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Published in: Systematic Reviews 1/2017

Open Access 01-12-2017 | Methodology

Putting research in place: an innovative approach to providing contextualized evidence synthesis for decision makers

Authors: Stephen Bornstein, Rochelle Baker, Pablo Navarro, Sarah Mackey, David Speed, Melissa Sullivan

Published in: Systematic Reviews | Issue 1/2017

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Abstract

Background

The Contextualized Health Research Synthesis Program (CHRSP), developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings.

Methods

As an integrated knowledge translation (KT) method, CHRSP:
  • Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams;
  • Considers local context both in framing the research question and in reporting the findings;
  • Makes economical use of resources by utilizing a limited number of staff;
  • Uses a combination of external and local experts; and
  • Works quickly by synthesizing high-level systematic review evidence rather than primary studies.
Although it was developed in the Canadian province of Newfoundland and Labrador, the CHRSP methodology is adaptable to a variety of settings with distinctive features, such as those in rural, remote, and small-town locations.

Results

CHRSP has published 25 syntheses on priority topics chosen by the provincial healthcare system, including:
  • Clinical and cost-effectiveness: telehealth, rural renal dialysis, point-of-care testing;
  • Community-based health services: helping seniors age in place, supporting seniors with dementia, residential treatment centers for at-risk youth;
  • Healthcare organization/service delivery: reducing acute-care length of stay, promoting flu vaccination among health workers, safe patient handling, age-friendly acute care; and
  • Health promotion: diabetes prevention, promoting healthy dietary habits.
These studies have been used by decision makers to inform local policy and practice decisions.

Conclusions

By asking the health system to identify its own priorities and to participate directly in the research process, CHRSP fully integrates KT among researchers and knowledge users in healthcare in Newfoundland and Labrador. This high level of decision-maker buy-in has resulted in a corresponding level of uptake. CHRSP studies have directly informed a number of policy and practice directions, including the design of youth residential treatment centers, a provincial policy on single-use medical devices, and most recently, the opening of the province’s first Acute Care for the Elderly hospital unit.
Footnotes
1
The province restructured their health care system in 2005 [45] to create four Regional Health Authorities: Eastern Health (which includes the tertiary care centers for the province in its capital, St. John’s), Central Health, Western Health, and Labrador-Grenfell Health, which includes all of sparsely populated Labrador.
 
2
Contextual factors for CHRSP include any variables involving feasibility, equity, cost, or acceptability that could have an impact on the local effectiveness and cost of a proposed policy, program, or practice.
 
3
Population, Intervention, Comparator, Outcome, and Setting parameters for the literature review [28].
 
4
Gray literature is non-commercially published materials, e.g., reports produced by government departments and agencies.
 
5
Each Evidence in Context project also produces an “Online Companion Document” that includes details of search strategies, search results, filtering and screening, critical appraisal, data extraction, analysis, and synthesis.
 
6
In particular, he or she should not have authored any of the systematic reviews included in the CHRSP study.
 
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Metadata
Title
Putting research in place: an innovative approach to providing contextualized evidence synthesis for decision makers
Authors
Stephen Bornstein
Rochelle Baker
Pablo Navarro
Sarah Mackey
David Speed
Melissa Sullivan
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2017
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-017-0606-4

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