Knowledge Brokering Comes to Sick Kids

1
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
2

• 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)

3

• 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.
4

• 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)
5

• 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.
6
Knowledge Brokering in Pediatric Healthcare
Research From Science, To Linkage, To Impact
Canadian Health Services Research
Foundation 2004-2007

• 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.

7
Project Team

• 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

8
Knowledge Brokering in Paediatric Healthcare
Research

• Two aims
• Building knowledge transfer competencies (i.e.,
  skills, knowledge) among health scientists, and
• Building exchange opportunities between
  scientists and decision-makers.

9

• 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
10
First Ever Knowledge Broker Hired at Sick Kids!
11
Enhance KTE competencies
Build exchange opportunities
Objectives
KTE Skill Building
KTE Linkage Exchange
Components
Interviews Surveys
Communications training
RTTP Training
Off-line support
Activities
Linkage Exchange
Target groups
PHS Scientists
Policy Decision-Makers
Sick Kids Directors

• Interviews/surveys completed.
• Off-line support requests time devoted
  description of activity follow-up action.
• Communication training training sessions,
  participants, participant evaluation,
• Scientist KT Training (RTTP) workshops, content
  of workshops, of participants, evaluation of
  training.
• Formal Linkage and exchange workshops
  workshops policy decision-makers PHS
  scientists, research partnerships developed
  participant evaluations.

Outputs

• Improved use of KTE strategies and knowledge
  among PHS scientists (PHS survey, RTTP
  evaluation)
• Improved attitudes and knowledge of KT among
  scientists (PHS survey, RTTP)
• Increase in scientist-decision maker
  collaborations (PHS survey)
• Increase in KTE activities KTE plans in research
  proposals (PHS survey)
• Increased support for scientists KTE activities
  from management (Management survey/interviews)

Short-term outcomes

• Sustainability of KB position within Sickkids
  (investment and leadership support by management)
• Growth of KTE activities within PHS Program and
  transfer/uptake to other Research Institute
  programs
• Partnership with CAPHC and the NCYHC to develop
  multi-site replications, with financial,
  leadership and in-kind supports from CAPHC.

Med-term outcomes
Long-term outcomes

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

12
Measuring Impact

• 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.

13
Impact on Health Outcomes (Level 4) costs, wait
time, morbidity mortality
Stryer et al 2000
None at this time

• Impact on
• Clinical Practice
• (Level 3)
• how our research changes what clinicians or
  patients do changes in a pattern of healthcare.

KTE activities among scientists that lead to
change in practice and/or consumer behaviour
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 of KTE activities on policies and/or
programs reported by decision/makers and within
hospital management
Impact on Healthcare Knowledge Base and 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.
New research collaborations developed through
Liaison Program and other brokering opportunities
that focus on real world issues
14
Accomplishments to Date

• Baseline survey Year 1
• SickKids Knowledge Transfer Training for
  Scientists Year 1
• Communications Training Year 1
• Liaison Program Year 1

15
(No Transcript)
16
(No Transcript)
17
(No Transcript)
18
(No Transcript)
19

• 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
  childrens 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 childrens
  healthcare.
• Barwick, 2003
• SickKids White Paper, Development of a Knowledge
  Translation Strategy
• for Population Health Sciences

20
Excellence in research is laudable, but unless
we can impact child health, it presents an
incomplete effort.