Methods of a multi-faceted rapid knowledge synthesis project to inform the implementation of a new health service model: Collaborative Emergency Centres

Abstract

BackgroundThe aim of this rapid knowledge synthesis was to provide relevant research evidence to inform the implementation of a new health service in Nova Scotia, Canada: Collaborative Emergency Centres (CECs). CECs propose to deliver both primary and urgent care to rural populations where traditional delivery is a challenge. This paper reports on the methods used in a rapid knowledge synthesis project to provide timely evidence to policy makers about this novel healthcare delivery model.MethodsWe used a variety of methods, including a jurisdictional/scoping review, modified systematic review methodologies, and integrated knowledge translation. We scanned publicly available information about similar centres across our country to identify important components of CECs and CEC-type models to operationalize the definition of a CEC. We conducted literature searches in PubMed, CINAHL, and EMBASE, and in the grey literature, to identify evidence on the key structures and processes and effectiveness of CEC-type models of care delivery. Our searches were limited to published systematic reviews. The research team facilitated two integrated knowledge translation workshops during the project to engage stakeholders, to refine the research goals and objectives, and to share interim and final results. Citations and included articles were categorized by whether they addressed the CEC model or component structures and processes. Data and key messages were extracted from these reviews to inform implementation.ResultsCEC-type models have limited peer-reviewed evidence available; no peer-reviewed studies on CECs as a standalone healthcare model were found. As a result, our evidence search and synthesis was revised to focus on core CEC-type structures and processes, prioritized through consensus methods with the stakeholder group, and resulted in provision of a meaningful evidence synthesis to help inform the development and implementation of CECs in Nova Scotia.ConclusionsA variety of methods and partnership with decision-makers and stakeholders enabled the project to address the limitations in the evidence regarding CECs and meet the challenge of identifying the best available evidence in a transparent way to meet the needs of decision-makers in a short timeframe.

Family‐provider consensus outcomes for children with medical complexity

“…The work needed to occur quickly, before onset of policy changes in complex care programs. A choice was made to employ principles of rapid knowledge synthesis and engagement strategies . The public funder provided in‐kind support to mitigate the demand of the rapid time cycle.…”

Engaging policy-makers, health system managers, and policy analysts in the knowledge synthesis process: a scoping review

“…None of the included documents conducted a formal evaluation of engagement; measurement tools specific to engagement were not identified. The authors of one paper asked participating knowledge users to answer an anonymous survey and 100% reported that the information provided in the review was “very” or “somewhat” useful in their decision-making [ 58 ]. One study [ 46 ] suggested ways to measure engagement in future research, including tracking how the research question, eligibility criteria, or other aspects of the review were modified after engagement, comparing reviews on the same topic with engagement and without engagement, retrospectively evaluating reviews that were conducted without engagement to determine their impact, or deliberately phasing in engagement at different parts of the process to measure how the engagement impacted the review.…”

“…Two conceptual frameworks were identified that provided a structure and mechanism to facilitate knowledge user engagement in knowledge synthesis. These were the 7Ps of Stakeholder Engagement and Six Stages of Research framework [ 58 ] and a conceptual framework on the models and mechanisms for engaging policy-makers in systematic reviews that focus on health policy and systems research [ 47 ]. An additional framework can also be used: the online survey patient and public engagement questionnaire (PPEQ) [ 64 ].…”

Contemporary evidence-based practice in Canadian emergency medical services: a vision for integrating evidence into clinical and policy decision-making

“…For example, recently, the Nova Scotia provincial government funded a rapid evidence review on collaborative emergency centres to inform decision-making for this program. 35 EMS stakeholders can use existing EBP processes established within Canada, as well as International EMS systems to advance their local systems. EM and EMS physicians who are in the position of developing and overseeing local practice guidelines need not feel they are alone in their venture.…”