The Inside Story: Knowledge Translation Lessons from the Need to Know Team
This session began with Dr. Martens observing the importance of having different perspectives on the same information, much as different-shaped lenses provide different perspectives on the same image, an idea from art called anamorphosis. She described how the idea for The Need To Know (NTK) Team grew out of MCHP's Rural and Northern Healthcare Days, which began in 1994. Five years later, she transformed the event into an interactive workshop. That workshop quickly led to a desire on the part of research scientists at MCHP to extend the partnership so that work on issues of importance to regional and provincial planners could incorporate research users from the start of the process rather than at the end. This change reflects the NTK Team's approach to integrated knowledge translation.
Dr. Martens also described the nature and membership of the NTK Team, which includes MCHP research scientists and graduate students, top-level planning representatives from each regional health authority (RHA) chosen by the CEOs, and representatives from Manitoba Health. Through this approach, the NTK Team incorporates people from a variety of roles and backgrounds: medical officers of health, VPs/directors of planning, managers of quality assurance and public health, among others. This variety is key to the NTK Team's success, as it means that a number of perspectives are included in all discussions. To date, the NTK Team has completed five major MCHP research reports, four evaluation reports and several peer-reviewed publications.
Dr. Fransoo discussed a number of findings that would not have been revealed by researchers working in isolation, because both the research topics and the methods used have been heavily influenced by NTK Team members. The impetus behind MCHP's mental illness report (Martens et al. 2004) was RHA members' insistence on its importance. It has been one of the NTK Team's more influential reports, in particular the finding of the substantial burden of physical illness among those with mental illness. In the sex differences report (Fransoo et al. 2005), the NTK Team insisted on producing age-specific rates by sex for all indicators. Among other findings, this detailed analysis showed the confounding of age and sex in cardiac care after heart attacks, revealing that there is no sex bias in cardiac care after heart attack.
Suzanne Dick explained the responsibilities of NTK Team members and spoke about how the team's activities have affected the North Eastman Health Association. Among other things, NTK Team activities led to the formation of an Evidence Informed Practice Team (EIPT), a group of staff from the region who work together to ensure that evidence is used to inform practice, and to provide input and feedback on other issues. The EIPT is also integral in completing the region's regular comprehensive Community Health Assessment Report.
Tannis Erickson spoke about the numerous benefits of NTK Team membership to RHAs and provided an example of how evidence from a team report was used to launch a more detailed study of adolescent health involving the Teen Clinic in Selkirk. Data from the MCHP report were triangulated with results from local Youth Health Surveys, which revealed the characteristics of clinic visitors, and connected with other health-related issues faced by local teens.
Deborah Malazdrewicz spoke about how the NTK Team has affected a number of aspects within Manitoba Health, including providing data and information on initiatives, enhancing linkage and integration with RHAs, capacity building, research partnerships, analysis methods, networking, improved understanding of the context and realities of rural health issues and their management, and of course encouraging evidence-informed practice within Manitoba Health. Interestingly, most of these items affect MCHP researchers as well, reflecting how the NTK Team has been a remarkable "win–win–win" experience.
Elaine Burland then spoke about her experience participating on the NTK Team as a graduate student. She explained how it provided her a more practical understanding of her studies as well as a chance to learn about issues of relevance for RHAs and to observe integrated knowledge translation in action. It also gave her opportunities to assist in the preparation of reports and to make numerous presentations at scientific conferences, as well as contribute as a co-author of academic publications. Finally, it helped her establish connections with key contact people for her doctoral research, which involves a program evaluation of fall management practices in personal care homes in two RHAs.
Pearl Soltys wrapped up the session by outlining the multi-stage evaluation process used by the NTK Team, and how the results inform ongoing team practices. This evaluation process also led to the creation of the project called From Evidence to Action (Bowen and Erickson 2007), a separately funded study that examined organizational factors associated with the use of evidence in the real world, and tools to enhance the use of evidence to inform decision-making.
Le fond de l'histoire: leçons en matière de transfert de connaissances de la part de l'équipe Need to Know
About the Author
Randall Fransoo, PhD, Research Scientist, Manitoba Centre for Health Policy (MCHP), Assistant Professor, Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB
Patricia J. Martens, PhD, Director, MCHP; Professor, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB
Suzanne Dick, RN, BN, Med, Projects Coordinator, North Eastman Health Association, Beausejour, MB
Tannis Erickson, BComm (H), CGA, Health Systems Analysis Manager, Interlake Regional Health Authority, Gimli, MB
Deborah Malazdrewicz, Executive Director, Health Information Management, Manitoba Health, Winnipeg, MB
Elaine Burland, MSc, Graduate Student, Community Health Sciences and Research Assistant, MCHP, University of Manitoba, Winnipeg, MB
Pearl Soltys, B.OT, MSc, Graduate Student, Community Health Sciences and Research Assistant, MCHP, University of Manitoba, Winnipeg, MB
Bowen, S. and T. Erickson. 2007. From Evidence to Action: Report of Phase I Activities. Winnipeg: Manitoba Centre for Health Policy. Retrieved December 9, 2010. <http://www.rha.cpe.umanitoba.ca/data_resource.shtml>.
Fransoo, R., P. Martens and The Need to Know Team, E. Burland, H. Prior, C. Burchill, D. Chateau and R. Walld. 2005. Sex Differences in Health Status, Health Care Use, and Quality of Care: A Population-Based Analysis for Manitoba's Regional Health Authorities. Winnipeg: Manitoba Centre for Health Policy. Retrieved December 9, 2010. <http://www.rha.cpe.umanitoba.ca/data_resource.shtml>.
Martens, P.J., R. Fransoo, N. McKeen, The Need to Know Team, E. Burland, L. Jebamani, C. Burchill, C. DeCoster, O. Ekuma, H. Prior, D. Chateau, R. Robinson and C. Metge. 2004. Patterns of Regional Mental Illness Disorder Diagnoses and Service Use. Winnipeg: Manitoba Centre for Health Policy. Retrieved December 9, 2010. <http://www.rha.cpe.umanitoba.ca/data_resource.shtml>.
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