Effecting changes across multiple settings and organizations can be challenging. This six-step approach was developed within the context of continuity-of-care innovations. The method uses the Ottawa Model of Research Use, a knowledge translation model, to guide the process of transferring research into practice.
Continuity-of-care innovations are particularly complex given that multiple sectors, settings, agencies and provider groups are often involved. The developers briefly discuss two broad types of knowledge translation theories and models relevant for continuity-of-care innovations.
Classical theories (also known as descriptive or normative theories) are theories of change that view innovation adoption as passive, and look at the naturalistic process of change. These theories look at the characteristics of the innovation and potential adopters as influencing the change process.
Planned change theories view innovation adoption as deliberately planned processes. Graham's Ottawa Model of Research Use is an example of a planned change theory. Although planned change theories may involve working with individuals, their aim is to effect change at the organizational and systems level. These theories help administrators control factors that will influence the likelihood of changes occurring at the organizational level and how these changes occur. Planned change theories inform the Knowledge-to-Action process (KTA), a comprehensive knowledge translation model developed by Graham and others at the Canadian Institutes of Health Research (CIHR). CIHR adopted the KTA process approach to conceptualize knowledge translation as encompassing knowledge synthesis, dissemination, exchange and application.
Specific to the Ottawa Model of Research Use, the developers discuss three implicit assumptions of knowledge translation:
- Dynamic and interactive processes between research development and use reflect the complex nature of knowledge translation.
- Patients/clients are central throughout knowledge translation processes, since their health outcomes are the main focus of evidence-based practice.
- Knowledge translation processes are affected by external societal and health-care environments.
These environments need to be considered when planning and implementing innovations.
Steps for Using Method/Tool
The Ottawa Model of Research Use follows a six-step approach to guide the implementation of an innovation.
1) Set the Stage
- Identify individuals with authority needed to make changes within organizations.
- Determine available resources that can be used for innovation implementation.
- Identify agents of change responsible for implementing the innovation.
2) Specify the Innovation
- Clearly articulate what the innovation is and what implementation will involve.
3) Assess the Innovation, Potential Adopters and the Environment for Barriers and Facilitators
- Conduct a situational assessment--determine current practice and identify any barriers and facilitators within the innovation, potential adopters and the practice environment that could influence adoption of the innovation.
- Identify ways to overcome any barriers to implementation.
- Identify perceptions and attitudes of potential adopters toward the innovation.
- Identify gaps between current practice and recommended changes.
4) Select and Monitor the Knowledge Translation Strategies
- Based on the situational assessment, select appropriate strategies and interventions to increase awareness of the innovation and understanding of the innovation, and provide skills or training for adopters to be able to carry out the innovation.
- Supplement with follow-up interventions to the initial knowledge translation strategies. This may be particularly useful for innovations that involve a long learning curve or diverse groups of adopters.
- Evaluate the knowledge translation strategies for effectiveness.
5) Monitor Innovation Adoption
- Evaluate adoption of the innovation.
- Determine the extent to which the innovation has spread throughout the organization and how practice has changed.
- Assess if the knowledge translation strategies applied have been sufficient for effective innovation adoption, or if the knowledge translation strategies need to be changed or additional strategies are required.
6) Evaluate Outcomes of the Innovation
- Evaluate the impact of the innovation on clients/patients, practitioners and systems to determine the effectiveness of the innovation.
These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.
We have provided the resources and links as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by McMaster University of any of the products, services or opinions of the external organizations, nor have the external organizations endorsed their resources and links as provided by McMaster University. McMaster University bears no responsibility for the accuracy, legality or content of the external sites.