Abstract

In this paper, the authors propose that the healthcare manager is well positioned to advance the research transfer process within the individual healthcare environment through two main mechanisms. First, healthcare managers can align decision-making structures within their own environment to facilitate evidence-based practice. This can occur by managers demonstrating a commitment to processes for the measurement and management of knowledge (identifying knowledge stewards) to the same extent that they demonstrate commitment to the measurement and management of finances . Within such a framework , the healthcare manager can build an environment in which there is an explicit "negotiation" between "knowledge stewards" (usually clinicians) and "financial stewards" (usually administrators) to achieve a common goal. The negotiation is an explicit, documented process that addresses the trade-offs that are made to avoid both financial and quality deficits in the organization (the quality deficit is defined as the gap between knowledge and practice).

The second way in which healthcare managers can act as catalysts for promoting evidence-based practice is through cataloguing and reporting, using documented stories, the unique barriers to evidence-based approaches that are peculiar to their specific healthcare environments . It is hypothesized that local contextual circumstances, which can be expressed only through stories, are the most powerful barriers to research transfer within specific organizations. This has implications for what we count as useful knowledge as we try to better understand how rigorous research on the one hand and research and stories on the other contribute to strategies for research transfer at the organizational level.