal is to bridge communities,
  brokering is built on a solid understanding of
  all the relevant environments

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Brokering Demonstration Sites

• Intent was to test the hypothesis that knowledge
  brokering is a useful way to encourage and
  increase the effectiveness of knowledge transfer
  activities.
• Goal1 To stimulate the implementation of
  structures, processes or people in
  decision-making organizations dedicated to
  linking researchers and decision-makers and
  facilitating their interaction
• Goal 2 To increase the appropriate use of
  quality research in the decision-making processes
  of successful applicant organizations

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Six Brokering Experiments

• A pediatric health centre in a large urban
  centre, which sought to manage knowledge more
  effectively for policymakers and managers
  involved in improving childrens health
• A coalition of aboriginal health organizations
  which wanted to improve the cultural
  sensitivity of the organization and delivery of
  healthcare to aboriginals
• A provincial long-term care system in which tried
  to nurture relationships between policymakers and
  planners with researchers, so as to encourage
  greater respect for the contribution of research
  in the activities of this organization

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Six Brokering Experiments

• A partnership of two regional health authorities,
  which wanted to collect and share data that could
  improve service planning and management
• A large health and social services agency, which
  implemented 11 service networks with the
  mandate of enhancing the management of health and
  social services by producing and sharing vital
  information to the directors of these networks,
  and
• A rural hospital that hired two knowledge brokers
  responsible for helping hospital staff pursue
  personal learning activities aimed at generating
  ideas for healthcare improvement and identifying
  the relevant knowledge in the area.

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Evaluation

• Draft formative evaluation focuses on whether the
  design and delivery of the program was
  appropriate to facilitate effective knowledge
  brokering by the sites, and how the experimental
  nature of the program impacted the sites.
• Addressed three questions
• Was the design of the program appropriate and
  effective?
• What factors led to effective delivery and what
  factors impeded program delivery?
• What effects did the experimental nature of the
  program have on success in achieving intended
  outcomes?
• Summative evaluation due in late 2008

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Evaluation Key Messages

• The highly adventurous and experimental nature of
  the knowledge brokering demonstration site
  program allowed for each site to adapt to local
  context, and also helped many knowledge brokers
  to formalize the informal nature of their work
• The benefits of the requirement for co-funding
  from sponsoring organizations, which helped
  brokers to support and sustain relationships
• Potential lost opportunities related for a
  community of practice of knowledge brokers that
  could have been better nurtured.

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Informing CHSRF Programming

• CHSRF focusing more explicitly on tools, training
  and capacity-building for research use.
• Knowledge brokers are an identifiable audience
  for
• Funded exchanges and learning events
• Support for knowledge networks
• Targeted research summaries
• Tools inventory (www.chsrf.ca/tools)