By Alison Kitson, AusHSI Adjunct Professor and Dean of Nursing and Head of School, University of Adelaide
In health services across Australia, there is now a real opportunity to commit to promoting innovations in clinical care and embracing evidence-based practice. Through the implementation research conducted in this area, we now understand how we can accelerate the spread of new knowledge through systems. This is extremely important in relation to the innovation and implementation agendas facing every health system.
A 1998 landmark study (insert link) reviewing the quality of care in the United States indicated that some 30% to 50% of care delivery was not in line with best available evidence. The 2012 CareTrack study in Australia, based on similar methods to the earlier US research, came to almost the same conclusion – that Australian patients only received care judged to be appropriate (that is, in line with evidence-based guidelines) 57% of the time.
Despite knowing this, until now, there has not been a collective push or a concerted effort by health systems to translate the knowledge to the people who need to use it – the doctors, nurses and medical professionals working directly with patients.
The importance of Knowledge Translation
Knowledge Translation describes the way knowledge moves across and through systems from the people who create the knowledge (usually researchers and clinicians), to the people who use it – e.g. health professionals, patients, the public and policy makers. The study of Knowledge Translation is often referred to as translational science, and when the research is particularly interested in the way new knowledge is used by frontline staff, then it tends to be described as implementation science.
When it comes to the innovation and implementation agendas facing every health system, we know local champions and opinion leaders (in medicine, nursing, management and allied health) are key to the successful introduction of new innovations – but their efforts need to be part of a coordinated approach by the whole system.
For example, think about the introduction of infection control champions (usually nurses) to ensure compliance with hand hygiene best-practice evidence. If the system does not ensure the correct sanctions and incentives, then this activity by the local champions, in terms of promoting awareness and changing clinician behavior, will be of limited impact.
Knowledge Translation is important because it help us put new knowledge into practice. It gives us insights into how we can change behaviours and systems to be more open and responsive to new evidence. Improvements in patient care and increasing the effectiveness and cost effectiveness of that care are by-products of Knowledge Translation. What’s also important is that Knowledge Translation enables healthcare staff to be kept up-to-date on their practice, keeping it contemporary and evidence based.
Queensland and Australia’s commitment
Queensland, in particular, is in a great position to leverage its commitment to promoting innovations in clinical care and in embracing evidence-based practice.
With the support of organisations like AusHSI, Queensland has access to some of the world’s leading thinkers and researchers in the implementation science field. It also has some awesome local champions who really ‘get’ Knowledge Translation and the importance of keeping systems open and being alert to new and better ways of doing things.
I am very excited about Queensland Health’s Implementation Funding Round that AusHSI supports. It is a great way of capturing the creativity of frontline clinical staff to help them introduce new evidence into practice.
Australia is catching up with countries such as the UK, Canada and the US in terms of its knowledge of and interest in Knowledge Translation. With the proposed changes to National Health and Medical Research Council funding and with the advent of the Medical Research Future Fund, there are real opportunities to invest more funding into implementation science and Knowledge Translation.
However, we do need to think about how we grow capacity around Knowledge Translation – both doing and researching it, and this is where our new partnership between the University of Adelaide and the AusHSI is really important.
My colleague Professor Gill Harvey is already supporting several research and implementation projects in Queensland and together we are looking forward to developing more partnerships between Adelaide and Queensland.
If you are interested in attending a short course on Knowledge Translation or understanding how AusHSI can assist your organisation in implementing an innovation, please email: contact@aushsi.org.au or phone:+61 (7) 3138 0307