Skip to main content
Top
Published in: Implementation Science 1/2013

Open Access 01-12-2013 | Research

What supports do health system organizations have in place to facilitate evidence-informed decision-making? a qualitative study

Authors: Moriah E Ellen, Gregory Léon, Gisèle Bouchard, John N Lavis, Mathieu Ouimet, Jeremy M Grimshaw

Published in: Implementation Science | Issue 1/2013

Login to get access

Abstract

Background

Decisions regarding health systems are sometimes made without the input of timely and reliable evidence, leading to less than optimal health outcomes. Healthcare organizations can implement tools and infrastructures to support the use of research evidence to inform decision-making.

Objectives

The purpose of this study was to profile the supports and instruments (i.e., programs, interventions, instruments or tools) that healthcare organizations currently have in place and which ones were perceived to facilitate evidence-informed decision-making.

Methods

In-depth semi-structured telephone interviews were conducted with individuals in three different types of positions (i.e., a senior management team member, a library manager, and a ‘knowledge broker’) in three types of healthcare organizations (i.e., regional health authorities, hospitals and primary care practices) in two Canadian provinces (i.e., Ontario and Quebec). The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software.

Results

A total of 57 interviews were conducted in 25 organizations in Ontario and Quebec. The main findings suggest that, for the healthcare organizations that participated in this study, the following supports facilitate evidence-informed decision-making: facilitating roles that actively promote research use within the organization; establishing ties to researchers and opinion leaders outside the organization; a technical infrastructure that provides access to research evidence, such as databases; and provision and participation in training programs to enhance staff’s capacity building.

Conclusions

This study identified the need for having a receptive climate, which laid the foundation for the implementation of other tangible initiatives and supported the use of research in decision-making. This study adds to the literature on organizational efforts that can increase the use of research evidence in decision-making. Some of the identified supports may increase the use of research evidence by decision-makers, which may then lead to more informed decisions, and hopefully to a strengthened health system and improved health.
Literature
1.
go back to reference World Health Organization: Bridging the “Know-Do” Gap. 2006, Geneva, Switzerland: WHO Press World Health Organization: Bridging the “Know-Do” Gap. 2006, Geneva, Switzerland: WHO Press
2.
go back to reference Grol R: Successes and failures in the implementation of evidence-based guidelines for clinical practice. Med Care. 2001, 39: II46-II54.CrossRefPubMed Grol R: Successes and failures in the implementation of evidence-based guidelines for clinical practice. Med Care. 2001, 39: II46-II54.CrossRefPubMed
3.
go back to reference Lavis JN, Catallo C, Permanand G, Zierler A, BRIDGE Study Team: BRIDGE Summary 1 – Communicating Clearly: Enhancing Information-Packaging Mechanisms to Support Knowledge Brokering in European Health Systems. 2011, Brussels, Belgium: European Observatory on Health Systems and Policies Lavis JN, Catallo C, Permanand G, Zierler A, BRIDGE Study Team: BRIDGE Summary 1 – Communicating Clearly: Enhancing Information-Packaging Mechanisms to Support Knowledge Brokering in European Health Systems. 2011, Brussels, Belgium: European Observatory on Health Systems and Policies
4.
go back to reference Lavis JN, Lomas J, Hamid M, Sewankambo NK: Assessing country-level efforts to link research to action. B World Health Organ. 2006, 84: 620-628. 10.2471/BLT.06.030312.CrossRef Lavis JN, Lomas J, Hamid M, Sewankambo NK: Assessing country-level efforts to link research to action. B World Health Organ. 2006, 84: 620-628. 10.2471/BLT.06.030312.CrossRef
6.
go back to reference Grimshaw JM, Eccles MP, Walker AE, Thomas RE: Changing physicians’ behavior: what works and thoughts on getting more things to work. J Contin Educ Health Prof. 2002, 22: 237-243. 10.1002/chp.1340220408.CrossRefPubMed Grimshaw JM, Eccles MP, Walker AE, Thomas RE: Changing physicians’ behavior: what works and thoughts on getting more things to work. J Contin Educ Health Prof. 2002, 22: 237-243. 10.1002/chp.1340220408.CrossRefPubMed
7.
go back to reference LaPelle N, Luckmann R, Simpson EH, Martin ER: Identifying strategies to improve access to credible and relevant information for public health professionals: a qualitative study. BMC Public Health. 2006, 6: 89-10.1186/1471-2458-6-89.CrossRefPubMedPubMedCentral LaPelle N, Luckmann R, Simpson EH, Martin ER: Identifying strategies to improve access to credible and relevant information for public health professionals: a qualitative study. BMC Public Health. 2006, 6: 89-10.1186/1471-2458-6-89.CrossRefPubMedPubMedCentral
8.
go back to reference Ouimet M, Bedard PO, Turgeon J, Lavis JN, Gélineau F, Gagnon F: Correlates of consulting research evidence among policy analysts in government ministries: a cross-sectional survey. Evid Policy. 2010, 6: 433-460. 10.1332/174426410X535846.CrossRef Ouimet M, Bedard PO, Turgeon J, Lavis JN, Gélineau F, Gagnon F: Correlates of consulting research evidence among policy analysts in government ministries: a cross-sectional survey. Evid Policy. 2010, 6: 433-460. 10.1332/174426410X535846.CrossRef
9.
go back to reference Revere D, Turner AM, Madhavan A, Rambo N, Bugni PF, Kimball A: Understanding the information needs of public health practitioners: a literature review to inform design of an interactive digital knowledge management system. J Biomed Inform. 2007, 40: 410-421. 10.1016/j.jbi.2006.12.008.CrossRefPubMed Revere D, Turner AM, Madhavan A, Rambo N, Bugni PF, Kimball A: Understanding the information needs of public health practitioners: a literature review to inform design of an interactive digital knowledge management system. J Biomed Inform. 2007, 40: 410-421. 10.1016/j.jbi.2006.12.008.CrossRefPubMed
10.
go back to reference Innvaer S, Vist G, Trommald M, Oxman AD: Health policy-makers’ perceptions of their use of evidence: a systematic review. J Health Serv Res Po. 2002, 7: 239-244. 10.1258/135581902320432778.CrossRef Innvaer S, Vist G, Trommald M, Oxman AD: Health policy-makers’ perceptions of their use of evidence: a systematic review. J Health Serv Res Po. 2002, 7: 239-244. 10.1258/135581902320432778.CrossRef
11.
go back to reference Lavis JN, Davies HTO, Oxman AD, Denis J-L, Golden-Biddle K, Ferlie E: Towards systematic reviews that inform health care management and policy-making. J Health Serv Res Po. 2005, 10: S1:35-S1:48. Lavis JN, Davies HTO, Oxman AD, Denis J-L, Golden-Biddle K, Ferlie E: Towards systematic reviews that inform health care management and policy-making. J Health Serv Res Po. 2005, 10: S1:35-S1:48.
13.
go back to reference Lavis JN: Research, public policymaking, and knowledge-translation processes: Canadian efforts to build bridges. J Contin Educ Health. 2006, 26: 37-45. 10.1002/chp.49.CrossRef Lavis JN: Research, public policymaking, and knowledge-translation processes: Canadian efforts to build bridges. J Contin Educ Health. 2006, 26: 37-45. 10.1002/chp.49.CrossRef
14.
go back to reference Ellen ME, Lavis JN, Ouimet M, Grimshaw J, Bedard PO: Determining research knowledge infrastructure for healthcare systems: a qualitative study. Implement Sci. 2011, 6: 60-10.1186/1748-5908-6-60.CrossRefPubMedPubMedCentral Ellen ME, Lavis JN, Ouimet M, Grimshaw J, Bedard PO: Determining research knowledge infrastructure for healthcare systems: a qualitative study. Implement Sci. 2011, 6: 60-10.1186/1748-5908-6-60.CrossRefPubMedPubMedCentral
15.
go back to reference Morse J, Field P: Qualitative Research Methods for Health Professionals. 1995, Thousand Oaks: Sage Morse J, Field P: Qualitative Research Methods for Health Professionals. 1995, Thousand Oaks: Sage
16.
go back to reference Marshall C, Rossman G: Designing Qualitative Research. 1989, Newbury Park: Sage Marshall C, Rossman G: Designing Qualitative Research. 1989, Newbury Park: Sage
17.
18.
go back to reference Heckathorn DD: Respondent-driven sampling: a new approach to the study of hidden populations. Soc Probl. 1997, 44: 174-199. 10.2307/3096941.CrossRef Heckathorn DD: Respondent-driven sampling: a new approach to the study of hidden populations. Soc Probl. 1997, 44: 174-199. 10.2307/3096941.CrossRef
19.
go back to reference Lavis JN, Oxman A, Moynihan R, Paulsen E: Evidence-informed health policy 1- Synthesis of findings from a multi-method study of organizations that support the use of research evidence. Implement Sci. 2008, 3: 1-7. 10.1186/1748-5908-3-1.CrossRef Lavis JN, Oxman A, Moynihan R, Paulsen E: Evidence-informed health policy 1- Synthesis of findings from a multi-method study of organizations that support the use of research evidence. Implement Sci. 2008, 3: 1-7. 10.1186/1748-5908-3-1.CrossRef
20.
go back to reference Dobbins M, Hanna S, Ciliska D, Manske S, Cameron R, Mercer S: A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies. Implement Sci. 2009, 4: 61-10.1186/1748-5908-4-61.CrossRefPubMedPubMedCentral Dobbins M, Hanna S, Ciliska D, Manske S, Cameron R, Mercer S: A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies. Implement Sci. 2009, 4: 61-10.1186/1748-5908-4-61.CrossRefPubMedPubMedCentral
21.
go back to reference Pentland D, Forsyth K, Maciver D, Walsh M, Murray R, Irvine L: Enabling integrated knowledge acquisition and management in health care teams. Knowledge Management Res Practice. 2013, 1-13. Pentland D, Forsyth K, Maciver D, Walsh M, Murray R, Irvine L: Enabling integrated knowledge acquisition and management in health care teams. Knowledge Management Res Practice. 2013, 1-13.
22.
go back to reference Myllärniemi J, Laihonen H, Karppinen H, Seppänen K: Knowledge management practices in healthcare services. Measuring Bus Excellence. 2012, 16: 54-65. 10.1108/13683041211276447.CrossRef Myllärniemi J, Laihonen H, Karppinen H, Seppänen K: Knowledge management practices in healthcare services. Measuring Bus Excellence. 2012, 16: 54-65. 10.1108/13683041211276447.CrossRef
23.
go back to reference Coburn AF: The role of health services research in developing state health policy. Health Affair. 1998, 17: 139-151. 10.1377/hlthaff.17.1.139.CrossRef Coburn AF: The role of health services research in developing state health policy. Health Affair. 1998, 17: 139-151. 10.1377/hlthaff.17.1.139.CrossRef
24.
go back to reference Leon G, Ouimet M, Lavis J, Grimshaw J, Gagnon MP: Assessing availability of scientific journals, databases, and health library services in Canadian health ministries: a cross-sectional study. Implement Sci. 2013, 8: 34-10.1186/1748-5908-8-34.CrossRefPubMedPubMedCentral Leon G, Ouimet M, Lavis J, Grimshaw J, Gagnon MP: Assessing availability of scientific journals, databases, and health library services in Canadian health ministries: a cross-sectional study. Implement Sci. 2013, 8: 34-10.1186/1748-5908-8-34.CrossRefPubMedPubMedCentral
25.
go back to reference Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004, 82: 581-629. 10.1111/j.0887-378X.2004.00325.x.CrossRefPubMedPubMedCentral Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004, 82: 581-629. 10.1111/j.0887-378X.2004.00325.x.CrossRefPubMedPubMedCentral
26.
go back to reference Kitson A, Harvey G, McCormack B: Enabling the implementation of evidence based practice: A conceptual framework. Qual Health Care. 1998, 7: 149-158. 10.1136/qshc.7.3.149.CrossRefPubMedPubMedCentral Kitson A, Harvey G, McCormack B: Enabling the implementation of evidence based practice: A conceptual framework. Qual Health Care. 1998, 7: 149-158. 10.1136/qshc.7.3.149.CrossRefPubMedPubMedCentral
27.
go back to reference Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009, 4: 4-10.1186/1748-5908-4-4.CrossRef Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009, 4: 4-10.1186/1748-5908-4-4.CrossRef
28.
go back to reference Landry R, Nabil A, Pablos-Mendes A, Shademani R, Gold I: The knowledge-value chain: a conceptual framework for knowledge translation in health. B World Health Organ. 2006, 84: 597-602. 10.2471/BLT.06.031724.CrossRef Landry R, Nabil A, Pablos-Mendes A, Shademani R, Gold I: The knowledge-value chain: a conceptual framework for knowledge translation in health. B World Health Organ. 2006, 84: 597-602. 10.2471/BLT.06.031724.CrossRef
29.
go back to reference Bowen S, Erickson T, Martens PJ, Crockett S: More than “Using Research”: the real challenges in promoting evidence-informed decision-making. Hlthc Policy. 2009, 4: 87-102. Bowen S, Erickson T, Martens PJ, Crockett S: More than “Using Research”: the real challenges in promoting evidence-informed decision-making. Hlthc Policy. 2009, 4: 87-102.
30.
go back to reference Stetler CB, Ritchie JA, Rycroft-Malone J, Schultz AA, Charns MP: Institutionalizing evidence-based practice: an organizational case study using a model of strategic change. Implement Sci. 2009, 4: 78-10.1186/1748-5908-4-78.CrossRefPubMedPubMedCentral Stetler CB, Ritchie JA, Rycroft-Malone J, Schultz AA, Charns MP: Institutionalizing evidence-based practice: an organizational case study using a model of strategic change. Implement Sci. 2009, 4: 78-10.1186/1748-5908-4-78.CrossRefPubMedPubMedCentral
31.
go back to reference Peirson L, Ciliska D, Dobbins M, Mowat D: Building capacity for evidence-informed decision-making in public health: a case study of organizational change. BMC Public Health. 2012, 12: Peirson L, Ciliska D, Dobbins M, Mowat D: Building capacity for evidence-informed decision-making in public health: a case study of organizational change. BMC Public Health. 2012, 12:
32.
go back to reference Nutley S, Walter I, Davies HTO: From knowing to doing: a framework for understanding the evidence-into-practice agenda. Eval. 2003, 9: 125-148. 10.1177/1356389003009002002.CrossRef Nutley S, Walter I, Davies HTO: From knowing to doing: a framework for understanding the evidence-into-practice agenda. Eval. 2003, 9: 125-148. 10.1177/1356389003009002002.CrossRef
33.
go back to reference Walter I, Davies HTO, Nutley SM: Increasing research impact through partnerships: Evidence from outside health care. J Health Serv Res Po. 2003, 8: 58-61. 10.1258/135581903322405180.CrossRef Walter I, Davies HTO, Nutley SM: Increasing research impact through partnerships: Evidence from outside health care. J Health Serv Res Po. 2003, 8: 58-61. 10.1258/135581903322405180.CrossRef
34.
go back to reference Denis J-L, Lomas J, Stipich N: Creating receptor capacity for research in the health system: the Executive Training for Research Application (EXTRA) program in Canada. J Health Serv Res Po. 2008, 13: 1-7.CrossRef Denis J-L, Lomas J, Stipich N: Creating receptor capacity for research in the health system: the Executive Training for Research Application (EXTRA) program in Canada. J Health Serv Res Po. 2008, 13: 1-7.CrossRef
35.
go back to reference Jones N, Datta A, Jones H: Knowledge, policy and power: Six dimensions of the knowledge–development policy interface. 2009, Overseas Development Institute Jones N, Datta A, Jones H: Knowledge, policy and power: Six dimensions of the knowledge–development policy interface. 2009, Overseas Development Institute
36.
go back to reference Lavis JN, Boyko JA, Oxman AD, Lewin S, Fretheim A: SUPPORT Tools for evidence-informed health Policymaking (STP) 14: organising and using policy dialogues to support evidence-informed policymakin. Health Res Policy Syst. 2009, 7 (Suppl 1): S14-10.1186/1478-4505-7-S1-S14.CrossRefPubMedPubMedCentral Lavis JN, Boyko JA, Oxman AD, Lewin S, Fretheim A: SUPPORT Tools for evidence-informed health Policymaking (STP) 14: organising and using policy dialogues to support evidence-informed policymakin. Health Res Policy Syst. 2009, 7 (Suppl 1): S14-10.1186/1478-4505-7-S1-S14.CrossRefPubMedPubMedCentral
37.
go back to reference Moynihan R, Oxman AD, Lavis JN, Paulsen E: Evidence-Informed Health Policy: Using Research to Make Health Systems Healthier. A Review of Organizations that Support the Use of Research Evidence in Developing Guidelines, Technology Assessments, and Health Policy. Report Prepared for the WHO Advisory Committee on Health Research. 2008, Oslo: Norwegian Knowledge Centre for the Health Services Moynihan R, Oxman AD, Lavis JN, Paulsen E: Evidence-Informed Health Policy: Using Research to Make Health Systems Healthier. A Review of Organizations that Support the Use of Research Evidence in Developing Guidelines, Technology Assessments, and Health Policy. Report Prepared for the WHO Advisory Committee on Health Research. 2008, Oslo: Norwegian Knowledge Centre for the Health Services
38.
go back to reference Kogan M, Henkel M, Hanney S: Government and Research: Thirty Years of Evolution. 2006, Dordrecht: SpringerCrossRef Kogan M, Henkel M, Hanney S: Government and Research: Thirty Years of Evolution. 2006, Dordrecht: SpringerCrossRef
39.
go back to reference Denis J-L, Lomas J: Convergent evolution: The academic and policy roots of collaborative research. J Health Serv Res Po. 2003, 8: 1-5.CrossRef Denis J-L, Lomas J: Convergent evolution: The academic and policy roots of collaborative research. J Health Serv Res Po. 2003, 8: 1-5.CrossRef
40.
go back to reference Caplan N: The two communities theory and knowledge utilization. Am Behav Sci. 1979, 22: 459-470. 10.1177/000276427902200308.CrossRef Caplan N: The two communities theory and knowledge utilization. Am Behav Sci. 1979, 22: 459-470. 10.1177/000276427902200308.CrossRef
41.
go back to reference Lomas J: Using ‘linkage and exchange’ to move research into policy at a Canadian foundation: Encouraging partnerships between researchers and policymakers is the goal of a promising new Canadian initiative. Health Affair. 2000, 19: 236-240. 10.1377/hlthaff.19.3.236.CrossRef Lomas J: Using ‘linkage and exchange’ to move research into policy at a Canadian foundation: Encouraging partnerships between researchers and policymakers is the goal of a promising new Canadian initiative. Health Affair. 2000, 19: 236-240. 10.1377/hlthaff.19.3.236.CrossRef
42.
go back to reference Berwick DM: Disseminating innovations in health care. J Am Med Assoc. 2003, 289: 1969-1975. 10.1001/jama.289.15.1969.CrossRef Berwick DM: Disseminating innovations in health care. J Am Med Assoc. 2003, 289: 1969-1975. 10.1001/jama.289.15.1969.CrossRef
43.
go back to reference Panisset U, Koehlmoos T, Alkhatib A, Pantoja T, Singh P, Kengey-Kayondo J: Implementation research evidence uptake and use for policy-making. Health Res Policy Syst. 2012, 10: 20-10.1186/1478-4505-10-20.CrossRefPubMedPubMedCentral Panisset U, Koehlmoos T, Alkhatib A, Pantoja T, Singh P, Kengey-Kayondo J: Implementation research evidence uptake and use for policy-making. Health Res Policy Syst. 2012, 10: 20-10.1186/1478-4505-10-20.CrossRefPubMedPubMedCentral
Metadata
Title
What supports do health system organizations have in place to facilitate evidence-informed decision-making? a qualitative study
Authors
Moriah E Ellen
Gregory Léon
Gisèle Bouchard
John N Lavis
Mathieu Ouimet
Jeremy M Grimshaw
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2013
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/1748-5908-8-84

Other articles of this Issue 1/2013

Implementation Science 1/2013 Go to the issue