DRAFT – NOT FOR CIRCULATION Knowledge Broker Capabilities: Translating Knowledge into Action for Healthcare Quality. Narrative Review and Analysis of Literature Contents 1. Background and Purpose.........................................................................3 2. Scope .......................................................................................................3 3. Methods....................................................................................................4 4. Results .....................................................................................................4 4.1 Knowledge translation models ............................................................5 4.3 Integration with healthcare teams .......................................................7 4.4 Operating as a collaborative network..................................................8 4.5 Bridging the worlds of research and practice ......................................8 4.6 Identifying and solving problems.........................................................8 4.7 Accessing and identifying knowledge .................................................9 4.8 Describing and organising knowledge ................................................9 4.9 Analysing, appraising and interpreting knowledge..............................9 4.10 Combining and presenting knowledge............................................10 4.11 Contextualising and customising knowledge ..................................10 4.12 Building relationships and networks................................................11 4.13 Facilitating organisational change...................................................11 4.14 Sustaining knowledge in action.......................................................12 4.14.2 Building workforce capabilities in knowledge into action. .........12 4.14.3 Embedding knowledge in education.........................................12 4.14.4 Disseminating and spreading knowledge .................................13 4.14.5 Monitoring knowledge implementation and outcomes.............13 4.15 Knowledge broker attributes ...........................................................14 5. Discussion..............................................................................................14 6. Conclusion..............................................................................................16 7. References.............................................................................................19 1 DRAFT – NOT FOR CIRCULATION Summary This narrative review of published literature on the knowledge broker role identifies key knowledge, skills, attitudes and behaviours which enable knowledge brokers to bridge the domains of research and practice. Knowledge brokers apply these capabilities through close collaboration with healthcare teams to help them apply knowledge in frontline practice, planning and policy, and embed knowledge in healthcare improvement. The review highlights that knowledge brokering involves a diverse range of capabilities which combine the strengths of established evidence-based practice (based on “know-what”) and more emergent quality improvement approaches (drawing upon “know-how” and “know-who”). In combination, these capabilities can provide a powerful knowledge system to underpin healthcare improvement, implementation support and innovation. This literature describes the broad range of clinical and non-clinical disciplines that can participate in knowledge brokering. It emphasises the importance of collaboration within knowledge broker teams or networks, to combine complementary areas of expertise. As identified through this analysis, knowledge broker capabilities fall broadly into three categories: 1. Applying inquiry and knowledge management techniques to define and solve problems . This is supported by use of technology and other tools to access, identify, describe and organise knowledge. This provides a foundation for combining and presenting knowledge in a format that is relevant to context and audience, embedding knowledge in routine practice wherever possible. 2. Facilitating relationships and networks , among people and across organisations, based on sharing tacit knowledge – e.g. expertise and experience. Fostering connections, dialogue and interaction In this way helps to generate innovation as well as to expedite uptake of knowledge into practice. 3. Building organisational capacity and capability for translation of knowledge into practice and policy . This includes development of organisational culture and values for use of knowledge, as well as approaches that help to sustain widespread application of knowledge in practice. This includes building workforce skills in using knowledge; embedding use of knowledge in education; targeted dissemination and spread of knowledge; promoting use of practice data and quality measures; monitoring and measuring impact of use of knowledge. Taken together, the findings from this review provide a strong foundation for development of a knowledge broker capability framework which aligns application of knowledge with the skills, behaviours and values of quality improvement. 2 DRAFT – NOT FOR CIRCULATION Knowledge Broker Capabilities: Translating Knowledge into Action for Healthcare Quality. Narrative Review and Analysis of Literature 1. Background and Purpose 1.1 The NHSScotland strategic review “Getting Knowledge into Action for Healthcare Quality” (1) defines a vision of a national network of knowledge brokers, integrated with clinical and improvement teams. This collaborative network will draw participants from a variety of backgrounds, including librarians, clinical effectiveness, public health, research, informatics, and clinical practice. Collectively, members of this network will provide a portfolio of services which support practitioners to apply knowledge in frontline practice, and embed knowledge in healthcare improvement activities. 1.2 This literature review aims to identify knowledge, skills, behaviours, attitudes and values associated with the knowledge broker role. This analysis will continue to inform development of the capability framework for the NHSScotland knowledge broker network. 2. Scope 2.1 The Canadian Institute for Health Research definition of knowledge translation was used as the basis for identifying knowledge broker roles which facilitate the translation of knowledge into healthcare practice: “a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products, and strengthen the healthcare system.” (2) 2.2 The scope of this overview included roles formally described as “knowledge brokers” as well as other terms used for knowledge support roles involving integrated working with healthcare teams to support translation of knowledge into practice – notably, clinical librarians, informationists, and, in some instances, healthcare practitioner roles. Knowledge broker roles associated with public health or clinical practice, originating from any professional background, both clinical and non-clinical, and working in research, education or practice, were all within scope. This literature review is primarily concerned with the capabilities required by individual healthcare workers in knowledge broker roles, though aspects may also be pertinent to teams, organisations and even whole countries operating as knowledge brokers. 2.3 While the primary focus of this review is on knowledge broker capabilities in the health setting, the original literature search identified knowledge broker functions in settings broader than healthcare, and reference is made to learning from wider contexts where appropriate. 3 DRAFT – NOT FOR CIRCULATION 3. Methods 3.1 The following databases were searched via The Knowledge Network: Cochrane Library including CRD Medline EMBASE CINAHL PsycInfo ASSIA HMIC ERIC EMERALD LISTA Campbell Collaboration Biomed Central Web of Science Social Science Citation Index Google search World Health Organisation website Some sources were identified via citation searches or from articles identified in the original K2A review. Search terms used knowledge translation knowledge broker* knowledge exchange knowledge gap evidence gap knowledge role* capabilit* framework* competenc* framework health librarian clinical librarian informationist clinical information specialis* outreach librarian clinical teams outreach librarian knowledge manage* 3.2 Abstracts were reviewed and fulltext obtained for articles which described knowledge broker roles. Given the practical focus of this literature overview, where available, systematic reviews were used as the main source of information for the primary research articles they covered. References to knowledge, skills, behaviours, values and attitudes were extracted, and common themes identified across articles. These themes are described below where they occurred across more than one primary article. 4. Results 4 DRAFT – NOT FOR CIRCULATION 4.1 Knowledge translation models 4.1.1 Reports of the knowledge broker role primarily referred to two models of knowledge translation: The Knowledge to Action model (3): This describes a knowledge creation process linked to a planned action cycle, with fluid boundaries between the two. While this model stresses the iterative and fluid nature of knowledge translation, it is underpinned by the positivist principle of driving towards, and determining,