'Push and Pull' Strategies for Research Use in
the Canadian Healthcare System
IDRC Round Table on the Use of Research Results
in Policy Decision-making, Formulation and Implementation
11th World Congress on Public Health
August 22, 2006
Outline
Context
Canada
the foundation
the spectrum of strategies
Three foundation examples from the ‘pull’ side
a brief description
a brief overview of early results
Emerging developments
Some information about Canada
10 Provinces
3 Territories
Population: ~ 32 million
2 official languages
2nd largest country in the world: land mass of
~ 9 million km2
The foundation’s mission
to support a culture of
evidence-based decision-making (EIDM)
in the (Canadian) healthcare system
“Are we having an impact?”
The ‘evidence’ in EIDM
“Evidence is information that comes closest to the facts of the
matter … form … depends on the context. ... research is often
incomplete, sometimes contradictory or unavailable (therefore)
other forms are necessary supplements or stand-ins for research.
The evidence base for decision makers is multiple forms of
evidence combined to balance rigour with expedience and rigour is
always privileged.”
Lead: [email protected]
Web: a series of papers in this discussion at:
http://www.chsrf.ca/other_documents/evidence_e.php
Combining multiple forms of evidence
Synthesis with an added twist - deliberative processes:
Decision Support Synthesis
Lead: [email protected]
JHSPR, Supplement 1 to Issue 3, July 2005:
http://rsm.publisher.ingentaconnect.com/content/rsm/jhsrp
Healthcare Policy Papers - Lomas & Lavis; Vol #1, Issue 2,
2006
Strategies for strengthening
evidence-informed decision-making (EIDM)
Strengthening EIDM
PUSH
research
findings into
health policy
PULL
research &
researchers
into health
policy
Increasing linkage& exchange
Three ‘Pull” programs
EXTRA – a national training program giving senior health system
managers (nurses, physicians & health service executives) the
skills to better use research in their day-to-day work
Knowledge Brokering – six demonstration sites in decision maker
organizations and an evaluation to increase understanding of
brokering, identify and link knowledge brokers, provide resources &
evaluate brokering effectiveness
Is Research Working for You? – a self-assessment checklist helps
organizations who want to generate an internal discussion about
how well they use research and where there is potential for
improvement
EXTRA – strong decisions rely on strong evidence
Mission: To develop capacity and leadership to
optimize the use of research-based evidence in
Canadian health service organizations
Format: Teaching modules; self-directed study;
mentorship, IT supported learning network
Lead: [email protected]
Web: http://www.chsrf.ca/extra/index_e.php
Early evaluation results
The fellows have gained new knowledge on the
meaning and application of research evidence.
This knowledge has been applied to the fellows’
respective organizational contexts.
Along the way there have been numerous challenges
faced and a variety of approaches used to effect
positive change in the host organizations.
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Knowledge brokers: finding and linking people
Knowledge brokering
Six demonstrations sites and evaluation to better understand
brokering, provide resources, and evaluate the effectiveness of
brokering
Lead: [email protected]
Web: http://www.chsrf.ca/brokering/index_e.php
Report of consultation and lit review:
http://www.chsrf.ca/brokering/pdf/Theory_and_Practice_e.pdf
Brokering digest:
http://www.chsrf.ca/brokering/brokering_digest_e.php
Is research working for you
Format: A checklist for decision-making organizations who want to
generate an internal discussion about how well they use research
and where there is potential for improvement
Lead: [email protected]
Web: http://www.chsrf.ca/other_documents/working_e.php
KEYS: http://www.chsrf.ca/keys/index_e.php
Promising Practices: http://www.chsrf.ca/promising/index_e.php
Related developments
WHO EVIP-NET – networks for synthesis and KT :
http://www.who.int/rpc/evipnet/en/
PEARL (Promoting Evidence-informed Action from Research
for Leadership) - a new program proposal developed in
partnership between the CHSRF and IDRC
Spin-off in Mexico (and potentially Tanzania and Cameroon) a one week course on EIDM for executives in Mexico and
other Latin American countries based on Module #1 of EXTRA
For more information
Thank you
[email protected]
www.chsrf.ca