Knowledge Mobilization in the Acute NHS Trust setting 13th March 2014 Dr Tim Doulton Director of Research & Development, Consultant Nephrologist

Cooksey Report, 2006

Knowledge Mobilization refers to moving available knowledge (often from formal research) into active use. It involves efforts to bridge the gap between research, policy and practice in order to improve outcomes in various organizations or sectors. involves knowledge sharing between research producers (e.g. university researchers) and research users (including professionals or others whose work can benefit from research findings), often with the help of third parties or intermediaries.

Producer push User pull Knowledge exchange Co-production Events Networks Collaborations Shared Resources Knowledge mobilization = proactive process involving specific efforts to build relationships between research producers & research users Methods: producer push, user pull, knowledge exchange & co-production of knowledge

PARIHS Framework Evidence Facilitation Context Successful implementation of evidence is a function of the nature and type of evidence, the qualities of the context in which the evidence is being introduced, and a process of facilitation Adapted from Rycroft-Malone et al. 2013

Scientifically robust Matches professional consensus Relevant to patient experiences/preferences (preferably based on local data) Evidence Facilitation Skilled internal/external facilitation Context Receptive culture Appropriate leadership Robust monitoring & feedback systems (evaluation) Receptive culture: decentralized decision making; focus on relationships between managers and workers; facilitative management styles Leadership: Potential to bring about clear roles; effective teamwork; effective organisational structures. TRANSFORMATIONAL leadership (vs. command & control) – create receptive contexts and challenge individuals/teams in an enabling way Evaluation: better = collects multiple sources of evidence of performance that feedback at individual, team & system level. Adapted from Rycroft-Malone et al. 2013

Challenges in implementation of SEIK Data governance Persuading GPs of need Seen as a small disease area (“much bigger fish to fry”) … but could be seen as an exemplar for other larger disease areas e.g. diabetes Transferring to operational system It is scalable? It is transferrable? How will it be funded? (soft money initially, then SHA)

‘How would I have done it differently?’ More advice from those who’d been there before (… stealers vs. helpers) More qualitative work on the ‘soft stuff’ i.e. what GPs actually wanted vs. what guidance said Having the right team & right leaders for each part of the job Hard funding with peer-review process ‘… will delay project but more likely to work in the end’

Shared Purpose Framework EKHUFTs clinical leadership programme is focussing on developing a context that enables person-centered, safe & effective care to be delivered across the organisation. Participants focus on: Triangulating data (include NICE guidelines/standards; patient experience; staff wellbeing) Becoming a transformational leader, using holistic facilitation, develop effective workplace culture Use of systematic evaluation Enable teams to develop ownership through engagement/involvement

Thank you for listening Thanks to … Dr Chris Farmer (Colleague & Director of IT, EKHUFT) Prof Kim Manley (Assoc Director Transformational Research & Practice Development, EKHUFT)

“Winning … not about doing one thing 100% better, but about doing 100 things 1% better” Sir Clive Woodward

“We do research because that’s how you get better treatment “We do research because that’s how you get better treatment. I’d like to see that carved in stone above every hospital door” Quote from a patient to PPI workshop Academy of Medical Sciences Report January 2011