Canadian Cancer Society Manitoba Division: Knowledge

Exchange Network (KEN) & CancerCare Manitoba

Manitoba Integrated Chronic Disease Primary Prevention System

Presented at the Need to Know Meeting

By Dexter Harvey & Jane Griffith

January 30, 2006

FRAMEWORK for KNOWLEDGE EXCHANGE NETWORK

Cancer Prevention

Canadian StrategyFor Cancer Control

Rebalance

Chronic Disease

PalliativeCare

SupportiveCare

KnowledgeExchange

Network (KEN)Preventionuser groups

Careuser groups

Human Resource Planning

Research Priorities

Primary Prevention

Rebalancing Focus

Standards & Guidelines

KEN Project

Objective:

To pilot a provincial knowledge exchange model to facilitate the uptake of evidence-based practice to support chronic disease prevention and palliative care.

Knowledge Construction/Utilization Framework

(KEN 2005; adapted from Manske, 2001; adapted from Cousins & Leithwood, 1993)

AssumptionsKnowledge:•Is socially constructed

Information Sources:•Must be credible •Contextually relevant •Congruent w/users’ priorities •Timely•Understandable

Knowledge Brokering:•Brings people to identify issues and construct evidence-based solutions•Is critical to knowledge transfer• Requires skills in: - Facilitative leader- ship- Networking - Business and marketing- Involves risk –taking

Characteristics of the Source & Information:Source: CREDIBILITYSophisticationCommunication Quality Information: RELEVANCETIMELINESSCONTENT - Relative Advantage - Complexity - Trialability - Observability

Characteristics of Contextfor Use:(Organizations,COPs,Individuals) •COMMITMENT— RECEPTIVENESS•MANDATE & PRIORITIES•RESOURCES• USER PERSONAL TACIT KNOWLEDGE• INSTITUTIONAL INFLUENCES (code of conduct)CHARACTERISTICS:•History of Prior Knowledge Use•Previous Experience•Leadership

ENVIRONMENTAL CONTEXT: Scientific Paradigm (nature of evidence); Health System Priorities; Other Sector System Priorities; Interorganizational Relationships

Interactive ProcessesSOCIAL PROCESSING•Involvement in creation of relevant knowledge•Ongoing Contact•Engagement

Creation ofContextually

RelevantKnowledge

Tacit Knowledge

Knowledge Utilization

Action

Social Capital

Information Processing

Decision to Act

Consequences & Feedback

Knowledge Translation Exchange (KTE)

• Early Years viewed as “pushing” research knowledge outwards to selected “audiences”.

• Current research shows that KTE involves people with different perspectives, knowledge and experience exchanging ideas and information for mutual benefit. Ongoing dialog must occur between those who generate research knowledge and potential users.

• If knowledge is socially constructed, then social processes that take place between members of a group (and outside the group) are key elements that facilitate knowledge creation and use in practice

Knowledge Brokering

• Brokering focuses on identifying and bringing together people interested in an issue, people who can help each other develop evidence-based solutions

• A key function of KEN

User Groups (Communities of Practice)

• Groups of People who share a concern, a set of problems, or a passion about a topic

• Innovation grows out of the relationship between an individual and the world of her or his work, and out of the ties between an individual and other human beings.

• Innovation results from interaction and collaboration among individuals with shared interests.

KEN Model

New Evidence

KEN – Knowledge Broker

Evaluation

Community ofPractice (CoP)

Needs

Evidence forEffectivePractice

Resources

CoPContextualizing

Evidence

ImplementEvidence-Based

Practice

ResearchInteractionInteraction Interaction Interaction Interaction

Integrated Chronic Disease Prevention System

KNOWLEDGEKNOWLEDGETRANSLATIONTRANSLATION

Implementation of Policies & Programs

KNOWLEDGEKNOWLEDGEBUILDINGBUILDINGResearch &Surveillance

KNOWLEDGEKNOWLEDGEEXCHANGEEXCHANGE

Communities of Practice; Brokering;

Training & Consultation

POPULATIONIMPACT

Evaluation

KnowledgeSynthesis

CapacityBuilding

Implementation of Policies and Programs

Surveillance

Interaction of Manitoba Knowledge System

(CCS;CCMB;HSFM; Health Regions &Regional & Community

Committees)In Knowledge Translation &

Exchange

Best Practices Identification and Dissemination

Strategic and Investigator Driven Research

PROVINCIAL

NATIONAL/INTERNATIONAL

Policy and Program Evaluation

Manitoba System

Manitoba Integrated Chronic Disease Prevention System

Knowledge Exchange NetworkBrokering Best Practices to Regional IntersectoralCommunities of Practice

Surveillance& Research

Policy & ProgramEvaluation

(Inter)NationalBest PracticesKnowledge Synthesis& Dissemination

Implementation of Chronic DiseasePrevention Policies & Programs

System Operation

Program Evaluation

Process, ProductEvaluation &Surveillance

System Evaluation

Needs & Resource

AssessmentSurveillance

PrioritizedGoals, TargetPopulations &

Objectives

Surveillance &Best Practice

Best PracticeEvidence to reach Goals

Best Practice& Evaluation

Fitting BestEvidence

To CommunityContext

Best Practice

ResearchInteraction

Interactions of Manitoba Knowledge System(CCS; CCSMB; HSFM; Health Regions; Regional &

Community Committees) for Knowledge Translation & Exchange

Interaction Interaction Interaction Interaction

CancerCare Manitoba

• Surveillance

• Evaluation

What Does It Take?

•Cutting Edge Thinking

•Momentum, commitment and goodwill

•Champions

•Learning communities

•“We adapt not adopt”

•NGOs: enable, advocate, convene

•We are the system

Manitoba Evidence-Based System

CCS KEN Knowledge Brokering Effective Practice Workshops on

Evidence-Based Practice

Tasks Effective Practices Using Evidence-Based Practices Evaluation Capacity Development Workshops

Tasks Surveillance Data Collection

and Dissemination Intervention Evaluation Data

Collection and Dissemination

Cancer Care Manitoba Primary Prevention Risk

Factor Surveillance Intervention/Program

Evaluation

Regional Networks & Communities Health Regions Recreation Commissions NGO’s Community Clubs

Schools/Divisions Municipal Councils Churches Community Interest Groups

Ready, Set, ‘Go’•Work together to co-create an integrated

prevention system•Conversations to bring meaning to ‘integration’

and to create a common vision•Enable collective leadership•Negotiate organizational roles within an integrated

system•Nurture a learning community – no ’one’ has the

answers; and there is no ‘right’ way. “Learn as we

go”