Accelerating Knowledge to Action on Client-Driven Care

Key Messages About Doing Knowledge Translation (KT)

To achieve “best practices” based on research evidence, organizations have to commit to giving their members the time and resources for KT.

Implementing KT to achieve evidence-based practice requires simultaneous changes throughout the organization. This includes relevant revision of organizational priorities, policies and procedures, team structures and functioning patterns, and individual attitudes and practice patterns. All of these changes are needed to overcome barriers and to implement actions and resources that facilitate the intended change.  Individuals create teams, and both individuals and teams create the organization, so no one can change without change in the teams and organizations of which they are a part, and teams and organizations cannot change unless individuals change.

KT for evidence-based change needs people representing all components of the organization to work together so that all are aware of and can coordinate the efforts required by each individual and organizational component.

Large organizations tend to have structures and approaches that make people conscious of their ‘place’ in a hierarchy. Therefore, people throughout the organization, regardless of assigned roles and responsibilities, have to work together to create a “level playing field” where all comfortably contribute to the process of KT for evidence-based change.

Interactive KT approaches cannot be prescribed or “written in stone”- everyone is a unique individual and every situation is unique.  While KT may be guided, the process of KT has to be left to unfold as participants create it. This means that all involved need to focus on and support all other participants to create a shared effort to get the KT process “right”.

Participants in this approach to KT share responsibility and accountability for adopting and adapting the research evidence for their work and work context by using their personal experiential knowledge and skills. This means that they also share responsibility and accountability for the outcomes they achieve in refining service delivery and care.  All involved need to know and understand this from the outset, and work together to decide mutually agreed goals and directions.

In an era of “evidence-based practice”, it is expected that researchers and organizational administrators will “push”  practitioners to use research evidence, and that experienced practitioners will “pull” into practice research evidence that their professional judgment leads them to believe will help to improve services and care. These two forces can create conflict and opposition where there are differences of opinion. Mature, open interaction to confront differences and to identify mutually acceptable directions can be used to integrate and transcend “push” and “pull” tendencies.

Ideally, KT for evidence-based practice would be a part of all aspects everyday work.  For this to happen, everyone throughout an organization has a role to play in promoting KT at all times.  This means that everyone needs to be a leader in transforming practice and service delivery to make it evidence-based. Applying the principles of transformative leadership therefore helps to promote KT.

As KT becomes a part of everyday work, the organization becomes a learning organization, created by all of the individuals who make up the organization. As this happens, researchers can and should gradually withdraw from the KT process, while continuing to provide evidence and consultations on its applicability to the organization.

In keeping with research that suggests that change throughout an organization often takes several years, KT to achieve evidence-based change takes prolonged time and effort. The quantitative findings of this project found significant gains in readiness to learn and positive trends in participant uptake of the evidence at the end of the first 3-month phase of KT effort.  The significant gains in readiness to learn were sustained to the end of the second phase, 18 months later, by which time participants also had significant gains in knowledge uptake.  Measures of actual application of the research evidence only indicated positive trends at the 18-month data collection. This evidence suggests that organizations wanting to undertake this approach to KT need to plan on long term effort.

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