From knowledge translation theory to practice: developing an evidence to care hub in a pediatric rehabilitation setting

Abstract

Purpose: Ensuring evidence-informed care happens systematically and consistently is not easy in complex health facilities. This paper describes the evolution of knowledge translation infrastructure (Evidence to Care) within a pediatric rehabilitation hospital to address barriers to evidence-informed decision-making and accelerate research uptake to influence clinical care.

Methods: Development of Evidence to Care involved a series of steps integrating knowledge translation principles, best evidence and stakeholder needs. Key aspects included: recognizing health system drivers and organizational enablers; establishing organizational structures and processes; building and operationalizing a strategic vision through activities and demonstration projects; and evaluating impact.

Results: By way of a fully realized working model, two large-scale demonstration projects aligned with the Knowledge-to-Action Cycle have been completed. Audit findings demonstrate tangible examples of improving healthcare quality through investment in knowledge translation resources, processes and tailored evidence products. Critical enablers of this infrastructure include strong leadership commitment and ongoing direction, a dedicated expert team, alignment with strategic priorities and situated within organizational structures to link research, clinical care and education.

Conclusions: With a replicable model, Evidence to Care addresses established health system barriers related to time, resources, skill and knowledge through dedicated knowledge translation specialists and knowledge brokers to facilitate knowledge translation practice.

Implications for rehabilitation

• Developing dedicated knowledge translation infrastructure is both novel and relatively new in healthcare.

• Sharing step by step processes helps other organizations learn from field-tested experiences of what works and what doesn’t in a particular setting.

• Involving stakeholders at all levels of an organization is key to valuing knowledge translation and fostering an evidence-friendly culture.

• Co-creating tailored knowledge products and planning for dissemination and uptake fosters inter-disciplinary collaboration and joint problem-solving among clients, families and providers.

Keywords:

• Evidence-informed decision making
• child health services
• knowledge mobilization

Acknowledgements

The authors would like to acknowledge the contributions of the Evidence to Care Steering Committee, with special recognition of Sheila Jarvis, Sonya Corkum, Dr. Tom Chau, Dr. Virginia Wright and Dr. Colin Macarthur for their guidance in shaping the vision for Evidence to Care. We also thank current and former members of the Evidence to Care team with special recognition of Christine Provvidenza, Ashleigh Townley, Julia Schippke and Hilary Edelstein for their contributions. Finally, we are indebted to our clients and families, as well as research and clinical partners who ensure these efforts will make a difference.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Funding for Evidence to Care is provided by the Holland Bloorview Kids Rehabilitation Hospital Foundation. Supplementary funding for demonstration projects was also provided by the Government of Ontario and the American Academy of Cerebral Palsy and Developmental Medicine