From Knowledge to Practice: Improving Dementia Care & Services in BC LEARNING FORUM

1. From Knowledge to Practice:Improving Dementia Care & Services in BCLEARNING FORUM September 25 & 26, 2008

2. Thursday, September 25

3. PROGRAM DAY ONE: Thursday, September 25

4. Before we begin… • Housekeeping • Speaker’s Corner • Grant Storyboards & Passports • Evaluation

5. Welcome from the Alzheimer Society of BC Rosemary Rawnsley, Executive Director Dr. Lynne Beattie, Forum Chair

6. VISION:  “People living with dementia will lead full lives, through a shared passion for action by all stakeholders”

8. Moving Dementia Understanding and Management Forward in BC • What are we doing that is right? • What are we doing that is wrong? • We need the wisdom to know that difference • And the knowledge to do it better

9. Many BC Initiatives for Practice • Dementia Framework • Dementia Guidelines • Dementia Care Mapping • Geriatric Referral • Mental Health Teams • + New Community Service • Education Priorities

10. And Research • Alzheimer Clinic • Brain Research Centre • BCNAR • Pacific Alzheimer Research Foundation (PARF) • Alzheimer Society of Canada Research program supported by all the provinces • CIHR

11. And the ASBC Initiative • 7 Provincial projects • Critical is evaluation of outcome & • Overall goal is to improve the quality of life of those with dementia and their caregivers

12. Did you Know? The stripe pattern on every zebra is different? • Every dementia person is different, every caregiver is different, every situation is different • And changes with time…

13. Challenges for All • We must continuously develop strategies that meet the needs of individuals and modify them often • Let’s learn from each other in the next day and a half! • We can do better and better!

15. Welcome from the Ministry of Health Services Val Tregillus, Executive Director Primary Health Care

16. Are you ready for action?An Introduction to Knowledge Mobilization Peter Levesque Knowledge Mobilization Works

17. Thank you Barbara Lindsay For the invitation Penny Lane For the guidance and conversations Sylvia Lee For keeping me on track Many colleagues on the phone For teaching me more about Alzheimer’s Et a vous tous! (To all of you!) For the energy, knowledge, and wisdom you bring.

18. Technology Exercise Two Groundbreaking Technologies Paper Pen During the Institute 3 Names 3 Ideas 3 Projects

19. You are Professionals! Some of Your Tools: Data Information Evidence Knowledge Experience Experimentation Standards Ethics Practice Technology

20. Professional Revolution Knowledge Management Knowledge Transfer Knowledge Exchange Knowledge Mobilization Knowledge Translation Evidence-based practice Evidence-based decision-making Evidence-informed policy Evidence-informed practice

21. But what is the goal? To do the best for those we care about

22. We are really talking about LOVE

23. If we love? In some ways we remain Amateurs [French, from Latin amātor, lover, from amāre, to love.] Thus, we need feedback from each other to balance our specializations with our needs and gaps.

24. The Future of Organizations? The typical large business 20 years hence …will bear little resemblance to the typical manufacturing company, circa 1950…it is far more likely to resemble organizations (like) the hospital, the university, the symphony orchestra…an organization composed largely of specialists who direct and discipline their own performance through organized feedback Peter Drucker, Harvard Business Review, The Coming of the New Organization, 1988.

25. Important Ideas Utility Value Emergence Complexity Social relationships Community Ideals Pragmatism Motivations Infrastructure Management Exploitation Leadership Intelligence Change Power

26. Hunting and Gathering Never in human history have we hunted for so much data, information and knowledge. Never in human history have we gathered so much that is useful but not used. Growing feeling of being “overfed” with information? Are we suffering from data obesity? What are the effects of this: slower organizations, poor sharing, lower morale, lost experience, poorer outcomes.

27. Publish or PerishNew Yorker: Mischa Richter 1966

28. Plain languageNew Yorker: Dana Fradon 1975

29. Use of evidenceNew Yorker: Mick Stevens 1989

30. ImpactNew Yorker: Sam Gross 1991

31. AccessNew Yorker: John Caldwell 2000

32. Richard Heinberg Taking in traumatic information and transmuting it into life-affirming action may turn out to be the most advanced and meaningful spiritual practice of our time. http://globalpublicmedia.com/how_do_you_like_the_collapse_so_far

33. Knowledge Mobilization as a Human Right? 10 December 1948, UN Universal Declaration of Human Rights Article 27. Everyone has the right freely to participate in the cultural life of the community, to enjoy the arts and to share in scientific advancement and its benefits. http://www.un.org/Overview/rights.html

34. KnowledgeMobilization A commonly cited definition: Getting the right information to the right people in the right format at the right time so as to influence decision-making. Easier said than done. How do we support doing this? What is a knowledge mobilization culture?

35. Shorthand Definitions Two definitions I use as reminders: Mobilize: to make ready for service or action Knowledge Mobilization: making what we know ready for service or action

36. Many emerging terms Graham ID et al. 2006. “Lost in Knowledge Translation: Time for a Map?” Journal of Continuing Education in the Health Professions; 26(1): 13-24.

37. CIHR - Knowledge Translation Knowledge translation is the exchange, synthesis and ethically-sound application of knowledge - within a complex system of interactions among researchers and users - to accelerate the capture of the benefits of research for Canadians through improved health, more effective services and products, and a strengthened health care system http://www.cihr-irsc.gc.ca/e/26574.html#defining

38. So…what do we mean by Knowledge? Hierarchy of Knowledge, Dave Sackett: Systematic reviews/ meta-analyses RCTs Experimental designs Cohort control studies Case-control studies Consensus conference Expert opinion Observational study Other types of study eg. Interview based, local audit Quasi-experimental, qualitative design Personal communication

39. This Hierarchy is Paradoxical We engage first in personal communication. How to we get the most credible forms of knowledge into our day to day conversations We are more connected than ever before but are we more connectable? It’s mostly about people – not technology - suggested formula is 10% technology/90% social (CEFRIO)

40. KMb practice to avoid! www.knowledgemobilization.net

41. Dissemination Scattering of seeds Spread widely How do we prepare the soil to receive the seeds? How do we nurture the growth of these seeds? What does the harvest look like? What happens in the marketplace?

42. KMb practice to avoid! www.knowledgemobilization.net

43. Accessibility Access Physical Increasing access to findings published in Journals, on-line, open access, systematic reviews Conceptual What does this mean for my practice, location, context, culture

44. KMb practice to avoid! www.knowledgemobilization.net

45. Systems need Diversity The challenge with herding cats is that the cats may have interests that are non-standard. How to support BOTH the utilization of standards and the exploration of the new? Managing for diversity provides the potential for resilience to learn from failure.

46. KMb practice perhaps? www.knowledgemobilization.net

47. Systems Diversity: Networks How to link together your daily functional networks so that you have better access - both physical and conceptual - to the growing neural network across the World? http://www.cheswick.com/ches/map/gallery/wired.gif

48. KMb: Basic Methods Réjean Landry, of l’Université Laval, has shown that the greatest value from knowledge mobilization happens when we LINK and EXCHANGE. Yet most KMb activities are still based on PUSH and PULL.

49. Links A network is a set of interconnected nodes. Networks are a very old form of human practice, but they have taken on a new life in our time by becoming information networks, powered by the Internet. Manuel Castells, The Internet Galaxy, 2001 The network is the pervasive organizational image of the new millennium. Janice Gross Stein and Richard Stren, Knowledge Networks in Global Society: Pathways to Development in Networks of Knowledge, 2001

50. Network Images: Collaboration of Physicists http://www-personal.umich.edu/~mejn/networks/collab.gif