Knowledge Brokering Comes to Sick Kids

1. Knowledge Brokering Comes to Sick Kids CHSRF Knowledge Brokering Workshop October 24th, 2005 Melanie Barwick, Ph.D., C.Psych. Health Systems Scientist, Community Health Systems Resource Group Associate Scientist, Population Health Sciences Assistant Professor, Psychiatry, Public Health Sciences, University of Toronto

2. Pediatric healthcare centres will be called upon to demonstrate that they are efficient producers of new knowledge and that they can apply and transfer that knowledge effectively to improve the health and well-being of children, contribute to research that is relevant to real-world issues, and inform policy and decision-making. The Commonwealth Fund Task Force on Academic Health Centers (2003)

3. Knowledge Translation and Our Mission The Hospital for Sick Children will create, evaluate, apply and disseminate knowledge to improve the health of children. We will lead in providing exemplary family-centered care, innovation and discovery, focusing on those areas in which we can make the greatest contribution. Collaborating with others, we will become one of the best pediatric academic health science centre in the world.

4. Our Knowledge Role "Sick Kids' most important product is knowledge. We generate knowledge when we do research, we apply it when we treat children and we disseminate it when we teach others. Our greatest future potential, where we will see the greatest return on investment, depends on our ability – through research, education and advocacy – to influence child health outcomes outside our walls, in Canada and around the world" (Hospital for Sick Children Trustee)

5. Population Health Sciences Program Population Health Sciences (PHS) is the largest and most diverse research program in The Hospital for Sick Children Research Institute. The members of PHS study the characteristics of health and disease in children, with an emphasis on the determinants of health. Methods used include a broad range of qualitative and quantitative science methods. The program also evaluates the health outcomes and cost-effectiveness of hospital and community programs and interventions.

6. Knowledge Brokering in Pediatric Healthcare Research: From Science, To Linkage, To Impact Our team will evaluate the impact of our knowledge brokering (KB) and knowledge translation (KT) activities in transferring our research knowledge to those who are poised to change practice and policy and improve the health of children. No other paediatric healthcare centre has taken on a similar challenge. Canadian Health Services Research Foundation 2004-2007

7. Project Team Research Team Dr. Melanie Barwick, Principal Investigator, Sick Kids Dr. Donna Lockett, Knowledge Broker, Sick Kids Dr. Teresa To, Program Head Population Health Sciences Program, Sick Kids Ms. Dale Butterill MSW, MPA, Manager, Knowledge Transfer, Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health Ms. Elaine Orrbine, CEO Canadian Association of Pediatric Health Centers (CAPHC) Ms. Laura Greer, Manager Public Affairs, Research Institute, Sick Kids Ms. Allyson Hewitt, Executive Director, Safe Kids Canada Members at Large Ms. Adrienne Einarson, Assistant Director, Motherisk Clinic, Sick Kids Dr. Beverley Antle, Academic & Clinical Specialist and Director of the PKU Program, Social Work, Sick Kids Dr. Gail McVey, Psychologist, Community Health Systems Resource Group, Sick Kids Dr. Alice Charach, Staff Psychiatrist, Psychiatry, Sick Kids Dr. Lillian Sung, Staff Physician, Haematology / Oncology, Sick Kids

8. Knowledge Brokering in Paediatric Healthcare Research Two aims: • Building knowledge transfer competencies (i.e., skills, knowledge) among health scientists, and • Building exchange opportunities between scientists and decision-makers.

9. Relative Advantage of Knowledge Transfer for Scientists: To ensure research actually has an impact on child health Increasingly, funders and academic institutions will require it Ultimately, the participation required with partners and stakeholders will strengthen the relevance of research for children To distinguish Sick Kids as a leader in knowledge translation for paediatric health and mental health

10. First Ever Knowledge Broker Hired at Sick Kids!

11. Enhance KTE competencies Build exchange opportunities Objectives KTE Skill Building KTE Linkage & Exchange Components Interviews & Surveys Communications training Off-line support RTTP Training Activities Linkage & Exchange Target groups Sick Kids Directors PHS Scientists Policy & Decision-Makers • Interviews/surveys: # completed. • Off-line support: # requests; time devoted; description of activity; follow-up action. • Communication training: # training sessions, # participants, participant evaluation, • Scientist KT Training (RTTP): #workshops, content of workshops, # of participants, evaluation of training. • Formal Linkage and exchange workshops: # workshops; # policy & decision-makers; # PHS scientists, # research partnerships developed; participant evaluations. Outputs • Improved use of KTE strategies and knowledge among PHS scientists (PHS survey, RTTP evaluation) • Improved attitudes and knowledge of KT among scientists (PHS survey, RTTP) • Increase in scientist-decision maker collaborations (PHS survey) • Increase in KTE activities KTE plans in research proposals (PHS survey) • Increased support for scientists’ KTE activities from management (Management survey/interviews) Short-term outcomes • Sustainability of KB position within Sickkids (investment and leadership support by management) • Growth of KTE activities within PHS Program and transfer/uptake to other Research Institute programs • Partnership with CAPHC and the NCYHC to develop multi-site replications, with financial, leadership and in-kind supports from CAPHC. Med-term outcomes Long-term outcomes • National dissemination and implementation support for Sick Kids’ Pediatric Healthcare Center KB/KT Program with support (financial, leadership, in-kind) from CAPHC and NCYHC.

12. Ultimately, knowledge translation within healthcare requires that we demonstrate how our research directly affects patient outcomes and influences clinical practice. We need systems in place to track and report impact. A model used by the Agency for Healthcare Research and Quality proposes how this can be operationalized. Measuring Impact

13. Impact on Health Outcomes (Level 4) costs, wait time, morbidity & mortality Stryer et al 2000 None at this time • Impact on • Clinical Practice • (Level 3) • how our research changes what clinicians or patients do; changes in a pattern of healthcare. KTE activities among scientists that lead to change in practice and/or consumer behaviour Impact on Health Practices (Level 2) requires demonstrating the impact of research on the creation of policies and / or programs in health, and other sectors including education and mental health Impact of KTE activities on policies and/or programs reported by decision/makers and within hospital management Impact on Healthcare Knowledge Base and Future Research (Level 1) includes innovations around tools and methods of research, instruments, and techniques to assist in clinical decision-making, and studies that identify areas in which scientific knowledge is needed but absent. New research collaborations developed through Liaison Program and other brokering opportunities that focus on real world issues

14. Accomplishments to Date • Baseline survey – Year 1 • SickKids Knowledge Transfer Training for Scientists– Year 1 • Communications Training – Year 1 • Liaison Program – Year 1

19. In the end, the number of grants we get, the number of research studies we do or the proliferation of publications produced matters little to children if they do not improve practice. What we really want to get at is not how much research we have done, but how many children’s lives are improved as a result of what we have accomplished. SickKids can develop a user-driven or child-centered research agenda that is focused on making research discoveries for the people who need information to make better and informed decisions about children’s healthcare. Barwick, 2003 SickKids White Paper, Development of a Knowledge Translation Strategy for Population Health Sciences

20. Excellence in research is laudable, but unless we can impact child health, it presents an incomplete effort.