1. Canadian Conference on Nursing Research: June 13, 2002
Creating Canada-wide Research & Funding Partnerships: Issues and Lessons Learned From a Study of Rural and Remote Nursing Practice
Martha MacLeod, UNBC
Judith Kulig, University of Lethbridge
Norma Stewart, University of Saskatchewan
Roger Pitblado, Laurentian University
Louise Lapierre, CHSRF
Marian Knock, BC Ministry of Health Planning
Canadian Conference on Nursing Research: June 13, 2002

2. The Study
Aim:
to examine and articulate the nature of registered nursing practice in primary care, acute care, community health, continuing care (home care) and long term care settings within rural and remote Canada 1

3. The Study Components Survey Registered Nurses Data Base (RNDB)
Narrative Study
Documentary Analysis

4. Project Germination Applications August 1999 “a casual comment”
October Saskatoon, Prince George
Applications
November CHSRF Open Grants Competition:
Submission of LOI
March Submission of full application
June CHSRF-Conditional approval
Summer CHSRF-Request for additional information/clarification
December Resubmission of full application
April Official grant approval
May Project underway
August All sub-contracts signed

5. Principal Investigators and Decision-maker
Martha MacLeod University of Northern
British Columbia
Judith Kulig University of Lethbridge
Norma Stewart University of Saskatchewan
Roger Pitblado Laurentian University
Marian Knock
B.C. Ministry of Health Planning 2

6. Co-Investigators Ruth Martin-Misener Dalhousie University
Ginette Lazure
Université Laval
Jenny Medves
Queen's University
Michel Morton
Lakehead University
Carolyn Vogt
U. Manitoba
Gail Remus
U. Saskatchewan
Debra Morgan
Dorothy Forbes
U. Saskatchewan
Barbara Smith
Carl D'Arcy
Elizabeth Thomlinson
U. Calgary
Kathy Banks
UNBC
Lela Zimmer 3

7. Advisory Team Members
Marian Knock, B.C. MOHP, Principal Decision-Maker
Denise Alcock, U. Ottawa
Madge Applin, Centre for Nursing Studies, Nfld.
Donna Brunskill, SRNA
Elizabeth Cook, Aurora College, Yellowknife, NWT
Marta Crawford, CRNM
Fran Curran, Yukon Health & Social Services
Joyce England, ANPEI
Fjola Hart Wasekeesikaw, Aboriginal Nurses Ass’n
Adele Vukic, Dalhousie U.
Joyce English, ANPEI
Barb Oke, N.S. MOH
Cecile Hunt, North Central Health District, SK
Kathleen MacMillan, FINHB – Health Canada
Maria MacNaughton, MSB - Health Canada
Suzanne Michaud, QHA
Rachel Munday, Health and Social Services, Nunavut
Debbie Phillipchuk, AARN
Francine Anne Roy, CIHI
Marlene Smadu, Saskatchewan Health
Roxanne A. Tarjan, NANB
Cathy Ulrich, Northern Health Authority, BC
Anne Ardiel, B.C.MOHP

9. Funding Partners Canadian Health Services Research Foundation
Canadian Institutes of Health Research
Nursing Research Fund
Ontario Ministry of Health and Long-Term Care
Alberta Heritage Foundation for Health Research
Michael Smith Foundation for Health Research
Nova Scotia Health Research Foundation
British Columbia Rural and Remote Health Research Institute
Saskatchewan Economic and Cooperative Development
Provincial and Territorial Nurses Associations
Government of Nunavut
Canadian Institute for Health Information 1

10. Researchers’ Perspective
Martha MacLeod
Lead Investigator
Co-Principal Investigator

11. Time, Timing and Flexibility
What is needed to develop and support a Canada-wide study?
Lessons Learned:
Take hold of the opportunity
Don’t underestimate infrastructure or time needed
Communicate, communicate, communicate
Funding for project development
Flexibility of funders is sometimes critical to development
Time, Timing and Flexibility
Time: It is impossible to overestimate the amount of time required to build teams and networks.
The time required of the lead investigators in the development stage was tremendous; the time required in implementation stage is beyond the 5-15% indicated in the Letter of Intent – a rational figure put forward as we were planning
Timing: - Taking hold of the opportunity - an important and timely research question, keen investigators, and the deadline of a LOI.
- interest in the nursing human resources within many jurisdictions
- increasing interest in rural research
Take the opportunity but recognize that it takes time to develop a team.
Flexibility: (see additional notes)
Learn and mobilize the systems in your various institutions; recognize that they may not all work in the same way and build that into the plan (e.g. differences in institutional commitments re publication) - mobilize resources to assist, where they are available
What was enormously helpful was the flexibility of the funding agency in the recognition of the developing team.

12. Building Teams, Building Trust
How do we develop and recognize the team?
How do we keep the momentum going over time and across country?
Lessons Learned:
Need a well-working, trusting core group
Need mechanisms for recognizing project involvement
Make the most of various talents
Calling on differing expertise at differing stages of the project
Structuring the team(s) into effective working groups with overall coordination
The amount of work to develop the proposal and get the project underway has been tremendous. It has taken commitment on the part of all the investigators, the institutions within which they work (e.g. finance), the advisors and the funders.
Challenges in keeping people involved, when fax, phone and meeting costs have to be absorbed, sometimes personally, and not are on the /internet.
Need a well-working, trusting core group. When one person’s energy and time is less available, another pulls more. Time and effort to develop this trust, understanding of working styles and strengths, in person, is well worth it.
Recognition in academic currency (money brought in, name of Co-PI’s on funding statements), is necessary, but not always built in. Funding agencies need to acknowledge that new forms of research teams are developing (e.g. change of policies about allowable PI’s).
Keep the overall goal and plan in mind, while creating the specifics as one goes along
Making the most of various talents – creating effective small working groups within the whole while maintaining overall coordination. This is a challenge as, with the exception of the survey team, the working groups are spread across the country. structure the research team in such a way that recognizes and uses varying aptitude, interests and areas of expertise.
All areas of expertise are going to be needed some time in the life of the study. Recognize many reasons people are on a research team – and make them work. 2

13. Developing and Engaging the Advisory Team
What do researchers need from an Advisory Team?
How can Advisors remain engaged?
Lessons Learned:
Recognize team will change and evolve
All areas of expertise will be needed sometime in the life of the study
Be specific in requests of Advisors
Don’t underestimate the talents of Advisors
Communicate, communicate, communicate (but in ways that Advisors need)
Why did we choose the various members on each team?
- Best advice re advisory team – look to what we need to shape the project given what nurses need, what managers need, the federal/provincial system and who listens to whom? Who will we get good advice from? Who, other than the research team will listen to them?
What do we need from the Advisory Team?
- Information on current issues, networks, make sure they’re relevant,.. What the decision-makers need to have from the study and when? How to make sure this study is received by decision-makers and nurses?
How are we developing capacity?
- In each of the Co-PI’s teams there are research trainees. The team is committed to working together in ways that enable experienced researchers to work with those less experienced in a particular approach, while drawing on their particular skills – These come out at various times in the overall project.
How do we address the realities of the Canadian situation?
Francophone capacity – still a challenge, for this project that originated and is being led in western Canada. 2

14. Louise Lapierre Canadian Health Services Research Foundation
Funder’s Perspective
Louise Lapierre
Canadian Health Services Research Foundation

15. CHSRF Overview
An independent, national, public, not-for-profit corporation established in 1997 with a federal fund.
Mission: To promote and fund applied health services research ( special focus on nursing research) and to increase the research’s quality, relevance and usefulness for policy makers.
Key Difference: Review proposals for potential impact and scientific merit by panels of decision makers and researchers.

16. Lessons Learned from Experience with this Project
Confirms need for matching funding at full-scale application stage.
Plans are in place to retain competition themes over a number competitions.
An exception was made to the policy of allowing only two co-principal investigators
Multi-jurisdictional nature of project can affect ethical approval.

17. Decision Maker Involvement in CHSRF Funded Research
Relationship between decision-maker and research team affects the impact of the research.
The decision-maker should be able to discern first messages for dissemination and important short-term deliverables for the project.
Appropriate and meaningful involvement of decision-maker partners will vary.
Articulation of the planned decision-maker involvement is required in the full-scale application and is assessed by the merit review panel.

18. Principal Decision Maker’s Perspective
Marian Knock
B.C. Ministry of Health Planning
Executive Director, Primary Care Program

19. Role of Principal Decision Maker
Theoretical Role
Actual Role
Issues
Time/Timing
Principal investigators involved early on
Not a major focus of the team at early stages
Principal decision-maker loses the plot
1.1 Theoretical role
input into policy related decisions
advise how research may influence policy
assist with dissemination of research findings
advise decision makers in Government and administer regarding results of research
advise regarding translating research results into policy/practice
1.2 Actual role
provide advice on where research findings could be shared
provide advice on naming key decision makers in Government and health care to receive reports/research
advise re ADM, HHR, HA contacts
advise re F/P/T
possible funding sources
media opportunities
1.3 Issue Time/Timing
principle investigators involved early on
not major focus of team
principal decision maker loses plot

20. Expectations Principal Investigators Principal Decision-Maker Issues
Getting to know each other
Role confusion – when to become involved
Role/connections with Advisory Team
Unclear expectations
What feedback is appreciated
Whose research is this?
2. Expectations
2.1 Principal Investigators
decision maker will stay in touch
decision maker aware of issues
decision maker knows role
2.2 Principal Decision maker
Principal Investigator will advise re what they want/need
Principal Investigator will advise when to become involved
Principal Investigator will give decision maker concrete tasks to do.
2.3 Issues
Getting to know each other - when you don’t know each other before
Role confusion - when to become involved
What is the role/connections expected with the Advisory Team?
Unclear expectations
what feedback is appreciated?
whose research is this?
3. Actuality
met with Martha early to discuss role
missed/didn’t meet with team until May 2002
length of research time influences involvement
unsure of role of Principal Investigator, Co-Principal Investigator and Principal Decision Maker.
missed two earlier opportunities for meeting due to travel restrictions
CHRF conference in February assisted understanding
met another Principal Investigator/ clarified expectations

21. Recommendations Written description-roles & responsibilities
Establish relationship early
Clarify expectations (PI/DM)
Regular meetings over life of research
Teleconferences after meetings
4. Recommendation
written description of roles and responsibilities
meeting with Principal Investigator early to establish relationship
clarify expectations on both sides (PI / DM)
meet at least 3 times over life of research
schedule teleconference after meeting

22. Choosing a Principal Decision Maker
Determine where you would like the research to make an impact.
Choose a person “high enough” to be able to make the appropriate contacts.
Meet in person to determine the fit.
Explain time commitment with expectations
How in the future would you choose a principal decision maker?
Determine where you would like the research to make impact
Choose person high enough up to be able to be in contact with ADM/DM level or CEO/VP level.
Meet in person with choice to determine fit
Explain time commitment with expectations

23. Summary
Developing partnerships in a Canada-wide study is exciting, demanding, and will ultimately result in a better study with a greater chance of its findings being used.
There are not many recipes out there.
Flexibility, trust, and commitment on the part of researchers, decision-makers, and funders make it possible.

24. Contact Information
Overall Project and Narratives:
Tel:
Documentary Analysis:
(403)
Survey:
(306)
RNDB
(705) ext: 3355