Reflections on Knowledge Brokering Within a Multidisciplinary Research Team

Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, NS B3H 2Y9.
Journal of Continuing Education in the Health Professions (Impact Factor: 1.36). 09/2011; 31(4):283-90. DOI: 10.1002/chp.20128
Source: PubMed


Knowledge brokering (KB) may be one approach of helping researchers and decision makers effectively communicate their needs and abilities, and move toward increased use of evidence in health care. A multidisciplinary research team in Nova Scotia, Canada, has created a dedicated KB position with the goal of improving access to quality colorectal cancer care. The purpose of this paper is to provide an in-progress perspective on KB within this large research team. A KB position ("knowledge broker") was created to perform two primary tasks: (1) facilitate ongoing communication among team members; and (2) develop and maintain collaborations between researchers and decision makers to establish partnerships for the transfer and use of research findings. In this article, we discuss our KB model and its implementation, describe the broker's functions and activities, and present preliminary outcomes. The primary functions of the KB position have included: sustaining team members' engagement; harnessing members' expertise and sharing it with others; developing and maintaining communication tools/strategies; and establishing collaborations between team members and other stakeholders working in cancer care. The broker has facilitated an integrated knowledge translation approach to research conduct and led to the development of new collaborations with external stakeholders and other cancer/health services researchers. KB roles will undoubtedly differ across contexts. However, descriptive assessments can help others determine whether such an approach could be valuable for their research programs and, if so, what to expect during the process.

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    • "A strengthening of the formal framework for teamwork should go hand-in-hand with interventions targeting the behavioural “software” of a team, because the “hardware” and “software” of teamwork seem to be interrelated. The individual behavioural aspects revealed in our study, such as communications among team members, respectful and non-hierarchical relationships, and team synergy could be strengthened via trainings, regular reflections and other team-building activities [46,47]. The existing research indicates the appropriateness of training for improving inter-professional attitudes, collaboration skills and collaborative behaviour [48]. "
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    ABSTRACT: A team approach in primary care has proven benefits in achieving better outcomes, reducing health care costs, satisfying patient needs, ensuring continuity of care, increasing job satisfaction among health providers and using human health care resources more efficiently. However, some research indicates constraints in collaboration within primary health care (PHC) teams in Lithuania. The aim of this study was to gain a better understanding of the phenomenon of teamwork in Lithuania by exploring the experiences of teamwork by general practitioners (GPs) and community nurses (CNs) involved in PHC. Six focus groups were formed with 29 GPs and 27 CNs from the Kaunas Region of Lithuania. Discussions were recorded and transcribed verbatim. A thematic analysis of these data was then performed. The analysis of focus group data identified six thematic categories related to teamwork in PHC: the structure of a PHC team, synergy among PHC team members, descriptions of roles and responsibilities of team members, competencies of PHC team members, communications between PHC team members and the organisational background for teamwork. These findings provide the basis for a discussion of a thematic model of teamwork that embraces formal, individual and organisational factors. The need for effective teamwork in PHC is an issue receiving broad consensus; however, the process of teambuilding is often taken for granted in the PHC sector in Lithuania. This study suggests that both formal and individual behavioural factors should be targeted when aiming to strengthen PHC teams. Furthermore, this study underscores the need to provide explicit formal descriptions of the roles and responsibilities of PHC team members in Lithuania, which would include establishing clear professional boundaries. The training of team members is an essential component of the teambuilding process, but not sufficient by itself.
    Full-text · Article · Aug 2013 · BMC Family Practice
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    ABSTRACT: Purpose of review: Knowledge translation is a growing area of specialisation. This review summarises the field perspectives and highlights recent work that has particular relevance to neurological rehabilitation. Recent findings: Research in knowledge translation can usefully be organised into three overlapping perspectives, namely a linear transfer of codified knowledge, a social interaction perspective, or a multilevel implementation perspective that incorporates contextual factors. Although systematic reviews remain foundational in supporting knowledge translation, they often lack structured updating and can be problematic to implement in complex cases. Knowledge brokers play an important role in evidence use; these may be managers or administrators of rehabilitation services. Organisational support that sustains and structures knowledge brokering roles has been found lacking. Numerous contextual factors influence knowledge translation, including leadership, fidelity monitoring, and divergent stakeholder perspectives. Integrative frameworks have been developed that consolidate the multiple contingencies. Summary: Knowledge translation is a complex process with an incomplete knowledge base; its uniprofessional focus is particularly limiting for neurological rehabilitation. Developing accessible systematic reviews remains central, as well as supporting knowledge brokers, being aware of stakeholder absorptive capacity in developing translational strategies and using integrative frameworks to guide knowledge translation for complex interventions.
    Full-text · Article · Oct 2012 · Current opinion in neurology
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    ABSTRACT: Background Non-small cell lung cancer, breast cancer, and colorectal cancer are commonly diagnosed cancers in Canada. Patients diagnosed with early-stage non-small cell lung, breast, or colorectal cancer represent potentially curable populations. For these patients, surgery is the primary mode of treatment, with (neo)adjuvant therapies (e.g., chemotherapy, radiotherapy) recommended according to disease stage. Data from our research in Nova Scotia, as well as others’, demonstrate that a substantial proportion of non-small cell lung cancer and colorectal cancer patients, for whom practice guidelines recommend (neo)adjuvant therapy, are not referred for an oncologist consultation. Conversely, surveillance data and clinical experience suggest that breast cancer patients have much higher referral rates. Since surgery is the primary treatment, the surgeon plays a major role in referring patients to oncologists. Thus, an improved understanding of how surgeons make decisions related to oncology services is important to developing strategies to optimize referral rates. Few studies have examined decision making for (neo)adjuvant therapy from the perspective of the cancer surgeon. This study will use qualitative methods to examine decision-making processes related to referral to oncology services for individuals diagnosed with potentially curable non-small cell lung, breast, or colorectal cancer. Methods A qualitative study will be conducted, guided by the principles of grounded theory. The study design is informed by our ongoing research, as well as a model of access to health services. The method of data collection will be in-depth, semi structured interviews. We will attempt to recruit all lung, breast, and/or colorectal cancer surgeons in Nova Scotia (n ≈ 42), with the aim of interviewing a minimum of 34 surgeons. Interviews will be audiotaped and transcribed verbatim. Data will be collected and analyzed concurrently, with two investigators independently coding and analyzing the data. Analysis will involve an inductive, grounded approach using constant comparative analysis. Discussion The primary outcomes will be (1) identification of the patient, surgeon, institutional, and health-system factors that influence surgeons’ decisions to refer non-small cell lung, breast, and colorectal cancer patients to oncology services when consideration for (neo)adjuvant therapy is recommended and (2) identification of potential strategies that could optimize referral to oncology for appropriate individuals.
    Full-text · Article · Oct 2012 · Implementation Science
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