Suchergebnisse

Communities of Practice in Health and Social Care highlights how communities of practice (CoPs) can make service development and quality improvement in health and social care easier to initiate and more sustainable.Using a series of case studies from the UK and Australia the book demonstrates how the theory of CoPs is implemented in the delivery of health and social care and highlights the associated potential, complexities, advantages and disadvantages.Communities of Practice in Health and Social Care equips practitioners, managers, educators and practice mentors with the knowledge and skills

Background:The Bristol Knowledge Mobilisation (KM) Team was an unusual collective brokering model, consisting of a multi-professional team of four managers and three academics embedded in both local healthcare policymaking (aka commissioning) and academic primary care.
Aims and objectives:They aimed to encourage 'research-informed commissioning' and 'commissioning-informed research'. This paper covers context, structure, processes, advantages, challenges and impact.
Methods:Data sources from brokers included personal logs, reflective essays, exit interviews and a team workshop. These were analysed inductively using constant comparison. To obtain critical distance, three external evaluations were conducted, using interviews, observations and documentation.
Findings:Stable, solvent organisations; senior involvement with good inter-professional relationships; secure funding; and networks of engaged allies in host organisations supported the brokers. Essential elements were two-way embedding, 'buddying up', team leadership, brokers' interpersonal skills, and two-year, part-time contracts. By working collectively, the brokers fostered cross-community interactions and modelled collaborative behaviour, drawing on each other's 'insider' knowledge, networks and experience. Challenges included too many taskmasters, unrealistic expectations and work overload. However, team-brokering provided a safe space to be vulnerable, share learning, and build confidence. As host organisations benefitted most from embedded brokers, both communities noted changes in attitude, knowledge, skills and confidence. The team were more successful in fostering 'commissioning-informed research' with co-produced research grants than 'research-informed commissioning'.
Discussion and conclusions:Although still difficult, the collective support and comradery of an embedded, two-way, multi-professional team made encouraging interactions, and therefore brokering, easier. A team approach modelled collaborative behaviour and created a critical mass to affect cultural change.

Aim:
Policymaking decisions are often uninformed by research and research is rarely influenced by policymakers. To bridge this 'know-do' gap, a boundary-spanning knowledge mobilisation (KM) team was created by embedding researchers-in-residence and local policymakers into each other's organisations. Through increasing the two-way flow of knowledge via social contact, KM team members fostered collaborations and the sharing of 'mindlines', aiming to generate more relevant research bids and research-informed decision-making. This paper describes the activities of the KM team, types of knowledge and how that knowledge was exchanged to influence mindlines.

Discussion:
KM team activities were classified into: relational, dissemination, transferable skills, evaluation, research and awareness raising. Knowledge available included: profession-specific (for example, research methods, healthcare landscape), insider (for example, relational, organisation and experiential) and KM theory and practice. KM team members brokered relationships through conversations interweaving different types of knowledge, particularly organisational and relational. Academics were interested in policymakers' knowledge of healthcare policy and the commissioning landscape. More than research results, policymakers valued researchers' methodological knowledge. Both groups appreciated each other as 'critical friends'.

Conclusion:
To increase research impact, 'expertise into practice' could be leveraged, specifically researchers' critical thinking and research methodology skills. As policymakers' expertise into practice also bridges the know-do gap, future impact models could focus less on evidence into practice and more on fostering this mutual flow of expertise. Embedded knowledge brokers from the two communities working in teams can influence the mindlines of both. These ambassadors can create improvements in 'inter-cultural competence' to draw academia and policymaking closer.

Background:Evidence regarding the impact of psychological problems on recovery from injury has limited influence on practice. Mindlines show effective practice requires diverse knowledge which is generally socially transmitted.
Aims and objectives:Develop and test a method blending patient, practitioner, and research evidence and using Forum Theatre to enable key stakeholders to interact with it.
Assess this methods; impact on contributing individuals/groups; on behaviour, practice, and research; mechanisms enabling these changes to occur.
Methods:Stage-1: captured patient (n=53), practitioner (n=62), and research/expert (n=3) evidence using interviews, focus groups, literature review; combined these strands using framework analysis and conveyed them in a play. Stage-2: patients (n=32), carers (n=3), practitioners (n=31), and researchers (n=16) attended Forum Theatre workshops where they shared experiences, watched the play, re-enacted elements, and co-produced service improvements. Stage-3: used the Social Impact Framework to analyse study outcome data and establish what changed, how and why.
Findings:This approach enhanced individuals'/group knowledge of post-injury psychopathology, confidence in their knowledge, mutual understanding, creativity, attitudes towards knowledge mobilisation, and research. These cognitive, attitudinal, and relational impacts led to multilevel changes in behaviour, practice, and research. Four key mechanisms enabled this research to occur and create impact: diverse knowledge, drama/storytelling, social interaction, actively altering outcomes.
Discussion and conclusions:Discourse about poor uptake of scientific evidence focuses on methods to aid translation and implementation; this study shows how mindlines can reframe this 'problem' and inform impactful research.
EPPIC demonstrated how productive interaction between diverse stakeholders using creative means bridges gaps between evidence, knowledge, and action.