Putting research in place: an innovative approach to providing contextualized evidence synthesis for decision makers

Abstract

BackgroundThe Contextualized Health Research Synthesis Program (CHRSP), developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings.MethodsAs an integrated knowledge translation (KT) method, CHRSP:Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams;Considers local context both in framing the research question and in reporting the findings;Makes economical use of resources by utilizing a limited number of staff;Uses a combination of external and local experts; andWorks quickly by synthesizing high-level systematic review evidence rather than primary studies. Although it was developed in the Canadian province of Newfoundland and Labrador, the CHRSP methodology is adaptable to a variety of settings with distinctive features, such as those in rural, remote, and small-town locations.ResultsCHRSP has published 25 syntheses on priority topics chosen by the provincial healthcare system, including:Clinical and cost-effectiveness: telehealth, rural renal dialysis, point-of-care testing;Community-based health services: helping seniors age in place, supporting seniors with dementia, residential treatment centers for at-risk youth;Healthcare organization/service delivery: reducing acute-care length of stay, promoting flu vaccination among health workers, safe patient handling, age-friendly acute care; andHealth promotion: diabetes prevention, promoting healthy dietary habits. These studies have been used by decision makers to inform local policy and practice decisions.ConclusionsBy asking the health system to identify its own priorities and to participate directly in the research process, CHRSP fully integrates KT among researchers and knowledge users in healthcare in Newfoundland and Labrador. This high level of decision-maker buy-in has resulted in a corresponding level of uptake. CHRSP studies have directly informed a number of policy and practice directions, including the design of youth residential treatment centers, a provincial policy on single-use medical devices, and most recently, the opening of the province’s first Acute Care for the Elderly hospital unit.

Integrated Knowledge Translation with Public Health Policy Makers: A Scoping Review

“…All studies provided reasons for involving KUs (i.e., assumptions about the theoretical merits of iKT), though it was occasionally unclear whether this could be attributed to an iKT approach or to something else (e.g., using community-based participatory research principles). While some introduced the value of KU involvement as a general enhancement to the research process (e.g., multiple perspectives) ( Valaitis et al 2012;Welch et al 2015), others anticipated KUs to assist in research design, such as shaping research questions or deciding research priorities (Bornstein et al 2017;Hayden et al 2015;Kothari et al 2014a;Naqshbandi Hayward et al 2016) and/or informing methods (e.g., intervention content) (Boivin et al 2011;McGrath et al 2009;Wathen et al 2011). Many believed that involving KUs would improve the use of their research (i.e., enhanced relevance and utility of research findings and adaptability to user contexts) and its spread (i.e., timely and facilitated dissemination, uptake or use of research findings, as well as overcome resistance to new ideas).…”

AHRQ Series on Improving Translation of Evidence: Perceived Value of Translational Products by the AHRQ EPC Learning Health Systems Panel

“…Overall, the feedback from the Learning Health Systems Panel members reinforced previous findings about challenges faced by health systems in translating evidence into practice 6,7,[19][20][21][22] and highlighted their particular needs for timely, concise, and actionable evidence that can be easily operationalized into existing clinical workflows. Thus, although they found value in some of the translational products, even the new products developed under the pilots leave some challenges unaddressed, suggesting a need for further improvements.…”

Improving Access to and Usability of Systematic Review Data for Health Systems Guidelines Development

“…We repeated the search in July 2018 using combination of index terms from the retrieved articles and reviews to identify new or updated research in MEDLINE ® , Google Scholar, and Scopus ® . 10,[38][39][40][41][42][43]…”

“…The overarching advantage of alternative formats is that data from a systematic review can be more readily manipulated to locate and display information in ways that reflect the needs and constraints of the user where the data will be applied. 39 The benefits and limitations to each of our two tested approaches, from the perspective of our project team, are summarized in Table 2 and discussed below. Awareness of the potential to convert currently static systematic review data into interactive Web-based applications could help shape the future preparation and presentation of data in EPC reports.…”