Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation

Abstract

Many representations of the movement of healthcare knowledge through society exist, and multiple models for the translation of evidence into policy and practice have been articulated. Most are linear or cyclical and very few come close to reflecting the dense and intricate relationships, systems and politics of organizations and the processes required to enact sustainable improvements. We illustrate how using complexity and network concepts can better inform knowledge translation (KT) and argue that changing the way we think and talk about KT could enhance the creation and movement of knowledge throughout those systems needing to develop and utilise it. From our theoretical refinement, we propose that KT is a complex network composed of five interdependent sub-networks, or clusters, of key processes (problem identification [PI], knowledge creation [KC], knowledge synthesis [KS], implementation [I], and evaluation [E]) that interact dynamically in different ways at different times across one or more sectors (community; health; government; education; research for example). We call this the KT Complexity Network, defined as a network that optimises the effective, appropriate and timely creation and movement of knowledge to those who need it in order to improve what they do. Activation within and throughout any one of these processes and systems depends upon the agents promoting the change, successfully working across and between multiple systems and clusters. The case is presented for moving to a way of thinking about KT using complexity and network concepts. This extends the thinking that is developing around integrated KT approaches. There are a number of policy and practice implications that need to be considered in light of this shift in thinking.

Cartão de Evento-Crítico: ferramenta analítica para translação do conhecimento

“…Over the last decades, one notices the increase in research on how to reduce the gap between practical-political evidence. In this sense, several authors suggest a strategy to potentiate KT by reducing the gap between the knowledge produced and its translation in the resolution of health problems, in the interface with other sectors and to progress in the science and practice of KT in the health area 8,9 .…”

How a Networked Approach to Building Capacity in Knowledge Mobilization Supports Research Impact

“…Summarizing the work of a number of organizational and network learning scholars, Omar Belkhodja, Nabil Amara, Réjean Landry, and Mathieu Ouimet (2007) observe that the transition from individuals to the organization seems … to stem from two main elements: first, the incorporation of knowledge into organizational memory, structures, and routines; and second, the usefulness of the knowledge as perceived by the individuals who make up the different organizational units. (p. 389) Similarly, emerging work that blends KMb, complexity, and network concepts (e.g., Beckett et al, 2018;Kitson, Brook, Harvey, Jordan, Marshall, O'Shea, & Wilson, 2018) calls to question how capacity building across multiple levels of research systems can be mutually reinforcing. In the case presented here, a challenge was to ensure that networked learning was preserved and iterated upon in order to contribute to institutions' long-term KMb goals.…”

Factors influencing implementation of evidence-based interventions in public health systems - a model

“…However, the existence of evidence-based public health strategies itself does not seem to be convincing or compelling enough to have decision makers put evidence into practice (4)(5)(6)(7). The complexity of public health systems requires more diverse actions (7)(8)(9)(10)(11)(12).…”

“…In fact, several authors have reported barriers to achieving uptake of evidence within complex public health systems, including both policy and practice (12−14). Others have indicated the need for research beyond identifying barriers and have suggested examination of broader concepts, such as setting targets, actors involved in implementation, and knowledge transfer and translation that influence the processes of evidence implementation within public health systems as a whole (2,8,9,(14)(15)(16)(17)). The conceptual model described in this paper explores these broader factors and attempts to illustrate how they interlink and continually impact each other to influence the uptake of evidence into the development, implementation and monitoring of public health policies and practice (10,18,19).…”