Translation of Knowledge into Better Quality Care

1. Translation of Knowledge into Better Quality Care Learning from the NIHR CLAHRC for South Yorkshire Kate Gerrish & Andrew Booth kate.gerrish@sheffield.ac.uk

2. Outline Knowledge into action: everybody’s business!

3. Doncaster Barnsley Sheffield Rotherham NIHR Collaboration for Leadership in Applied Health Research and Care for South Yorkshire (CLAHRC)

4. Translating knowledge into action

5. Principles

6. Knowledge translation

8. Clinically focused KT projects

9. KT projects focused on service delivery

10. KT projects focused on theory development

11. Translating knowledge into action Implementing evidence on the prevention of hospital acquired venous thrombo-embolism

12. Aims

13. Approach

14. Knowledge Inquiry TailoringKnowledge Synthesis Products/ Tools Monitor Knowledge Use Select, Tailor, Implement Interventions Evaluate Outcomes KNOWLEDGE CREATION Assess Barriers/ Supports to Knowledge Use Sustain Knowledge Use Adapt Knowledge to Local Context Identify Problem Identify, Review, Select Knowledge ACTION CYCLE APPLICATION Knowledge to Action Graham et al 2006

15. Knowledge creation Primary research Knowledge Inquiry Systematic reviews risk assessment & prevention of VTE Exemplar sites Knowledge synthesis Tailoring knowledge Knowledge tools / products NICE guidance NICE Quality Standards Risk assessment tools Patient information

16. Multi-level problem identification Understand macro, meso, micro context Ensure ownership of need for change at different levels of the organisation Ongoing audit to monitor sustainability Roll out of interventions and disseminate learning Appraise national screening tool, patient information Review guidelines Develop local policy Phased withdrawal of facilitation Action research approach Collect baseline data observation, audit Measure patient & staff outcomes Evaluate intervention / implementation strategies Survey knowledge, risk assessment / prevention VTE Feedback baseline data to ward teams Repeat baseline data collection Feedback from best practice champion, clinical staff and patient representatives via Project Steering Group Develop interventions and tailor to local context. Facilitate implementation of interventions in collaboration with front-line staff Modify interventions in response to changes in local context

17. Outcomes

18. Challenges

19. Knowledge Into Action: Everybody’s Business! Andrew Booth

20. Take Home Points

21. The Knowledge Supply Chain Information Evidence Knowledge

22. The Knowledge Supply Chain Information Brokerage roles Evidence Knowledge Brokerage roles Brokerage roles Increasing Importance of Context

23. Q. Who are the Knowledge Brokers?

25. What is the Knowledge? * e.g. Professor Huw Davies; Professor Ian Graham

26. Some Examples

27. Achievements

28. 150 Google Scholar Citations

30. Knowledge Throughout Action

31. Building on Existing Skills

32. A Brief Note on Sources

33. Take Home Points - Recap

35. Conclusions

36. Conclusions • Implementation in the real world is complex and messy • We need to be able to deal with unpredictability, be able to adapt and cope with complexity • Knowledge brokering, leadership and collaboration, tools and techniques help handle this complexity

37. Contacts Kate Gerrish: kate.gerrish@sheffield.ac.uk Andrew Booth: A.booth@sheffield.ac.uk This presentation presents independent research by the Collaboration for Leadership in Applied Health Research and Care for South Yorkshire (NIHR CLAHRC SY). The views and opinions expressed are those of the authors, and not necessarily those of the NHS, the NIHR or the Department of Health. CLAHRC SY would also like to acknowledge the participation and resources of our partner organisations. Further details can be found at www.clahrc-sy.nihr.ac.uk.