Accelerating Knowledge to Action on Client-Driven Care

Overview of the Project

In this 2-year project, university and home care collaborators implemented and studied mutual effort by researchers, policy personnel, decision-makers and providers to get research evidence from 17 studies on an empowering partnering approach (i.e., “client-driven care”) used in all in-home service delivery and care across South Western Ontario. Formally known as “knowledge translation” (KT), the aim of this exercise was to get all involved to learn about, reflect on, regularly discuss, and apply research evidence about this partnership approach throughout their everyday practice in the home care sector, combining their own experience and knowledge with the research evidence to refine their approaches to partnering in service delivery and care.

The exercise was repeated twice in two “action cycles” or “phases”. In Phase 1, the network included 50 participants (30 providers including nurses, therapists, personal support workers and social workers; 5 decision makers, including case managers and supervisors, and 12 researchers), divided into 5 geographically-defined action groups, each representing a mix of the participant categories. These groups each met five times over a three month period. In Phase 2, an expanded group of 203 participants (152 providers, including nurses, therapists, personal support workers and social workers; 39 decision makers, including senior administrators, case managers and supervisors, and 12 researchers) were divided into 9 geographically-defined groups each representing a mix of the participant categories. These groups each met approximately monthly over an eight-month period. In both phases, all action groups came together in end-of-phase workshops to share and assess their progress, and to make recommendations for further refining approaches and effort to get client-driven care understood and used in all service delivery and care on a daily basis.

Qualitative methods were used to gain in-depth knowledge of the barriers, facilitators and strategies for achieving knowledge translation. Quantitative methods were used to measure the changes in readiness to learn, knowledge uptake and knowledge application from the outset of the project to the end of both phases. Findings from the qualitative study describe the organization’s fiscal and human resources, team-level trust, support, patterns of relating, time, work and ownership, and individuals’ attitudes, motivation and commitment as important challenges. As well, qualitative study revealed patterns of interaction that helped to achieve knowledge translation, with everyone involved contributing their knowledge and skills to leading evidence-based change. Quantitative findings revealed significant gains in readiness to learn and uptake of the knowledge related to the empowering partnering strategies, as well as positive trends in applying the evidence in everyday work.

UWO Research Team Members: C. McWilliam (PI); D. Forbes; A. Kothari; M. Kloseck; B. Leipert; C. Ward-Griffin; K. Ferguson et al.
SW-CCAC Collaborators: S. Coleman, D. Ladouceur, G. Milak, A. Cole et al.
Funded by: Canadian Institutes of Health Research

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