From Evidence to Action: Addressing Challenges to Knowledge Translation in RHAs The Need to Know Team Meeting May 30, 2005

2 The Need to Know Project: Levels of impact Personal learning – All partners “How I do my job” – All partners How RHAs make decisions – Less evidence Provincial networks – Expectations, how business conducted National impact – “CIHR model program” – National consultations

3 Challenges identified through evaluation Organizational vs. Individual “capacity building” – N.B. to RHA Team Members 1 or 2 people from each RHA Focus on workshops vs. RHA activity Limited change in RHA decision – making “We need to build organizational capacity, not just one person” Sustainability – Dependent on relationships? – Funding

4 Organizational barriers identified Failure to institutionalize NTK activities – Lack of formal reporting requirements – Little communication initiated by CEOs Time constraints, work demands of staff – Not protected time Organizational priorities – “there is always time for the important things” Lack of awareness/skills – Importance of research, benefits

5 Organizational barriers, con’t Organizational Culture – Crises bump research off the agenda Leadership commitment to change – I’m not sure there is the will to change – (EBDM is) more rhetoric – I’m not sure people want to change Structural barriers to communication – I’m not allowed to talk to the Board, and the CEO chose not to invite them Larger political context

6 Response: “From Evidence to Action” Proposal to CIHR (KT) – submitted May 2004, accepted Feb Purpose: identify and develop strategies to address organizational barriers to EB planning and decision-making within RHAs Participants: All RHAs (including WRHA) + MCHP Timeline: 3 years

7 Key Activities – Interviews & focus groups – Development & application of organizational assessment instrument – Identification and piloting interventions to address barriers Builds on NTK project – Team meetings – RHA Team members as “KT experts” BUT separate from it (objectives, activities, participants, funding) Specifics

8 Key points Focus: Organizational planning & decision making Methodology: Qualitative, collaborative – Input from RHA team at all stages (planning, implementation, evaluation) – Project will adapt to issues emerging Participants: RHA Board, Executive, Staff Location of activities: In RHAs vs. Team Meetings

9 Objectives Develop collaboratively designed tool Apply tool in all MB RHAs Evaluate effectiveness of tool – RHAs of varying characteristics Collaboratively develop & implement strategies to address identified barriers Assess effectiveness of strategies Produce user friendly resources

10 Research questions What are the greatest barriers to increased use of research in planning? – Are barriers similar across RHAs? – What RHA characteristics are associated with specific barriers? – Which barriers require the participation of other stakeholders? What are strengths and weaknesses of RHAs in addressing these barriers? – Are there differences based on size, structure, leadership, resource availability, remoteness?

11 Does a collaborative approach result in unique characteristics of an assessment tool? – Does it promote acceptance of assessment results, and willingness to engage in strategies to address identified barriers? – Is it feasible to develop one tool that is appropriate for RHAs with diverse characteristics? What strategies are proposed by RHA decision- makers? – What similarities and differences are found between urban/rural/remote, and large, medium and small RHAs? – Does linkage with other RHAs with similar challenges assist in developing effective strategies for addressing identified barriers? What strategies are most effective in a) increasing awareness & commitment to research utilization? b) addressing specific planning issues facing RHAs? What difficulties are found in implementing these strategies?

12 Expected outcomes Understanding of barriers/solutions from perspective of RHAs themselves Assessment instrument developed in collaboration with RHAs Similarities and differences – RHAs with varying characteristics – E.g., size, organizational structure, leadership characteristics User friendly resources

13 Comparison – The Need to Know & From Evidence to Action Similarities Collaborative, community – university partnership CIHR KT funding Key role of RHA Need to Know team members Response to issue identified by regions Differences Includes WRHA, not MB Health Practical focus on barriers to use of research in RHAs Key activities take place in regions Greater role for RHA board & management

14 Opportunities and Challenges Opportunities Issue identified by Team Members “Cutting edge” of KT research Opportunities for organizational growth Further opportunities for networking, MB leadership, high profile project But… Organizational change always painful Varying support, readiness among RHAs? Need to convince RHA leadership to make time, resources available Demands on NTK team members

15 Activities to date RHAM meeting launch April 14 Staffing Ethics

16 Phases 1. Consultation Phase (months 1-6) 2. Development and Implementation of Assessment Instrument (2-12) 3. Analysis, Feedback and Prioritization of Strategies (8-18) 4. Selection and Implementation of Intervention Strategies (16-30) 5. Evaluation of Interventions (16-34) 6. Institutionalizing Change (32-36) 7. Reporting and Dissemination (18-36)

17 Consultation phase (1) Essential to rest of project Establish framework for consultation and communication, & methods used – Advisory (Working) Group established Communication strategy for each RHA – Visits by research staff to each RHA Project understanding Effective strategies for RHA input Clarification of roles and expectations Ethics/confidentiality

18 Consultation phase (2) Generate assessment by stakeholders of – Perceived NB of EBDM – Regional KT to date – Barriers to EBDM – Suggested indicators of barriers/facilitators – Project evaluation Combined with consultation phase 1? (North) Timed to coincide with Board/Exec meetings Methods: Key informant interviews, discussion at board/exec meetings, focus groups

19 Communication from CEOs?

20 What we need to decide today: Major adaptations, issues that would affect project planning and implementation? – Key events and timelines Advisory Committee – who, T of R? – Role of NTK team Communication plan – recommendations Recommendations re: next steps: – MCHP to do….. – Each Team Member to Do……

21 Questions for Manitoba Health Team What communication should occur within the Ministry? – Communication plan What role do MB Health team members see for themselves in the FEA project? How can MB Health support the project, and its activities?