What is KT Consultation?

There has been an explosion in interest in KT from researchers, clinicians, managers and policy makers. This consultation service is aimed at trying to meet the KT needs of these groups. We will work with you to answer your KT questions and to appropriately triage your KT needs.

This service will serve 3 different categories of participants:

1. Decision makers and knowledge users (including clinicians, managers and policy makers) who are interested in enhancing their knowledge and skills for practicing KT;
2. Researchers interested in developing a KT research project that is focused on advancing the science of KT; and,
3. Researchers from other fields such as the basic sciences or health services who are interested in learning how to apply the basic principles of the practice of KT to their own work.

Please click on the following list to see examples of the kinds of stakeholder-driven projects to which the Li Ka Shing Knowledge Institute Knowledge Translation program may provide consultation (this is by no mean an exhaustive list; please do not hesitate to contact our program if your knowledge translation need is not covered in the following):

Steps to bridge the knowledge-to-action gap (Click here to learn more about the Knowledge-to-Action Cycle)

• Knowledge-To-Action Cycle:
  1. Knowledge creation and distillation:
     1. Training and support on accessing and apprising different levels of evidence
     2. Conducting systematic reviews and/or meta-analyses
  2. Identifying the knowledge-to-action gap using quality indicators (surveillance initiatives):
     1. Gap analysis on population: secondary analyses of provincial/national database, systematic reviews, meta-analysis
     2. Gap analysis on organization: secondary analyses of local agency administrative data
     3. Gap analysis on care provision: chart audit or work-flow analysis
  3. Adapting knowledge to a local context:
     1. Adaptation (customizing) of a clinical guideline to a local context according to the ADAPTE process, including assessment of the original guideline to be adapted using the AGREE instrument
     2. Development of decision support system based on successfully adapted guideline
  4. Assessing barriers and facilitators to knowledge use:
     1. Assessing potential barriers and facilitators to knowledge use according to the model and taxonomies presented in the extended version of the Clinical Practice Guidelines Framework for Improvement.
     2. Identifying barriers and facilitators to change using the Delphi procedure
     3. Identifying barriers and facilitators qualitatively using focus groups, interviews, and questionnaires.
     4. Identifying barriers and facilitators by statistically analyzing variation in health care delivery with respect to potential determinants based on observational dataset (eg. regression analysis)
     5. Identifying barriers and facilitators by statistically analyzing potential determinants that account for the heterogeneity of effects across studies on guideline implementation (e.g. meta-regression)
  5. Overcoming the barrier to knowledge implementation by linking (exploratory or theory-driven) one or more of the following KT interventions to all barriers identified, and implementing them in local context:
     1. Passive educational interventions: Written guidelines, workshops, lectures and conferences
     2. Active educational interventions: Opinion leadership, educational outreach visits, development of 'quality circles,' active self-study material or website
     3. Professional intervention that brings information close to the point of decision making: Reminders and decision support (informatics), and audit-and-feedback
     4. Patient-directed interventions: i) Health literacy intervention, ii) clinical decision-making intervention that focuses on improving patients' clinical communication skills and the development of patient decision aids, and iii) self-care intervention that focuses on patient self-management education and improved access to patients' own information
     5. Organizational interventions: A top-down approach to revise professional role and develop a special-purpose multidisciplinary team with the goal of implementing i) quality management such as encouraging feedback from patients and rank-and-file staff upwards, ii) change management such as developing cultural change program and empowerment program, iii) organizational evidence-based practice guideline, and iv) organizational knowledge creation and synthesis
  6. Monitoring and evaluating knowledge use:
     1. Monitoring the use of knowledge by physicians: measure the use of care pathways or the ordering of relevant medication through secondary analysis of administrative or clinical databases
     2. Monitoring the use of knowledge by the patients: measure patient attitudes or uses of resources through surveys and secondary analysis of administrative database
     3. Evaluating the impact of knowledge use by physicians: measure satisfaction with practice and time taken for new practice through questionnaires and interviews
     4. Evaluating the impact of knowledge use by the patients: measure the change in health status (morbidity or mortality) and quality of life through secondary analysis of administrative or clinical databases, and measure their length of stay and the satisfaction with care through questionnaires.
     5. Evaluating the impact of knowledge use at the organizational level: measure change in health care system in terms of wait list, length of stay and costs through secondary analysis of administrative or clinical database.
  7. Sustaining knowledge use:
     1. Develop sustainability action plan that includes the following components: i) achieve consensus and clarify priority on what knowledge to be sustained, ii) identify expected beneficial outcomes, iii) identify attitudes or potential resistance from stakeholders, iv) identify the network of facilitators, v) secure leadership commitment in sustaining knowledge use, vi) integrate knowledge use in existing policy, vii) develop funding model and cost-effective strategies, and viii) leverage power and support from essential stakeholder groups.
• End-of-grant KT: typical dissemination and communication activities undertaken by most researchers
  1. Assist researchers translate research to fellow researchers, through venue such as conference presentations and publications in peer reviewed journals
  2. Assist researchers to tailor their message and medium to a specific audience, such as summary briefings to stakeholders; more interactive approaches such as educational sessions with patients, practitioners, and/or policymakers; media engagement; or the use of knowledge brokers.
• Conducting KT research project
  1. Support clinical unit or research team to conduct KT research, in terms of how knowledge uptake is evaluated or what is the determinants of knowledge use.

Who can request a consult?

This service is open to all employees and medical staff affiliated with St. Michael's Hospital. University of Toronto faculty, staff and students are also welcome to apply.

Click here to submit your own question