Executive Training for Research Application

Formation en recherche pour cadres qui exercent dans la santé

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Executive Training for Research Application

Formation en recherche pour cadres qui exercent dans la santé

Developing capabilities for evidence-based management in

healthcare settingsJune 2004

EXTRA is a trademark of the Canadian Health Services Research Foundation. EXTRA is funded by a grant from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.

Developing capabilities forevidence-based management in

healthcare settings Armand Boudreau

Organizational liaison – East Consultant in health services management

Élise ComtoisExecutive training, CHSRF

Jean-Louis DenisAcademic co-ordinatorCHSRF/CIHR Chair, Université de Montréal

Jonathan LomasCEO, CHSRF

David RochefortEducation co-ordinatorConsultant in professional development

Nina StipichExecutive training, CHSRF

“Evidence-based management has been defined as practicing managers incorporating evidence from well conducted studies into their decision-making.” (Bigelow & Arndt, 2004)

“Overall, the tightly defined, well-organized, highly quantitative, and relatively generalizable research base for many clinical professions provides a strong and secure foundation for evidence-based practice and lends itself to a systematic process of review and synthesis and to the production of guidelines and protocols.”(Walshe & Rundall, 2001)

“In contrast, the loosely defined, methodologically heterogeneous, widely distributed, and hard-to-generalize research base for health care management is much more difficult to use in the same way… which make the development of evidence-based management more challenging.”(Walshe & Rundall, 2001)

What can we expect from the implementation of an evidence-based culture in healthcare organizations?

Better interpretation of research-based evidence

Increased use of research-based evidence Development of competencies and strategies

among managers to exert demand and to interact with the research communities

Development of knowledge as a strategic asset in healthcare organizations

What are the strategies to promote a realistic perspective of

evidence-based management in healthcare settings?

Strategies to promote EBM inhealthcare settings

Focusing on change in research communities and activities

Focusing on change in decision makers’ or practitioners’ communities and activities

Focusing on communicative strategies and activities across these two communities

Integrative approach is probably more successful

Instruments to promote EBM in healthcare settings

Incentives in researchers’ and practitioners’ communities

Interactions between researchers’ and practitioners’ communities

Creating new organizational arrangements (e.g. consortiums…)

Developing capabilities through training programs

Synergy across different levers for change is probably more transformative

Investing in a training program to promote evidence-based

management in healthcare settings: The Executive Training for Research

Application (EXTRA) program

The EXTRA program An inter-disciplinary program An inter-professional program A program in partnership with

professional associations A program based on a network of

academic and professional resources A program structured around a close

synergy between theory and practice

The EXTRA program A program focusing on the management

and leadership levels rather than on clinical practice

A program designed to increase organizational as well as individual capacity

A program which requires significant organizational support and participation

EXTRA is based on the assumption that the implementation of an

evidence-based culture in healthcare settings represents a major change

for organizations and their usual decision-making process

Vision and mission for EXTRAVISION A health system in which nurses, physicians, and

health service executives collaborate as teams of evidence-based decision makers, optimizing the health of the Canadian population

MISSION To develop capacity and leadership to optimize

the use of research-based evidence in Canadian health service organizations

The conception of research-based evidence behind the EXTRA program

Evidence on the factors that push for change in interventions and modes of service delivery

Evidence for the design of new interventions and modes of service delivery

Evidence on the process of implementation of innovative interventions and modes of service delivery

Evidence on factors and processes that promote the use of research-based evidence

EXTRA program principles Professional development, organization

enhancement Collaborative leadership Heterogeneity Full support in both official languages Continuous improvement

Target audience The EXTRA program is designed for

health service professionals in senior management positions

Leaders of today and tomorrow From three professional streams:

Health service executives Nurse executives Physician executives

Learning objectives To demystify and clarify what research-based

evidence is, and how it differs from other influences on decision-making

To enhance research literacy among the fellows so that they are able to find research, appraise its quality and relevance to their decision-making settings, and identify its potential applications

Learning objectives To refine leadership skills for the specific

purpose of developing an organizational culture that promotes the role of research-based evidence in decision-making.

To provide tools and strategies for using research-based evidence to promote change in practice and services delivery and to facilitate change management

Roles and responsibilities Partners (CNA, CMA, CCHSE, Quebec

consortium) Nominate members for advisory council; assist in

program development, promotion, and marketing

Advisory council Assists with strategic direction, monitoring, and

final selection of fellows (24 per year)

CHSRF Ensures overall program management and delivery

Advisory council members Dr. Jean Rochon, Chair and Former

Minister, Department of Health and Social Services, Quebec

Dr. Christopher C. Carruthers, Chief of Staff, The Ottawa Hospital, and President of the Canadian Society of Physician Executives

Mr. K.J. Fyke, Health Policy Consultant, Victoria, BC

Dr. W. David Helms, President and CEO, AcademyHealth, Washington, D.C.

Dr. Edouard Hendriks, CEO, Regional Health Authority 4, Edmunston, NB

Dr. John Horne, COO, Health Sciences Centre, Winnipeg, MB

Dr. Judith Kazimirski, Vice President Medicine, Capital District Health Authority, Halifax, NS

Ms. Wendy Nicklin, VP Nursing, Allied Health, Clinical Programs and Patient Safety, The Ottawa Hospital and Member of the Academy of Canadian Executive Nurses

Dr. Judith Ritchie, Associate Director for Nursing Research, McGill University Health Centre

Mr. John Vogelzang, President and CEO, David Thompson Health Region, Red Deer, AB

Program format Five core program components:

Away-from-home residency sessions Intervention projects undertaken in fellows’

home organizations Educational activities between residency

sessions Network building Post-program support and activities

Support team for fellows Organizational sponsor to facilitate and

support all aspects of the program in fellows’ home organizations

Academic mentor to provide curriculum advice, assist with intervention project

Decision-maker mentor to help with the implementation of the intervention project

EXTRA mentoring model Regional “pools” of mentors Mentors will include both research

experts and decision-maker mentors Mentors are matched with fellows to

form a mentoring team Regular check-in points and assessment

of the fellows’ progress

Intervention projects as a vehicle for application and integration

A structured activity relating to a specific policy, program, or administrative issue/problem within fellow’s organization

An intervention which aims to create demand for and commitment to the use of research-based evidence in an organization

A problem/issue of sufficient scope to generate change in the organization

A systematic analysis of available evidence to support the design and implementation of the intervention

Curriculum framework Module 1: Demystifying the research world

How research is designed and conducted Identification, assessment, and exploitation of

various evidence sources Definition, potential, and shortcomings of evidence-

based decision-making and policy Current trends in research policies and their

implication for health organizations Credibility of fellows in their roles as research

advocates

Curriculum framework Module 2: Promoting the use of research-based

evidence in healthcare organizations Strategies to promote the use of research and

evidence Political factors and policy influence on the use of

research and evidence Strategies for managing politics and policy Linkages between the nature of evidence and its

application in organizational decision-making

Curriculum framework Module 3: Becoming a research champion

Leadership issues related to the role of research advocates

Personal capabilities required of a research champion

Dealing with issues of inter-professional collaboration

Communication and diplomacy skills

Curriculum framework Module 4: Using research-based evidence to create

and manage change The influence of organizational cultures and politics

on the design and application of research and evidence

Applying the concept of “communities of practice” to assess the dynamics of evidence use in an organizational context

Identifying change management strategies to encourage research implementation

Curriculum framework Module 5: Sustaining change in an organizational

context Exemplary cases of evidence use Validity of strategies developed in other

organizational contexts Strategies for integrating knowledge management

and performance management functions in fellows’ health organizations

Fellows’ organizational strategies for promoting research use

Curriculum framework Module 6: Synthesis

A week dedicated to the presentation of fellows’ intervention projects, attended by academics and practitioners

Strategies for post-program learning and interaction among fellows will also be developed

Accreditation Successful completion will earn fellows

a program diploma Canadian College of Health Service

Executives will offer certification Fellows will be able to accrue continuing

education credits

Evaluating the EXTRA program Guaranteed decade-long intake period Ongoing evaluation to ensure its adaptability

to changing needs focusing on: Formative evaluation of all aspects of EXTRA Residency sessions Web-based learning Nature and extent of related KT and use of

evidence in and among the home organizations Overall evaluation, including broader impact

Challenges in implementing EXTRA

Implementing effective decentralized units for various program components

Co-ordinating various program components

Ensuring true commitments from fellow’s organization

Building synergy across program cohorts of participants

Challenges in implementing EXTRA Sustaining enthusiasm and commitment after

program closure Learning from the evaluative study Setting up appropriate governance structure

to respond to these previous challenges Create a professional network with people

across the country Fostering the use of the EXTRA desktop as a

learning resource in the program.

For more information

Visit www.chsrf.ca/extra/