Knowledge to action for solving complex problems: insights from a review of nine international cases

Riley, Barbara; Robinson, Ken; Gamble, Jason S.; Finegood, Diane T.; Sheppard, Deri; Penney, Tarra L.; Best, Allan

doi:10.24095/hpcdp.35.3.01

Cited by 26 publications

(26 citation statements)

References 21 publications

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“…However there is little evidence to inform development of organisation-wide systematic approaches to disinvestment at the local level [7, 10–16]. …”

Section: Introductionmentioning

confidence: 99%

Sustainability in Health care by Allocating Resources Effectively (SHARE) 5: developing a model for evidence-driven resource allocation in a local healthcare setting

Harris

Allen

Waller

et al. 2017

BMC Health Serv Res

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BackgroundThis is the fifth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. This paper synthesises the findings from Phase One of the SHARE Program and presents a model to be implemented and evaluated in Phase Two. Monash Health, a large healthcare network in Melbourne Australia, sought to establish an organisation-wide systematic evidence-based program for disinvestment. In the absence of guidance from the literature, the Centre for Clinical Effectiveness, an in-house ‘Evidence Based Practice Support Unit’, was asked to explore concepts and practices related to disinvestment, consider the implications for a local health service and identify potential settings and methods for decision-making.MethodsMixed methods were used to capture the relevant information. These included literature reviews; online questionnaire, interviews and structured workshops with a range of stakeholders; and consultation with experts in disinvestment, health economics and health program evaluation. Using the principles of evidence-based change, the project team worked with health service staff, consumers and external experts to synthesise the findings from published literature and local research and develop proposals, frameworks and plans.ResultsMultiple influencing factors were extracted from these findings. The implications were both positive and negative and addressed aspects of the internal and external environments, human factors, empirical decision-making, and practical applications. These factors were considered in establishment of the new program; decisions reached through consultation with stakeholders were used to define four program components, their aims and objectives, relationships between components, principles that underpin the program, implementation and evaluation plans, and preconditions for success and sustainability. The components were Systems and processes, Disinvestment projects, Support services, and Program evaluation and research. A model for a systematic approach to evidence-based resource allocation in a local health service was developed.ConclusionA robust evidence-based investigation of the research literature and local knowledge with a range of stakeholders resulted in rich information with strong consistent messages. At the completion of Phase One, synthesis of the findings enabled development of frameworks and plans and all preconditions for exploration of the four main aims in Phase Two were met.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2208-1) contains supplementary material, which is available to authorized users.

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“…However there is little evidence to inform development of organisation-wide systematic approaches to disinvestment at the local level [7, 10–16]. …”

Section: Introductionmentioning

confidence: 99%

Sustainability in Health care by Allocating Resources Effectively (SHARE) 5: developing a model for evidence-driven resource allocation in a local healthcare setting

Harris

Allen

Waller

et al. 2017

BMC Health Serv Res

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“…Knowledge mobilization interventions therefore need to enable knowledge to be adapted and integrated into the local setting with its particular networks, resources and constraints (Harvey et al 2011). There is thus a growing interest in broader, multi-level 'systems approaches' to knowledge mobilization which recognize that local relationships and processes are embedded in larger organizational and social structures (Best et al 2009;Riley 2012;Willis et al 2014;Riley et al 2015;Holmes et al 2016). The challenge for knowledge mobilizers then increases, and the lack of operational Third, it is increasingly recognized that research-based knowledge does not occupy a privileged dominant position (Nicolini et al 2008;Contandriopoulos et al 2010;Gabbay and le May 2011;Oborn et al 2013).…”

Section: Background: What Does the Knowledge Mobilization Literaturmentioning

confidence: 99%

Facing the challenges of research‐informed knowledge mobilization: ‘Practising what we preach’?

Powell

Davies

Nutley

2017

Public Administration

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The political imperative to make public services more evidence based has contributed to the growth in the past two decades of both research and practice in the field of knowledge mobilization: the range of approaches to encourage the creation, sharing and use of research‐informed knowledge alongside other forms of knowledge. Paradoxically the growth of the field has made the challenge of encouraging research use much more complex and uncertain, and the roles of knowledge mobilizers much more diverse and demanding. This in‐depth interview study of knowledge mobilization in 51 agencies concerned with knowledge for public services breaks new ground in exploring a paradox at the heart of knowledge mobilization practice: the challenges that research agencies face in practising in research‐informed ways themselves.

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“…However, there is a lack of information to guide local healthcare services regarding an organisational approach to disinvestment [3–12]. …”

Section: Introductionmentioning

confidence: 99%

Sustainability in Health care by Allocating Resources Effectively (SHARE) 6: investigating methods to identify, prioritise, implement and evaluate disinvestment projects in a local healthcare setting

Harris

Allen

Brooke

et al. 2017

BMC Health Serv Res

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BackgroundThis is the sixth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE program was established to investigate a systematic, integrated, evidence-based approach to disinvestment within a large Australian health service. This paper describes the methods employed in undertaking pilot disinvestment projects. It draws a number of lessons regarding the strengths and weaknesses of these methods; particularly regarding the crucial first step of identifying targets for disinvestment.MethodsLiterature reviews, survey, interviews, consultation and workshops were used to capture and process the relevant information. A theoretical framework was adapted for evaluation and explication of disinvestment projects, including a taxonomy for the determinants of effectiveness, process of change and outcome measures. Implementation, evaluation and costing plans were developed.ResultsFour literature reviews were completed, surveys were received from 15 external experts, 65 interviews were conducted, 18 senior decision-makers attended a data gathering workshop, 22 experts and local informants were consulted, and four decision-making workshops were undertaken. Mechanisms to identify disinvestment targets and criteria for prioritisation and decision-making were investigated. A catalogue containing 184 evidence-based opportunities for disinvestment and an algorithm to identify disinvestment projects were developed. An Expression of Interest process identified two potential disinvestment projects. Seventeen additional projects were proposed through a non-systematic nomination process. Four of the 19 proposals were selected as pilot projects but only one reached the implementation stage. Factors with potential influence on the outcomes of disinvestment projects are discussed and barriers and enablers in the pilot projects are summarised.ConclusionThis study provides an in-depth insight into the experience of disinvestment in one local healthcare service. To our knowledge, this is the first paper to report the process of disinvestment from identification, through prioritisation and decision-making, to implementation and evaluation, and finally explication of the processes and outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2269-1) contains supplementary material, which is available to authorized users.

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Knowledge to action for solving complex problems: insights from a review of nine international cases

Cited by 26 publications

References 21 publications

Sustainability in Health care by Allocating Resources Effectively (SHARE) 5: developing a model for evidence-driven resource allocation in a local healthcare setting

Sustainability in Health care by Allocating Resources Effectively (SHARE) 5: developing a model for evidence-driven resource allocation in a local healthcare setting

Facing the challenges of research‐informed knowledge mobilization: ‘Practising what we preach’?

Sustainability in Health care by Allocating Resources Effectively (SHARE) 6: investigating methods to identify, prioritise, implement and evaluate disinvestment projects in a local healthcare setting

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