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G1 Kate Donaldson - Knowledge Translation in Residential Care and Assisted Living


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G1 Kate Donaldson - Knowledge Translation in Residential Care and Assisted Living

  1. 1. Knowledge Translation inResidential Care and Assisted Living Fraser Health Authority Kate Donaldson, MA
  2. 2. ConsultationThe consultation process “must include theimportant tasks of helping the client figure outwhat the problem or issue is and – only afterthat – deciding what further kind of help isneeded”(Schein, 1995, p. 644).
  3. 3. 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).
  4. 4. The Inquiry“How can RCAL leaders working withdirect care nursing staff support thetransfer of new knowledge intopractice?”
  5. 5. 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?
  6. 6. Action ResearchAction research engages people in the processof investigating and identifying solutions tochallenges they may be experiencing in their dayto day lives(Coghlan & Brannick, 2010; Stringer, 2007).
  7. 7. 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
  8. 8. Caring Journey Workshops2 day workshops designed to give staff theknowledge and skills to create an environmentthat supports a person-centred culture of care
  9. 9. 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
  10. 10. 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)
  11. 11. Participant Comments“I think it (CJ) also has to flow through thevarious things that you do . . . . Person-centredneeds to permeate all the different kinds ofeducation, . . . because otherwise it’s notconsistent. So the way you teach a CPG or theway you go through a policy, all those thingsneed to come out of that [person-centred]framework, otherwise people get confused”.(focus group participant)
  12. 12. Themes• Collaboration• Trust• Inquiry and Consultation• Building a Shared Vision• Modelling the Way
  13. 13. 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
  14. 14. 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.
  15. 15. Building a Shared Vision“Clearly, the leadership practice of inspiring a sharedvision involves being forward-looking and inspiring thepractice of modeling the way includes the clarificationof a set of values and being an example of those toothers”(Kouzes & Posner, 1995, p. 29).
  16. 16. 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).
  17. 17. ConclusionsChanging practice requires the support ofknowledgeable leaders who consistently providecoaching and role modeling of the desiredbehaviours.
  18. 18. ConclusionsLearners need opportunities for collaboratingand consulting about practice issues to helpmake lasting changes.
  19. 19. ConclusionsA communication strategy that links theorganization’s vision, mission, and goals to theconcepts being taught can help to communicatea clear and consistent message about theorganization’s priorities.
  20. 20. ConclusionsOngoing planning, evaluation, and redesign oftraining will help to ensure that the training ishaving the intended impact.
  21. 21. Recommendations• Ensure leaders in RCAL have the confidence and knowledge to support KT• Plan and schedule opportunities for support of interdisciplinary collaboration and consultation
  22. 22. 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
  23. 23. Collaboration and TrustWe don’t accept an organizational redesignbecause a leader tells us it is necessary. Wechoose to accept it if, and only if, we see howthis new design enables us to contribute more towhat we’ve defined as meaningful.(Wheatley, 2006, p. 149)
  24. 24. References• Canadian Institutes of Health Research. (2012). Knowledge translation. Retrieved from• 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 Services