Background Middle Managers (MMs) are thought to play a pivotal role as knowledge brokers (KBs) in healthcare organizations. However, the role of MMs who function as KBs (MM KBs) in health care is under-studied. Research is needed that contributes to our understanding of how MMs broker knowledge in health care and what factors influence their KB efforts. Methods We used a critical interpretive synthesis (CIS) approach to review both qualitative and quantitative studies to develop an organizing framework of how MMs enact the KB role in health care. We used compass questions to create a search strategy and electronic searches were conducted in MEDLINE, CINAHL, Social Sciences Abstracts, ABI/INFORM, EMBASE, PubMed, PsycINFO, ERIC and the Cochrane Library. Searching, sampling, and data analysis was an iterative process, using constant comparison, to synthesize the results. Results We included 41 articles (38 empirical studies and 3 conceptual papers) that met the eligibility criteria. No existing review was found on this topic. A synthesis of the studies revealed 12 MM KB roles and 63 associated activities beyond existing roles hypothesized by extant theory, and we elaborate on two MM KB roles: 1) convincing others of the need for, and benefit of an innovation or evidence-based practice; and 2) functioning as a strategic influencer. We identified organizational and individual factors that may influence the efforts of MM KBs in healthcare organizations. Additionally, we found that the MM KB role was associated with enhanced provider knowledge, and skills, as well as improved organizational outcomes. Conclusion Our findings suggest that MMs do enact KB roles in healthcare settings to implement innovations and practice change. Our organizing framework offers a novel conceptualization of MM KBs that advances understanding of the emerging KB role that MMs play in healthcare organizations. In addition to roles, this study contributes to the extant literature by revealing factors that may influence the efforts and impacts of MM KBs in healthcare organizations. Future studies are required to refine and strengthen this framework. Trial registration A protocol for this review was not registered.

Background Knowledge brokers (KB) are increasingly being employed in health care to implement evidence‐based practice and improve quality of care. Middle managers (MMs) may play a KB role in the implementation of an innovative or evidence‐based practice in hospitals. However, how MMs' broker knowledge in hospitals and their impact on practice has not been adequately studied. Aim To describe the role that MMs play in brokering knowledge in hospitals and their impact. Method A qualitative descriptive study was conducted to generate a detailed description of MM experiences as KBs in hospitals. Data were collected using semi‐structured telephone interviews with MMs in Ontario, Canada. Participants were purposively sampled to ensure variation in MM characteristics and a diverse representation of perspectives. Data were collected and analyzed concurrently using an inductive constant comparative approach. Results Twenty‐one MMs from teaching and non‐teaching hospitals participated. MMs described 10 roles and activities they enacted in hospitals that aligned with published KB roles. We found differences across professional groups and hospital type. Teaching status emerged as a potential factor relating to how MM KBs were able to function within hospitals. MMs reported enhanced patient, provider, and organizational outcomes. Linking Evidence to Action Middle managers may play an important KB role in the implementation of evidence‐based practice in hospitals. An improved understanding of the KB roles that MMs play may be important in boosting evidence base practice in health care to ultimately improve quality of care. Administrators need a better understanding of the current KB roles and activities MMs enact as this may lead to more organizational structures to support MM KBs in health care.

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Background: Although interprofessional education (IPE) is not new, there has been limited research in IPE focused on the care of older adults. The objective of this study was to develop and implement an interprofessional education and care (IPE/C) toolkit, to help staff and students understand and apply the concepts of IPE/C.Methods and Findings: Focus groups identified staff and students’ understanding of IPE/C and informed development of an IPE/C toolkit comprised of IPE/C tools and resources. Five clinical teams (N = 51) attended workshops that introduced the toolkit and educated teams about IPE/C. Focus group participants had heard of but had limited exposure to IPE/C. Responses to the Attitudes Toward Health Care Teams (ATHT) questionnaire indicated a positive trend on all questions; 2 questions in subscale 1 were statistically significant (p = .01 & p = .005), indicating a positive attitude toward teams and teamwork. Several limitations were identified, including inconsistent attendance at workshops, scheduling challenges, and limited physician participation.Conclusions: This pilot project provided baseline data on staff and students’ understanding of and attitudes toward IPE/C in a multilevel geriatric centre and demonstrated that an IPE/C toolkit delivered via team workshops can enhance healthcare team attitudes. Next steps include expanding the rollout to other teams and introducing the toolkit to all staff and students.

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