Research Implementation

Lecture 1: Introduction and Overview Carl Thompson

Aims of the Module

Theoretical Concepts (knowledge, information, change

management) Organisation of concepts/models (information

seeking, organisational complexity) Practical

Reflection on change & thinking differently about strategic approaches to change

Techniques and skills – SWOT, force field

What Do We Mean by Utilisation?What Do We Mean by Utilisation?

UtilisationInstrumentalConceptual Symbolic

Information Vs Knowledge Vs Data

“Information usually seen as the precondition of debate, is better understood as its by-product. When we get into arguments that focus and engage our attention, we become avid seekers of relevant information. Otherwise we take in information passively – if we take it in at all.”

Lasch 1995 p162.

Hierarchy…

Data

Information

Knowledge

Meaning

Shannon’s Mathematical Theory of Communication (‘Information Theory’)

source transmitter receiver destination

noise

message signal sent signal received

message

Shannon & Weaver 1949

Knowledge

Knowledge as information that is sifted, organised and understood. Information acquired by being told. Knowledge acquired by thinking – internal

and cannot be received it must be created (Hayes 1993).

Information implies transfer. Knowledge is a state (knowing). Knowledge = actionable understanding.

Policy Making Models

How policy is made Rationality (and its bounded ‘real

world’ alternative)Herbert Simon (1957)

Incrementalism Charles Linblom (1959)

(Bounded) Rationality

Decide on the values to guide the policy

Decide on the goals to be achieved

Search for possible means to achieve goals

Evaluate each set of means and options

Select the ‘best’ option and implement it

Problems…

Relies on (value and political) consensus with little or no ideological conflict

Discounts ‘competing rationalities Within (elite) group bargaining It is prescriptive rather than descriptive Discounts cognitive limitations of

humans (error, info processing, heuristics)

Economic Vs. Administrative Man

‘While economic man maximises – selects the best alternative among all those available to him,his cousin, whom we shall call administrative man, satisfices – looks for a course of action thatIs satisfactory or ‘good enough’ Simon 1957, p.198)

Incrementalism

Decision makers ‘muddle through’. Decision making: Has previous policy as its start point Proceeds through incremental change Involves mutual adjustment and negotiation Excludes options by accident rather than

systematically or deliberately Policies are not cast in stone A ‘good’ decision is agreement rather than

objective meeting Involves trial and error

Evidence Based Decision Making

Active process. Combining the clinical expertise, patient’s

preferences, and research evidence within the context of available resources.

Research evidence weighted. Forming a clinical question from recognised

information needs. Searching. Appraising. Incorporating evidence into planned action. Evaluating impact.

Prescriptive, information deficit model…

Information Behaviour Models

Wilson Krikelas Johnson Leckie

Context of Information

need

Activatingmechanism

Interveningvariable

Activating mechanism

InformationSeeking behaviour

Person-in-contextStress/coping

theorypsychological

Risk/rewardtheory

Passive attention

demographic

Role-related or interpersonal

environmental

Source characteristics

Passive search

Active search Self-efficacy

Ongoing search

Social learningtheory

Information Processing

And use

Wilson’s Information Behaviour Model

Wilson 1999

Krikelas’ Information Seeking Model

Information gathering Information giving

Need creating event/environment

Needs(deferred)

Needs(immediate)

Source preferenceinternal external

Direct(structured)

observations

memory

Personal files

Direct (interpersonal)

Contact

Recordedliterature

Krikelas

1983

Johnson’s Information Seeking Model

demographics

beliefs

salience

Direct experience

utilities

characteristics

Actions

Background factors

Personal relevancefactors

ANTECEDENTS INFORMATION CARRIER FACTORS

INFORMATION SEEKING ACTIONS

Johnson

1997

Leckie et al.

Work roles

Tasks

Characteristics of information needs

Sources of information

Awareness of information

outcomes

Information is

sought

feedback feedback

Importance of Context for Knowledge Transfer

The environment or setting in which the proposed change is to be implemented (Kitson et al. 1998) Prevailing culture The quality of work relationships

(evidenced by leadership roles) Org approach to routine monitoring of

systems and services (measurement) Implementation = ExCxF

Myths Surrounding Info for EBP Number One: Only Objective Information Is Valuable

Normatively – possibly

Descriptively - untrue

Two:more Information Is Better

Problem is making sense of existing information rather than adding to it.

Increasing the flow of info as a route to knowledgeable doers is not the answer.

Three: Objective Information Can Be Transmitted Out of Context

Nurses reject ‘acontextual’ information sources in favour of context-rich advice

Lack the appraisal skills to inject context into information

Four: Information Can Only Be Acquired From Formal Sources

Information is ‘differences that makes a difference’ (Bateson 1979)

Differences that made a difference (with the exception of drug-reference material) are informally located

Five: Relevant Information Exists for Every Need

Nurses don’t recognise (or cannot verbalise) information needs.

Satisficing.

Nurses (like doctors) may acquire [over] confidence quickly (Urquhart 1999).

Six: Every Information Need Situation Has a Solution

Information seeking = transforming need into workable format

Unfitness for purpose = negative feedback

Seven: Information Can Always Be Made Accessible

Physical sense = yes

Intellectual/cognitive = no

Eight: Functional Units of Information Sources Fit the Needs of Individuals

EBN functional units = systems, synopses, syntheses and studies (Haynes 2001)

Nurses functional units = colleague advice, ideas and consultation

intuition

‘pure’ scientific experiment

Peer aided judgement

System aided judgement

good

Task Structure

poor

+

Time,VisibilityOf process

-

intuition Analysis

(cf. Hammond, Hamm, Dowie 1963-2002)

Nine: time and space ignored

Ten: Easy Conflict Free Connections Between External Information and Internal Reality

Defensiveness and conflict

We simply do not know!