Anita Kothari ⢠U Western ⢠Health Sciences/Knowledge Translation. Laurel Taylor ⢠CPSI ... Lynn Stevenson ⢠Vancouver Island Health Authority, BC.
USING MANAGEMENT KNOWLEDGE TO ADVANCE KNOWLEDGE IMPLEMENTATION IN HEALTHCARE: SCOPING THE LITERATURE KAREN HARLOS, ANITA KOTHARI, JUDITH RITCHIE, LAUREL TAYLOR, DOUG ANGUS, JULIA BAXTER, NINA HOVANEC, AND MADELEINE BIRD Introduction
MKT Toolkit Research Group
Background Management knowledge provides key insights into improved functioning of healthcare organizations, quality of care, and patient outcomes. Yet research-oriented healthcare professionals are less exposed to findings from organizational and management literatures than they might be, which limits the successful implementation of evidence into practice and policy decisions. Our interdisciplinary team conducted a scoping review of the management literature to identify measurement tools associated with transferring knowledge in healthcare. Next, we are synthesizing the literature and developing a Management Knowledge Transfer (MKT) Tool Kit with coordinated outreach to help health decision-makers and researchers use management knowledge for evidence-informed practice and policy. Objectives • To conduct a scoping review of management literature for empirical studies conducted in healthcare settings • To compile concise descriptions of study samples , index measurement tools used, assess tool psychometric properties , and give overall recommendation for research use • To organize results in a searchable database according to preliminary categorization of conceptual domains (below) in a user-friendly format
Karen Harlos ♦ McGill, U Winnipeg ♦ Management Anita Kothari ♦ U Western ♦ Health Sciences/Knowledge Translation Laurel Taylor ♦ CPSI ♦ Management/Medicine Doug Angus ♦ U Ottawa ♦ Health Economics Judith Ritchie ♦ MUHC ♦ Nursing/Knowledge Transfer Julia Baxter ♦ Psychology Nina Hovanec ♦ U Western ♦ Health Sciences/Knowledge Translation Madeleine Bird ♦ U de Montréal♦ Santé communautaire
Methods Scoping Review Hand searching of the journals: Human Relations, Journal of Management, Organizational Science, Organizational Behavior and Human Decision Processes, and Psychological Bulletin from 1996 to 2006 Included Articles that describe a study set in a healthcare organization with implications for knowledge transfer Excluded Articles that focus on strategic or structural issues in organizations with little or no relevance to knowledge transfer To identify articles, we followed protocol from previous knowledge syntheses on: a) planned action theories from the social science, education and health literatures ; and 2) organizational change studies from the management literature. Two raters independently examined early decisions on article inclusion. Differences were resolved by discussion.
End-User Advisory Group to Develop Data Abstraction Template We formed an Advisory Group of six CHSRF-EXTRA fellows to help us design a template for describing study samples, tools and their psychometric properties. The Advisory Group represents diverse health occupations across the country. They reviewed our materials and provided iterative feedback to identify information valued by health decision-makers and shape how we record it for relevance and clarity. Members: Brendan Carr ♦ Capital Health, NS Sonja Glass ♦ Grey Bruce Health Services, ON Nancy Lefebre ♦ Saint Elizabeth Health Care, ON Jocelyne Sauve ♦ Montérégie Health and Social Services Agency, QC Lynn Stevenson ♦ Vancouver Island Health Authority, BC James Worthington ♦ The Ottawa Hospital, ON
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Coding Articles Articles were categorized by primary (and sometimes secondary) conceptual domain areas. Categorizations have yet to be independently examined for consistency and accuracy.
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Preliminary Results Results are based on 41 articles that met inclusion criteria out of a pool of approximately 2400 articles (across 5 journals from a 10-year period). A diverse range of 19 conceptual domains appear across the set of articles (some coded conjointly across two domains). Most common conceptual domains were: 1) performance (either at organizational or job levels); 2) decision-making and behaviour; and 3) innovation. The next cluster of domains, identified by 3 different articles, were groups/teams, work attitudes, and employee turnover. The breadth of domains expanded markedly among remaining articles. Five domains ranging from leadership to quality of work relationships were foundational in 2 articles each. Lastly, 8 domains —from knowledge transfer to stress management were represented only once as a conceptual focus across articles. Results from an earlier conceptual analysis from a scoping review of 5 management journals that identified articles conducted in healthcare settings with implications for organizational change and knowledge transfer informed the current analysis.
The Way Forward ● Coding conceptual domains according to level of focus ranging from environmental to the individual. Coding articles into 3 categories for relevance to knowledge transfer consistent with
the earlier scoping review (above). Together, these steps should help reveal patterns in conceptual analysis as well as patches or gaps in knowledge. ● ata abstraction templates (see above) for about ¼ of articles in this study. To produce the Tool Kit, we plan to aggregate the compiled descriptions and assessments of measures, relying on further feedback from the End-User Advisory Group. We then plan to pilot test the Tool Kit for relevance, clarity and utility using a sample of EXTRA fellows to generate hypotheses about organizational-level interventions to support Tool Kit use. ●We will add data on measurement tools from the earlier scoping review (noted above ). This review identified 100 articles. Added tools – yet to be summarized and assessed – will strengthen the database. •Most measures (or sub-scales) tend to have established reliability and validity but psychometric results in healthcare applications are generally not well known. Properties of newer or combined scales have received even less attention. By synthesizing and evaluating measurement tools for easy identification and use, the scoping review and MKT Tool Kit addresses constraints from lack of time or skills that can prevent research-oriented professionals from creating and using knowledge for health service improvement.
Acknowledgements
USING MANAGEMENT KNOWLEDGE TO ADVANCE KNOWLEDGE IMPLEMENTATION IN HEALTHCARE: SCOPING THE LITERATURE KAREN HARLOS, ANITA KOTHARI, JUDITH RITCHIE, LAUREL TAYLOR, DOUG ANGUS, JULIA BAXTER, NINA HOVANEC, AND MADELEINE BIRD Introduction
MKT Toolkit Research Group
Background Management knowledge provides key insights into improved functioning of healthcare organizations, quality of care, and patient outcomes. Yet research-oriented healthcare professionals are less exposed to findings from organizational and management literatures than they might be, which limits the successful implementation of evidence into practice and policy decisions. Our interdisciplinary team conducted a scoping review of the management literature to identify measurement tools associated with transferring knowledge in healthcare. Next, we are synthesizing the literature and developing a Management Knowledge Transfer (MKT) Tool Kit with coordinated outreach to help health decision-makers and researchers use management knowledge for evidence-informed practice and policy. Objectives • To conduct a scoping review of management literature for empirical studies conducted in healthcare settings • To compile concise descriptions of study samples , index measurement tools used, assess tool psychometric properties , and give overall recommendation for research use • To organize results in a searchable database according to preliminary categorization of conceptual domains (below) in a user-friendly format
Karen Harlos ♦ McGill, U Winnipeg ♦ Management Anita Kothari ♦ U Western ♦ Health Sciences/Knowledge Translation Laurel Taylor ♦ CPSI ♦ Management/Medicine Doug Angus ♦ U Ottawa ♦ Health Economics Judith Ritchie ♦ MUHC ♦ Nursing/Knowledge Transfer Julia Baxter ♦ Psychology Nina Hovanec ♦ U Western ♦ Health Sciences/Knowledge Translation Madeleine Bird ♦ U de Montréal♦ Santé communautaire
Methods Scoping Review Hand searching of the journals: Human Relations, Journal of Management, Organizational Science, Organizational Behavior and Human Decision Processes, and Psychological Bulletin from 1996 to 2006 Included Articles that describe a study set in a healthcare organization with implications for knowledge transfer Excluded Articles that focus on strategic or structural issues in organizations with little or no relevance to knowledge transfer To identify articles, we followed protocol from previous knowledge syntheses on: a) planned action theories from the social science, education and health literatures ; and 2) organizational change studies from the management literature. Two raters independently examined early decisions on article inclusion. Differences were resolved by discussion.
End-User Advisory Group to Develop Data Abstraction Template We sought help from six fellows of Canadian Health Services Research Foundation’s Executive Training for Research Application (EXTRA) program to design a template for describing study samples, tools and their psychometric properties. Advisory Group members are in diverse health occupations across the country. They reviewed our materials , providing feedback from “end-user” perspectives through iterative consultations. They helped us identify information valued by health decision-makers and how to record it for relevance and clarity. Members: Brendan Carr ♦ Capital Health, NS Sonja Glass ♦ Grey Bruce Health Services, ON Nancy Lefebre ♦ Saint Elizabeth Health Care, ON Jocelyne Sauve ♦ Montérégie Health and Social Services Agency, QC Lynn Stevenson ♦ Vancouver Island Health Authority, BC James Worthington ♦ The Ottawa Hospital, ON 1
1
Coding Articles Articles were categorized by primary (and sometimes secondary) conceptual domain areas. Categorizations have yet to be independently examined for consistency and accuracy.
1
Preliminary Results Results are based on 41 articles that met inclusion criteria out of a pool of approximately 2400 articles (across 5 journals from a 10-year period). A diverse range of 19 conceptual domains appear across the set of articles (some coded conjointly across two domains). Most common conceptual domains were: 1) performance (either at organizational or job levels); 2) decision-making and behaviour; and 3) innovation. The next cluster of domains, identified by 3 different articles, were groups/teams, work attitudes, and employee turnover. The breadth of domains expanded markedly among remaining articles. Five domains ranging from leadership to quality of work relationships were foundational in 2 articles each. Lastly, 8 domains —from knowledge transfer to stress management were represented only once as a conceptual focus across articles. Results from an earlier conceptual analysis from a scoping review of 5 management journals that identified articles conducted in healthcare settings with implications for organizational change and knowledge transfer informed the current analysis.
The Way Forward ● Coding conceptual domains according to level of focus ranging from environmental to the individual. Coding articles into 3 categories for relevance to knowledge transfer consistent with
the earlier scoping review (above). Together, these steps should help reveal patterns in conceptual analysis as well as patches or gaps in knowledge. ● Data abstraction templates (above) now completed for about ¼ of articles. To produce the Tool Kit, we will aggregate compiled descriptions and assessments of measures with ongoing feedback from our End-User Advisory Group. We will pilot test the Tool Kit for relevance, clarity and utility using a sample of EXTRA fellows and generate hypotheses about interventions to support Tool Kit use. ● We will add data on measurement tools from the earlier scoping review (above ), which identified 100 articles. These tools – to be summarized and assessed – will build the database. By synthesizing and evaluating measurement tools for easy identification and use, the scoping review and MKT Tool Kit addresses constraints from lack of time or skills that can prevent research-oriented professionals from creating and using knowledge for health service improvement.
Acknowledgements
