Developing capabilities for evidence-based management in healthcare settings June 2004
-
Upload
zaccheus-meboo -
Category
Documents
-
view
35 -
download
0
description
Transcript of Developing capabilities for evidence-based management in healthcare settings June 2004
Executive Training for Research Application
Formation en recherche pour cadres qui exercent dans la santé
disclaimer
Executive Training for Research Application
Formation en recherche pour cadres qui exercent dans la santé
Developing capabilities for evidence-based management in
healthcare settingsJune 2004
EXTRA is a trademark of the Canadian Health Services Research Foundation. EXTRA is funded by a grant from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.
Developing capabilities forevidence-based management in
healthcare settings Armand Boudreau
Organizational liaison – East Consultant in health services management
Élise ComtoisExecutive training, CHSRF
Jean-Louis DenisAcademic co-ordinatorCHSRF/CIHR Chair, Université de Montréal
Jonathan LomasCEO, CHSRF
David RochefortEducation co-ordinatorConsultant in professional development
Nina StipichExecutive training, CHSRF
“Evidence-based management has been defined as practicing managers incorporating evidence from well conducted studies into their decision-making.” (Bigelow & Arndt, 2004)
“Overall, the tightly defined, well-organized, highly quantitative, and relatively generalizable research base for many clinical professions provides a strong and secure foundation for evidence-based practice and lends itself to a systematic process of review and synthesis and to the production of guidelines and protocols.”(Walshe & Rundall, 2001)
“In contrast, the loosely defined, methodologically heterogeneous, widely distributed, and hard-to-generalize research base for health care management is much more difficult to use in the same way… which make the development of evidence-based management more challenging.”(Walshe & Rundall, 2001)
What can we expect from the implementation of an evidence-based culture in healthcare organizations?
Better interpretation of research-based evidence
Increased use of research-based evidence Development of competencies and strategies
among managers to exert demand and to interact with the research communities
Development of knowledge as a strategic asset in healthcare organizations
What are the strategies to promote a realistic perspective of
evidence-based management in healthcare settings?
Strategies to promote EBM inhealthcare settings
Focusing on change in research communities and activities
Focusing on change in decision makers’ or practitioners’ communities and activities
Focusing on communicative strategies and activities across these two communities
Integrative approach is probably more successful
Instruments to promote EBM in healthcare settings
Incentives in researchers’ and practitioners’ communities
Interactions between researchers’ and practitioners’ communities
Creating new organizational arrangements (e.g. consortiums…)
Developing capabilities through training programs
Synergy across different levers for change is probably more transformative
Investing in a training program to promote evidence-based
management in healthcare settings: The Executive Training for Research
Application (EXTRA) program
The EXTRA program An inter-disciplinary program An inter-professional program A program in partnership with
professional associations A program based on a network of
academic and professional resources A program structured around a close
synergy between theory and practice
The EXTRA program A program focusing on the management
and leadership levels rather than on clinical practice
A program designed to increase organizational as well as individual capacity
A program which requires significant organizational support and participation
EXTRA is based on the assumption that the implementation of an
evidence-based culture in healthcare settings represents a major change
for organizations and their usual decision-making process
Vision and mission for EXTRAVISION A health system in which nurses, physicians, and
health service executives collaborate as teams of evidence-based decision makers, optimizing the health of the Canadian population
MISSION To develop capacity and leadership to optimize
the use of research-based evidence in Canadian health service organizations
The conception of research-based evidence behind the EXTRA program
Evidence on the factors that push for change in interventions and modes of service delivery
Evidence for the design of new interventions and modes of service delivery
Evidence on the process of implementation of innovative interventions and modes of service delivery
Evidence on factors and processes that promote the use of research-based evidence
EXTRA program principles Professional development, organization
enhancement Collaborative leadership Heterogeneity Full support in both official languages Continuous improvement
Target audience The EXTRA program is designed for
health service professionals in senior management positions
Leaders of today and tomorrow From three professional streams:
Health service executives Nurse executives Physician executives
Learning objectives To demystify and clarify what research-based
evidence is, and how it differs from other influences on decision-making
To enhance research literacy among the fellows so that they are able to find research, appraise its quality and relevance to their decision-making settings, and identify its potential applications
Learning objectives To refine leadership skills for the specific
purpose of developing an organizational culture that promotes the role of research-based evidence in decision-making.
To provide tools and strategies for using research-based evidence to promote change in practice and services delivery and to facilitate change management
Roles and responsibilities Partners (CNA, CMA, CCHSE, Quebec
consortium) Nominate members for advisory council; assist in
program development, promotion, and marketing
Advisory council Assists with strategic direction, monitoring, and
final selection of fellows (24 per year)
CHSRF Ensures overall program management and delivery
Advisory council members Dr. Jean Rochon, Chair and Former
Minister, Department of Health and Social Services, Quebec
Dr. Christopher C. Carruthers, Chief of Staff, The Ottawa Hospital, and President of the Canadian Society of Physician Executives
Mr. K.J. Fyke, Health Policy Consultant, Victoria, BC
Dr. W. David Helms, President and CEO, AcademyHealth, Washington, D.C.
Dr. Edouard Hendriks, CEO, Regional Health Authority 4, Edmunston, NB
Dr. John Horne, COO, Health Sciences Centre, Winnipeg, MB
Dr. Judith Kazimirski, Vice President Medicine, Capital District Health Authority, Halifax, NS
Ms. Wendy Nicklin, VP Nursing, Allied Health, Clinical Programs and Patient Safety, The Ottawa Hospital and Member of the Academy of Canadian Executive Nurses
Dr. Judith Ritchie, Associate Director for Nursing Research, McGill University Health Centre
Mr. John Vogelzang, President and CEO, David Thompson Health Region, Red Deer, AB
Program format Five core program components:
Away-from-home residency sessions Intervention projects undertaken in fellows’
home organizations Educational activities between residency
sessions Network building Post-program support and activities
Support team for fellows Organizational sponsor to facilitate and
support all aspects of the program in fellows’ home organizations
Academic mentor to provide curriculum advice, assist with intervention project
Decision-maker mentor to help with the implementation of the intervention project
EXTRA mentoring model Regional “pools” of mentors Mentors will include both research
experts and decision-maker mentors Mentors are matched with fellows to
form a mentoring team Regular check-in points and assessment
of the fellows’ progress
Intervention projects as a vehicle for application and integration
A structured activity relating to a specific policy, program, or administrative issue/problem within fellow’s organization
An intervention which aims to create demand for and commitment to the use of research-based evidence in an organization
A problem/issue of sufficient scope to generate change in the organization
A systematic analysis of available evidence to support the design and implementation of the intervention
Curriculum framework Module 1: Demystifying the research world
How research is designed and conducted Identification, assessment, and exploitation of
various evidence sources Definition, potential, and shortcomings of evidence-
based decision-making and policy Current trends in research policies and their
implication for health organizations Credibility of fellows in their roles as research
advocates
Curriculum framework Module 2: Promoting the use of research-based
evidence in healthcare organizations Strategies to promote the use of research and
evidence Political factors and policy influence on the use of
research and evidence Strategies for managing politics and policy Linkages between the nature of evidence and its
application in organizational decision-making
Curriculum framework Module 3: Becoming a research champion
Leadership issues related to the role of research advocates
Personal capabilities required of a research champion
Dealing with issues of inter-professional collaboration
Communication and diplomacy skills
Curriculum framework Module 4: Using research-based evidence to create
and manage change The influence of organizational cultures and politics
on the design and application of research and evidence
Applying the concept of “communities of practice” to assess the dynamics of evidence use in an organizational context
Identifying change management strategies to encourage research implementation
Curriculum framework Module 5: Sustaining change in an organizational
context Exemplary cases of evidence use Validity of strategies developed in other
organizational contexts Strategies for integrating knowledge management
and performance management functions in fellows’ health organizations
Fellows’ organizational strategies for promoting research use
Curriculum framework Module 6: Synthesis
A week dedicated to the presentation of fellows’ intervention projects, attended by academics and practitioners
Strategies for post-program learning and interaction among fellows will also be developed
Accreditation Successful completion will earn fellows
a program diploma Canadian College of Health Service
Executives will offer certification Fellows will be able to accrue continuing
education credits
Evaluating the EXTRA program Guaranteed decade-long intake period Ongoing evaluation to ensure its adaptability
to changing needs focusing on: Formative evaluation of all aspects of EXTRA Residency sessions Web-based learning Nature and extent of related KT and use of
evidence in and among the home organizations Overall evaluation, including broader impact
Challenges in implementing EXTRA
Implementing effective decentralized units for various program components
Co-ordinating various program components
Ensuring true commitments from fellow’s organization
Building synergy across program cohorts of participants
Challenges in implementing EXTRA Sustaining enthusiasm and commitment after
program closure Learning from the evaluative study Setting up appropriate governance structure
to respond to these previous challenges Create a professional network with people
across the country Fostering the use of the EXTRA desktop as a
learning resource in the program.
For more information
Visit www.chsrf.ca/extra/