Knowledge Exchange

Ask a Researcher

Dr. Marlene Smadu, RN, EdD, Associate Dean, Southern Saskatchewan Campus and International Student Affairs, College of Nursing, University of Saskatchewan

There has been so much research done already to describe high quality health care workplaces-why don't people just put it into action?

The challenge of translating knowledge from research into practice is a longstanding one in health care. People will frequently cite the story that it took 17 years from the time it was determined that Vitamin C could prevent scurvy to have that implemented on ocean-crossing vessels. We all participate in practices, sometimes called our “sacred cows”, that likely never had an evidence-base, and should be replaced or eliminated if we implemented current research. These same challenges exist when it comes to changing health care workplaces to make them better, healthier, more productive, safer, more appealing to providers and clients. There is lots of evidence now to tell us what to do—why do we still have health care workplaces that are not healthy?

In 2004, Health Canada’s Health Policy Research Program created a funding opportunity for researchers to investigate whether the existing research and documents, including government commissioned studies related to the creation of high quality health care workplaces, were being utilized to improve health care workplaces. With a multi-organizational, multi-sectoral, and interprofessional research team, I was awarded one of the grants to look at the creation of high quality health workplaces in Saskatchewan. The study had several parts, and the summary of the report submitted to Health Canada and Saskatchewan Health, which also provided funding support, can be found at Health Canada . Of interest in answering the question that is posed here are the findings related to the awareness and utilization of a number of documents (Advisory Committee on Health Human Resources, 2002; Backman, 2000; Bauman et al, 2000; Government of Saskatchewan, 2001; Koehern et al, 2002; Saskatchewan Health, 2003) that were available at that time to support the development of high quality workplaces. Overall, the awareness of the documents was low by those surveyed in this study; the document with the highest rating of awareness was the Saskatchewan Action Plan for Health Care (Government of Saskatchewan, 2001), which had been released in 2001 and was accompanied by the implementation of a number of policies to support the recommendations, e.g. the development of the Saskatchewan Health Quality Council.

During the 23 focus groups involving over 200 health care providers from across Saskatchewan, it became clear to the research team that many of the participants were interested in knowing what was being recommended in the research and reports, but they also wanted to talk about how that research fit with what they knew from their personal experiences in the workplaces. Clearly, they wanted to share their experiences and be involved in the solutions to make the workplaces better.

In our research we learned how important it is to have those involved in the workplaces everyday have the chance to be heard and be part of the solution finding to make the workplace better. This takes time and opportunity, and many of the initiatives that have been successful in improving the quality of health care workplaces, such as the 80-20 project that Dr. Debra Bourne wrote about in January, and Releasing Time to Care: The Productive Ward, which is being implemented in Saskatchewan, have ensured that staff have the time, tools, opportunity and education to create better workplaces for themselves and their patients. We also learned how important it is for organizations to not only disseminate and share information, but to manage it, so that it is easily accessible, credible, and current. Researchers need to look at a variety of dissemination strategies to support the transfer of knowledge to a variety of users of health research. Reports and books that get dusty on shelves are of no use to busy providers who need information and ideas at their fingertips. Credible websites, intranets, brief updates, video links, pod casts—there are many ways to make research evidence accessible and easy to implement.

We also learned that there are practical ways to create knowledge networks, where those interested in improving their workplaces can exchange information and experiences, be engaged in developing questions to be addressed and throughout the research process, and then be instrumental in implementing the recommendations.

We learned that there is no “they” when it comes to creating high quality health care workplaces—we can’t wait for “them” to do it, and we need to ensure that we create opportunities for all involved in these workplaces to be actively engaged in making them better.

References

Advisory Committee on Health Human Resources. (2002). Our health, our future: Creating quality workplaces for Canadian Nurses: Final report of the Canadian Nursing Advisory Committee. Ottawa, ON: Health Canada. “CNAC Report”

Backman, A. (2000). Job satisfaction, retention, recruitment and skill mix for a sustainable health care system: Re- port to the Deputy Minister of Health for Saskatchewan. Regina, SK: Saskatchewan Health

Baumann, A., et al (2001). Commitment and Care: The benefits of a healthy workplace for nurses, their patients and the system. A policy synthesis. Ottawa, ON: Canadian Health Services Research Foundation and the Change Foundation.

Government of Saskatchewan (2001). Action Plan for Saskatchewan Health Care. Regina, SK: Author.

Koehorn, M., et al (2002). Creating high quality health care workplaces. Discussion Paper. Ottawa, ON: Canadian Policy Research

Saskatchewan Health. (2003). A progress report on Saskatchewan’s nursing strategies: The Action Plan for Saskatchewan Health Care Update July 2003. Regina, SK: Author.