New healthcare research is being produced at an exponential rate and the challenges for clinicians to keep abreast of it are well documented. Perhaps less frequently discussed is the question of what happens once relevant evidence has been identified. How does it move from the page to have a tangible influence on patient care or health system outcomes?
Despite the abundance of research evidence available, we know that it is often slow to reach those that need it, and even slower to be implemented. An oft cited time lag is a staggering 17 years! The implication is that patients may be receiving ineffectual treatments, out of step with best practice recommendation, in the meantime. This must inevitably impact on patient safety, quality improvement processes, and healthcare costs across the sector.
Knowledge Translation, or KT, is a systematic, holistic approach to moving evidence (or ‘knowledge’) into practice that can be applied by organisations or policy/decision makers to accelerate the pace of research uptake. CareSearch, in conjunction with the Centre for Research Excellence in End of Life Care, has developed a new learning module that introduces the concepts of Knowledge Translation, illustrating it with a ‘real world’, end-of-life care scenario. The scenario shows a clinical team using a KT framework called the Knowledge-to-Action Cycle to identify a clinical problem, discover evidence, incorporate it into their processes, change practice, evaluate the results, and then work to sustain any improvements across time.
The module was developed in consultation with palliative care clinicians. It particularly emphasises the point that not all research findings need to be translated into practice. Knowledge translation needs to be driven by practice concerns and not adopted for its own sake. So before starting a KT project, it is important to ask:
- Is there a recognised clinical problem that needs addressing?
- Is this problem having an impact on patient care?
- Is the problem serious enough to invest time and resources in tackling it? And will gains be worthwhile?
In other words, real world needs must drive the KT process. The module takes the learner through these and other points with the aim of making KT understandable and applicable for anyone working with patients and their families in end-of-life care.
The module is free to use and can be found at https://www.caresearch.com.au/caresearch/tabid/3973/Default.aspx.
For further information, we recommend as a useful model the Knowledge to Action (KTA) cycle developed by Straus and Tetroe at the Canadian Institutes of Health Research. KTA is useful theoretical framework, bringing in the important elements of knowledge creation, monitoring evidence and evaluating outcomes.
The following article also states the case well for KT: Straus SE, Tetroe JM, Graham ID. Knowledge translation is the use of knowledge in health care decision making. J Clin Epidemiol. 2011 Jan;64(1):6-10.
I encourage you to work through the module, try the included online quiz, and send us any feedback. We’d love to hear from you. For me, this work adds depth to my role as a research librarian. I can better see how my part in finding evidence feeds into a wider process of building knowledge into the important work of providing the best possible care for those at the end of life.
Raechel Damarell, Research Librarian, CRE ELC and CareSearch, Flinders University, South Australia