Steps, Tools and Resources for Knowledge Translation: Implementation of Evidence

1. KT2 Knowledge Translation Actions Template at the Micro Level
Knowledge Translation Template: Realizing the Successes of High Reliability Organizations in Healthcare Establishments
Standardization of Care Inputs--Timely-Monitoring—Robust Process Improvement
1. Identify the
Knowledge-To-
Action Gap
(Process Change
Skills)
DMAIC’s Define
________________
(Sources of
Information for
Pin-pointing the
Gap)
Organization
level:
{ } Health records
{ } Chart audits
e.g. M&M reports
Provider level:
{ } Direct
observation
{ } Questionnaires
Patient initiated:
{} Complaints
{} Questionnaires
2. Measure the
Magnitude of the
Defect
(Process Change
Skills)
DMAIC’s
Measure
_____________
(Audit e.g. Chart
Review)
Baseline for
future
comparison-post-
Intervention.
3. Develop your
KT Team
Champions or
Pass the
Information to
your KT
Committee
(Process Change
Skills)
_____________
(Flow Chart a
Patient Journey
to Identify the
Team Members)
Multidisciplinary
a. Clinicians
b. Pharmacists
c. Nursing
d. Trainees
e. Quality Mgt
staff
f. Monitors
g. Statistician
h. Librarian (EBM)
i. Patient
representative
4. Search for,
Appraise &
“GRADE” the
Evidence
(EBM skills)
________________
1. For Identifying
‘New”
Evidence:
a. Secondary
Sources e.g.
Guidelines
Clearinghouse,
Cochrane etc.
b. Primary Sources
e.g. Pubmed etc.
2. For
Publications on
KT
Interventions
for a Similar
KT Gap e.g. in
a. AHRQ website
b. NICE website
c. Guidelines
websites
d. Pubmed
5. Assess Barriers
to Knowledge
Use: Identify the
Cause(s) e.g. Root
Cause Analysis,
Fish-bone
Diagram
Analysis etc
(Process Change
Skills)
DMAIC’s
Analyze
___________
a. Organizational
(Structure e.g. no
policy, poor
staffing/training
program etc. &
Process e.g. no
reminder tools,
no monitoring
etc.)
b. Individual
[ ] Knowledge
[ ] Attitude
[ ] Skills
c. Social
(acceptability by
society &
patients)
6. Adapt
Knowledge to
Local Context
(Adaptability)
(EBM skills)
(Process
Change
Skills)
___________
Presence or
Absence of
Adequate
Resources:
a. Manpower
b. Financial
c. Equipment
d. Etc.
(The ADAPTE
Tool).
7. Select, Tailor,
Disseminate, Implement
Interventions
(EBM skills)
(Process Change Skills)
(System Redesign Skills)
DMAIC’s
1. Organization Directed:
a. Leadership/Legislation
b. Policies & Procedures
c. Clinical Decision Support
& Reminder Systems:
Clinical Pathways, Protocols,
Order Sets, Check-lists etc.
d. System Redesign/ Talent
Profiling e.g. Care Teams,
Monitors etc.
e. Human Factor
Engineering
2. Healthcare Provider
Directed
a. Cognitive Schemes
b. Training Program
c. Competency-
Certification
3. Patient Directed:
a. Education
b. Partnership agreements
etc.
4. Community Directed
a. Education
b. Integrated Care (e.g.
Home Health Care)
8a. Monitor
Knowledge Use
(Process
Change Skills)
_____________
[ ] Process
Variance
(Audit)
-Knowledge use
by providers.
-Knowledge use
by patients.
8b. Monitor
Outcomes
(Process
Change Skills)
_____________
[ ] Outcome
Variance
(Audit)
Impact on:
- Patients
- Providers
- Organization
[ ] Balancing
Variance
Impact on other
unrelated
outcomes/
services
9. Sustained
Knowledge Use
(Process Change
Skills)
DMAIC’s Control
_____________
a. Regular Audit
b. Regular Update
c. Incentives
d. Accredit/Certify
 AHRQ Agency for Healthcare Research and Quality http://www.ahrq.gov/
 National Guidelines Clearinghouse™ : http://www.guideline.gov/
 NICE National Institute for Health and Clinical Excellence: www.nice.org.uk
 Institute for Healthcare Improvement:
http://www.ihi.org/IHI/Topics/LeadingSystemImprovement/
 ICSI Institute for Clinical Systems Improvements https://www.icsi.org/
 Society of Hospital Medicine: http://www.hospitalmedicine.org/
 Innovations Exchange for New Ideas of Care
http://innovations.ahrq.gov/
 NHS Improvement: http://www.institute.nhs.uk/,
http://www.nhsiq.nhs.uk/
 Google: www.google.com
 Pubmed: www.pubmed.org
 Clinical Improvement
Skills: http://www.improvementskills.org/index.cfm
 Knowledge Translation Clearinghouse: http://ktclearinghouse.ca/Useful Websites for KT