Canadian Knowledge Mobilization Forum: Keynote Address June 28, 2016 Michael Hillmer, PhD Ministry of Health and Long-Term Care

2 IMPORTANCE

3 “as we embark on the 21st century, we have found that the 20th century has given us a volume and knowledge and skill that is beyond what any individual can simply hold in their head, can know how to deliver on…. The volume of knowledge and skill has exceeded our individual capabilities.” Dr. Atul Gawande, 2014 Reith Lecture

Confidential Draft for Discussion4

5 …take the lead in ensuring that changes are informed by evidence …. Ontario’s precious health care dollars improve quality of care and health outcomes for patients and families …. improving patient outcomes and value for money

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7 Patients’ First lays out an ambitious transformation agenda for the Ontario healthcare system …more innovative approaches based on evidence Our choices must be rooted in evidence and patient experience …. making decisions based on value and quality, to sustain the system for generations to come

Mobilizing Knowledge in a Complex World 8

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10 Mobilizing Knowledge: The Power of Systems Structures Processes Tools

The Importance of Organizational Practices 11 Toronto Skyline | by tsaiproject

Patient Journey Patient ED Acute In- Patient In-Patient Rehab Primary Care Physician Specialist Independent Health Facility Long- Term Care Home (Home Care) Tests Out- Patient Tests 1 to 3 years

13 Mobilizing Knowledge: The Power of Systems Attitudes and Beliefs Self Efficacy Social Norms

14 CULTURE ORGANIZATIONAL MINDSET

Mobilizing Knowledge: It Takes a System 15 A multitude of people are involved in the uptake of an innovative idea. Success requires an organizational approach to knowledge mobilization. Source: Greenhalgh, T. (2004). How to Spread Good Ideas: A systematic review of the literature on diffusion, dissemination and sustainability of innovations in health service delivery and organisation. The Innovation The Individual The Organization The Environment The Implementation Process

MOHLTC Knowledge Mobilization Structures 16 Health System Information Management Division Information Management, Data, and Analytics Health Data Branch Health Analytics Branch Information Management Strategy and Policy Strategic Policy and Planning Division Research, Analysis, and Evaluation Branch Evidence Synthesis Unit Research, Planning, and Management Unit Economic Analysis and Evaluation Unit Mission 1.Collect data and make it available. 2.Make data actionable. 3.Establish an IM and privacy framework. Mission Provide research, analysis, and evaluation services and expertise to enable evidence- based policy in alignment with ministry priorities.

PROCESSES 17

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19 Examining how every government dollar is spent Evidence …. better choices … improve outcomes ….. best way to deliver services.… transform programs and achieve savings Centre of Excellence for Evidence-Based Decision Making this work will be supported by the

TOOLS 20

OPS Framework: Evidence-Based Decision Making 21 Source: Treasury Board Secretariat. (2016). Putting Outcomes First: A Roadmap for Evidence-Based Decision Making in the OPS. The framework is a practical roadmap that embeds the core elements of evidence-based decision making into the work of government.

TBS Knowledge Mobilization Tools 22 The Treasury Board Secretariat’s CoE has tools for each phase of the Framework for Evidence-Based Decision Making. Jurisdictional reviews Literature reviews Meta-analysis Program evaluation Enterprise risk management Logic model/map Performance measurement Program evaluation Counterfactual analysis Baseline analysis Jurisdictional review Literature review Meta-analysis Financial analysis Impact analysis Sensitivity analysis Market assessment Logic model/map Performance measurement Project plan Market assessment Financial analysis Program evaluation Counterfactual analysis Baseline analysis Logic model/map Financial analysis

MOHLTC Data/Analytics Knowledge Mobilization Tools 23 Use self- serve tools Intellihealth Health Data Branch Portal Template reports Produce actionable information IMDA Health Analytics Health Data IMSP Custom analysis tools

MOHLTC Evidence Knowledge Mobilization Tools 24 Research, Analysis, and Evaluation Branch Applied Health Research Questions (AHRQs) AHRQs are research questions posed by health-system policy makers or providers to researchers. Training on Research Evidence Facilitated training sessions on finding, understanding and using research evidence. These training sessions are run by Dr. John Lavis at McMaster University. Research to Policy (R2P) Dialogues and KT Roundtables Designed to bring researchers and decision-makers together.

Health Quality Ontario Quality Standards (Guidance) Quality Improvement (Capacity) Quality Improvement Plans (Tools) Adopting Research to Improve Care (Structures)

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THANK YOU 27