Knowledge Translation inResidential Care and Assisted Living

Fraser Health AuthorityKate Donaldson, MA

Consultation

The consultation process “must include the important tasks of helping the client figure out what the problem or issue is and – only after that – deciding what further kind of help is needed”

(Schein, 1995, p. 644).

Knowledge Translation

Knowledge translation is about:• Making users aware of knowledge and

facilitating their use of it• Closing the gap between what we know and

what we do• Moving knowledge into action

(Canadian Institutes of Health Research [CIHR], 2012, Knowledge translation, part 1).

“How can RCAL leaders working with direct care nursing staff support the transfer of new knowledge into practice?”

The Inquiry

Sub-questions

• What are the barriers to moving new knowledge into practice in RCAL?

• What motivates registered nurses, licensed practical nurses, and health care attendants to change practice?

• What behaviours can RCAL leaders exhibit that will help to reinforce the use of new knowledge?

Action research engages people in the process of investigating and identifying solutions to challenges they may be experiencing in their day to day lives

(Coghlan & Brannick, 2010; Stringer, 2007).

Action Research

Focus Group Participants

Direct Care Nursing Staff•Health Care Attendants•Licensed Practical Nurses•Registered Nurses

Leaders•Managers•Clinical Nurse Educators and Specialists•Resident Care Coordinators

Caring Journey Workshops

2 day workshops designed to give staff the knowledge and skills to create an environment that supports a person-centred culture of care

Research Participants

• All research participants attended CJ workshops between 3 and 6 months prior to the focus group discussions.

• 2 focus groups with the direct care nursing staff

• 1 focus group with leaders• Focus groups were approximately 60 minutes

long

Participant Comments

• “If you want to enhance the ability of everybody…really you need some strong people to keep it positive and kind of trump the negative ones.” (focus group participant)

• “I think it is information, its knowledge, …it’s slowly changing mindsets.” (focus group participant)

Participant Comments

“I think it (CJ) also has to flow through the various things that you do . . . . Person-centred needs to permeate all the different kinds of education, . . . because otherwise it’s not consistent. So the way you teach a CPG or the way you go through a policy, all those things need to come out of that [person-centred] framework, otherwise people get confused”.

(focus group participant)

Themes

• Collaboration• Trust• Inquiry and Consultation• Building a Shared Vision• Modelling the Way

5 Key Findings

• KT takes place through changes to personal practice, role modeling, and talking about the concepts

• Training should be wide reaching and inclusive of all disciplines and stakeholders

5 Key Findings

• Leaders need the knowledge and a plan to support KT

• KT can be supported through collaboration and opportunities to discuss practice issues

• Time is seen as a barrier to sharing new knowledge and changing practices.

Building a Shared Vision

“Clearly, the leadership practice of inspiring a shared vision involves being forward-looking and inspiring the practice of modeling the way includes the clarification of a set of values and being an example of those to others” (Kouzes & Posner, 1995, p. 29).

Participant Comments

“I think sometimes people feel frustrated because they think that we should be all the way there. Whereas it’s really a process of becoming that never ends”

(focus group participant).

Conclusions

Changing practice requires the support of knowledgeable leaders who consistently provide coaching and role modeling of the desired behaviours.

Conclusions

Learners need opportunities for collaborating and consulting about practice issues to help make lasting changes.

Conclusions

A communication strategy that links the organization’s vision, mission, and goals to the concepts being taught can help to communicate a clear and consistent message about the organization’s priorities.

Conclusions

Ongoing planning, evaluation, and redesign of training will help to ensure that the training is having the intended impact.

Recommendations

• Ensure leaders in RCAL have the confidence and knowledge to support KT

• Plan and schedule opportunities for support of interdisciplinary collaboration and consultation

Recommendations

• Develop a communication strategy that links learning to RCAL’s vision, mission, and goals

• Incorporate KT strategies into the planning and evaluation of training programs

Collaboration and Trust

We don’t accept an organizational redesign because a leader tells us it is necessary. We choose to accept it if, and only if, we see how this new design enables us to contribute more to what we’ve defined as meaningful. (Wheatley, 2006, p. 149)

References

• Canadian Institutes of Health Research. (2012). Knowledge translation. Retrieved from http://www.cihr-irsc.gc.ca/e/33747

• Coghlan, D., & Brannick, T. (2010). Doing action research in your own organization (3rd ed.). Thousand Oaks, CA: Sage.

• Kouzes, J., & Posner, B. (1995). The leadership challenge. San Francisco, CA: Jossey-Bass.• Schein, E. (1964). The mechanisms of change. In W. Burke, D. Lake, & J. W. Paine (Eds.),

Organization change: A comprehensive reader (pp. 78–88). San Francisco, CA: Jossey-Bass.• Stringer, E. (2007). Action research (3rd. ed.). Thousand Oaks, CA: Sage.• Wheatley, M. J. (2006). Leadership and the new science: Discovering order in a chaotic world

(3rd ed.). San Francisco, CA: Berrett-Koehler.Kate Donaldson, acting manager

Peace Arch Hospital, Residential ServicesKatherine.donaldson@fraserhealth.ca