Translating knowledge into practice
In recent years, there has been increasing interest in translational research, which simply means translating research into practice: ensuring that new treatments and research knowledge actually reach the patients or populations for whom they are intended and implemented correctly (Woolf 2008). There is a plethora of terms for getting research knowledge into practice, including evidence-based practice, research utilization, implementation science and knowledge translation. A glossary is available here.
Although there are subtle differences between each concept, all focus on translating research knowledge into everyday clinical practice to improve the quality and effectiveness of health care. For example, Knowledge translation is defined as:
a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products, and strengthen the health care system. The common element among these different terms is a move beyond the simple dissemination of knowledge into actual use of knowledge (Strauss et al 2009 p165).
Knowledge translation is crucial because research can not change health outcomes unless health care systems, organizations, and individuals use the best available research evidence to inform their decision making and action. Yet the transfer of research findings into practice remains unpredictable and can be a slow and haphazard process (Eccles et al 2009).
Knowledge Translation Case Book: showcasing local exemplars
We are developing a Knowledge Translation Case Book about self care / self management of people with long-term conditions from NHS organisations across South Yorkshire. The Case Book is modelled upon the Canadian Institute of Health Research (CIHR) Knowledge Translation Case Book. This showcases examples of transferring knowledge into practice and highlights the patient and service outcomes from successful knowledge translation.
Our Case Book will contain practical examples that illustrate barriers and facilitators to changing practice, and highlight tangible benefits from embedding research into mainstream health care in South Yorkshire. All the exemplars will be published on our website http://clahrc-sy.nihr.ac.uk/ so that the learning about what facilitates and impedes knowledge translation can be shared more widely.Project Aim
To develop a Case Book that contains a variety of examples of knowledge translation in relation to the self care / self management of long term conditions.
1. Provide a vehicle for CLAHRC partners to share and recognise knowledge translation experiences;
2. Identify how knowledge translation can contribute to patient, staff and organisational outcomes, such as patient safety, staff satisfaction and team working;
3. Provide concrete examples of knowledge translation to use in education, in professional curricula and continuing professional development;
4. Increase interest in knowledge translation (ie encourage knowledge translation activity) among CLAHRC partners by highlighting the impact that health research has had (and therefore can have) in shaping research use across the various levels of decision-making in the health system;
5. Begin to identify barriers, facilitators and other factors related to successful implementation and/or application of health research in various contexts;
6. Document and demonstrate the impact of health research through knowledge translation stories and examples, for the purpose of communication (eg inventory of knowledge translation cases for spokespersons), reporting and evaluation of knowledge translation.
We are working in partnership with each of the NHS organisations (Primary Care Trusts and acute Trusts) that are part of the CLAHRC-SY collaborative, to collect examples of knowledge translation. Each Trust identifies 2-4 well-established innovation / evidence-based practice / clinical governance projects that address the needs of people with long-term conditions. The projects are about:
a. People with long term conditions, covering any age group or diagnosis;
b. Based on high quality research evidence and/or policy priorities and/or clinically-led evaluation /change in practice;
c. Involve the multi-disciplinary team and/or cross primary and secondary care;
d. Knowledge translation activities such as educational interventions, action learning sets, active facilitation by knowledge brokers/opinion leaders, social marketing, audit and feedback, and decision aids such as algorithms, clinical guidelines, care pathways and protocols;
e. An established project with some evidence of impact and outcomes for patients and/or the service and/or the staff.
A reflective conversation is held with the Trust spokesperson for the project. This is to elicit information about i) the context, ii) how knowledge translations activities help to change / improve practice and then iii) the impact and outcomes for service improvement.
After the meeting, an exemplar is prepared for the CLAHRC-SY website. The exemplar is a 800-1,000 word summary with headings about the background, knowledge translation activities and impact. The Trust spokesperson then checks and approves the exemplar before it is published on our website http://clahrc-sy.nihr.ac.uk/
In the future, knowledge translation activities that are undertaken as part of the CLAHRC-SY collaborative will be added to the Case Book The longer-term plan is to publish a report that showcases a variety of exemplars from all the partner organisations and the themes within CLAHRC-SY. This will provide a valuable resource as it will also synthesize key success factors and barriers to translating research into practice.
A Strategic Management Group, comprising representatives from the CLAHRC-SY academic and Trust partners, provides a governance framework for the Knowledge Translation Case Book. This Group is chaired by Professor Kate Gerrish, the lead for the Knowledge into Action Theme.
Dr Irene Ilott is the CLAHRC-SY Project Lead for the Case Book.
For more information, please email: Irene.Ilott@sth.nhs.uk
Eccles MP et al (2009) An implementation research agenda. Implementation Science 4:18 (07 Apr 2009).
Available at http://www.implementationscience.com/
Strauss SE et al (2009) Defining knowledge translation. Canadian Medical Association Journal. 4 August, 165-168.
Woolf S H (2008) The meaning of translational research and why it matters. JAMA, 299, 2, 211. January 2010.