You Can Do This! Bringing Evidence Based Practice into the Workplace

1. You Can Do This! Bringing Evidence Based Practice into the Workplace Sheila Kennedy and Kellie Duckworth Wednesday September 10, 2014 at noon BCTRA Webinar

2. Learning objectives • FLW: Upon the completion of the session the participants will be able to define and understand the role of ‘Knowledge Broker’ • ADV: Upon the completion of the session the participants will be able to identify three resources available to support evidence based practice. • ADV: Upon the completion of the session the participants will be able to develop an action plan to bring evidence based practice to their workplace.

3. What to expect • Context of our talk • History of our journey thus far • Lessons learned • Where we are now • Role of the Knowledge Broker • Our next steps • Resources to share • Applying evidence at your workplace

4. A little context • Sunny Hill Health Centre is a provincial facility, part of BC Children’s Hospital, but on a different site in east Vancouver • We see children/youth with disabilities and their families from across the province • Therapeutic Recreation has been part of the provision of inpatient, outpatient and outreach services for more than 30 years – services are currently shifting

5. Some history • Became increasingly evident that we needed to have measurable outcomes and proof that we were using the best evidence available to back up what we were doing in TR • Drivers propelling us forward included: a) budget constraints, focus on best value b) shift from interdisciplinary to interprofessional collaboration

6. A little more history c) models of rehabilitation being reviewed and “core therapies” being identified d) looking at “best standard of care” in specific situations within the organization e) outside influences – govt priorities, policies • The Department began looking for help both within and outside the organization

7. Last bit of history • Looked to Douglas College’s TR Program to provide increased focus on research in their curriculum – encouraged these changes as a member of the Advisory Board and 2 staff have taken research courses to upgrade • Found some “champions” in other staff within the organization (PT/OT based) willing to assist us in new learning, how to move forward

8. Lessons learned • Enlist Support Wherever You Can Get It! (Physicians, Other Therapists, Families, Students) • Look for ways to increase the team’s skills, self-confidence, and visibility (learn how to do a professional poster, encourage public speaking opportunities) • Engage a motivated leader – “Knowledge Broker”

9. More lessons • Doing it “on your own” will be unsuccessful (the group needs to be involved in annual goal setting, in-services, reviewing articles, learning from and supporting each other) • Support from all levels of the organization is crucial • Start small with a methodical approach, use regular set time to review progress

10. Where are we now? • Developing a portfolio of evidence with our program protocols to help support some of the recreation activities we regularly use with clients • One staff member has now been through the rigorous ethics approval process in the organization and is in the process of completing a formal research project with the support of both Sunny Hill and Douglas College

11. Where are we now? • We’re certainly not there yet! • Have made EBP an ongoing priority within the Department • Continue to struggle with “dedicated time” issue (although there has been some progress) • Education funding requests being more closely examined to ensure opportunities are evidence-based

12. Where are we now? • Have significantly increased our presence in various public speaking opportunities and in outreach visits throughout the province • Have 2 certified staff (with another upcoming), have internship students help us with finding and using the evidence • all “service learning” requests relate to EBP • Monthly prof. practice meeting specific to EBP

13. Evidence Based Practice Evidence Client’s Perspective Research Clinical Experience

14. Knowledge Broker • Helps to facilitate evidence based practice • A capacity builder who improves access to evidence and empowers colleagues to use relevant evidence • Leads in the development of strategies and tools to improve the efficiency and ease by which department colleagues can access, appraise and apply pertinent quality evidence to practice with the ultimate goal of improving TR service delivery for clients.

15. Competencies of a Knowledge Broker • Four basic competencies • Staying Current • Needs assessment • Facilitating EBP • Evaluating EBP http://www.childdevelopment.ca/Libraries/Knowledge_Brokering_webpage_resources/KB_Competency_Self-Evaluation.sflb.ashx

16. What we’ve done…our steps • Developing an understanding of the role • Needs assessment • Group learning • Annual Department Goals • Staff Meetings • Annual Calendar

17. What we’ve done…our steps continued • Students • Ipads • TR Research Network • Evidence based folder • Research project(s)

18. Where we’re headed……… • Students • Find partners –CFRI, Douglas College • Research project • Learning opportunities • Capacity building • Presentations • Networking

19. Web resources • Child Development & Rehabilitation • http://www.ktdrr.org/ktlibrary/articles_pubs/ktmodels/ktintro.pdf @SunnyHill_Evid

20. Group Activity/Discussion How can you apply evidence based practice in your workplace?

21. Resources • http://www.childdevelopment.ca/Home.aspx • http://www.ktdrr.org/ktlibrary/articles_pubs/ktmodels/ktintro.pdf • Atherton, C., Barratt, M. & Hodson, R. ((2005). Teamwise using research evidence a practical guide to teams. www.rip.org.uk/teams • Glasziou, P., Del Mar, C., & Salisbury, J. (2003). Evidence-based practice workbook. 2nd Ed. Malden: BMJ Books. • Glegg, S. (2010) Knowledge brokering as an intervention in paediatric rehabilitation practice. International Journal of Therapy and Rehabilitation. 7(4):203-211. • Hodson, R. & Cooke, E. (2007). Leading evidence-informed practice a handbook. www.rip.org.uk • O’Donnell, M.E. & Roxborough, L. (2002) Evidence-based practice in pediatric rehabilitation. Physical Medicine and Rehabilitation Clinics of North America 13, 991-1005

22. Resources Continued….. • Schon, D.A. (1983). The reflective practitioner: how professionals think in action. New York: Basic Books. • Stumbo, N.J. & Wardlow, Brad. (2011). Facilitation of therapeutic recreation services: an evidence-based and best practice approach to techniques and processes. State College. Venture Publishing Inc. • Wenger, E. (1998). Communities of practice: learning, meaning, and identity. New York: Cambridge University Press. • Wenger, E., McDermott, R., & Snyder, W.M. (2002) Cultivating communities of practice a guide to managing knowledge. Boston: Harvard Business School Press.

23. Thank you! Questions? skennedy@cw.bc.ca kduckworth@cw.bc.ca