Requests for Proposals (RFP 015) Quality Workplaces for Health Professionals: Research on Knowledge Utilization
Funding and General Information
Deadline for letters of intent: May 7, 2003.
Up to $1,000,000 has been set aside in this competition for the
support of up to 6 projects. Maximum funds per project: $300,000.
Funding is expected to begin in April, 2004. Project final reports
must be submitted by March 2006.
Preference will be given to proposals that:
- will produce findings that may be generalized to multiple jurisdictions
and health care settings, as well as to various health professional
groups; and
- provide the most coverage of the research questions outlined
in this document.
Applicants are encouraged to consider the four key reports identified
in this document 1, 2, 3, 4 as
well as a combination of these with provincial and other reports.
Scope of Competition
Objectives
The overall goal of this research is to inform Health Canada's
understanding of the utilization of recommendations resulting from
national and other reports aimed at improving the workplaces of
health professionals.
The specific objectives are: (1) to study the dissemination results
of the reports by surveying users of the research; (2) to study
various jurisdictions (provincial/regional governments) and health
care workplaces that have mandates to make policy decisions and
which have or have not adopted and implemented the current evidence
to policy and practice; and (3) to understand the factors which
affect the implementation of recommendations (i.e. barriers, enablers).
Results from this research will assist Health Canada in its leadership
role, in collaboration with the provinces/territories as well as
other key stakeholders, to develop a shared vision for Canada's
health system, identifying key priorities as well as implementation
approaches to improve the timeliness of access, and the quality
and integration of health services. 5 More specifically,
the results of this research will assist Health Canada in its ongoing
policy work involving health human resources. The Department is
currently working in partnership with HRDC to conduct labor market
analysis of occupational groups, including health professionals
and their work environments, as well as working with numerous jurisdictions
to identify and determine national approaches to health human resource
issues. Health Canada's Office of Nursing Policy is also currently
developing Healthy Workplace Guidelines that will provide employers
with fact sheets containing information on interventions which
are known to positively influence workplaces for nurses. Lessons
learned from this research will inform future work on this topic.
Background/Context
Health human resources has been identified as a primary research
theme for the next two to five years through a national consultation
process involving key stakeholders.6 Quality workplaces
for health professionals are recognized as essential not only to
promote health and well-being but also to provide effective retention
strategies in a time of shortages of qualified personnel. There
is also increasing evidence to suggest that, in the area of nursing,
workplace factors can, and do, affect patient outcomes.
Since the 1997 final report of the National Forum on Health7 which
tabled recommendations for improving the health system and the
health of Canadians, there has been a growing number of national
and provincial synthesis, technical and research reports which
identify strategies to improve workplace conditions and to address
related issues of supply and retention. (See References for further
information.)
Despite the continued production of studies and reports, there
is little understanding of how or if the evidence has been utilized
by various jurisdictions and health care settings in implementing
strategies for improving workplaces.
Research Questions
The questions outlined below follow the Knowledge Utilization
Process 8(see Appendix A) as adapted by Dr. Réjean
Landry, an internationally recognized expert on research dissemination
and knowledge utilization. Applicants may also wish to consult
certain websites for information on research dissemination and
knowledge utilization9, 10.
- What were the results of the dissemination?
Determine who is aware of the reports and who actually received
them, how they received them, and whether they have read and
understood the reports.
- What changes have been made or are being considered at
the policy, system, and/or workplace levels to improve workplace
conditions? What efforts were made to adopt and implement specific
report recommendations?
Identify specific changes made (or being considered) to improve
workplaces by various jurisdictions and in various health care
settings, the process by which these changes were decided upon,
and the extent to which they were directly or indirectly influenced
by report recommendations. Identify efforts made to adopt and
implement report recommendations as well as specific recommendations
which have already been implemented. Examine the consideration
given to recommendations deemed to be of priority by employees.
- What factors have affected the adoption and implementation
of report recommendations?
Examine the enablers and barriers to the adoption and implementation of report
recommendations and develop policy recommendations for overcoming the identified
barriers. Map the process which led to the adoption and implementation of
report recommendations.
Policy Contact
Applicants must get in touch with the policy contact at least
once during the development of the letter of intent. The policy
contact is responsible for ongoing interaction with researchers
on the policy issues and context. Policy inquiries should be directed
to Dr. Patricia Griffin, Office of Nursing Policy, Health Policy
and Communications Branch, Health Canada. (tel: 613-952-7892: e-mail;
pat_griffin@hc-sc.gc.ca ).
How to Apply
There is a two phase application process. Researchers are invited
to submit a letter of intent by fax (613-954-7363) before 12:00
noon (E.S.T) on May 7, 2003. Only researchers with letters of intent
found to be eligible and relevant to the identified policy research
priority will then be invited to submit a full proposal.
Applicants are required to register in order to obtain a letter
of intent form and a registration number which must be quoted on
the form. Applicants are encouraged to consult the HPRP Guide
for Applicants before registering.
Inquiries regarding registration, eligibility/ineligibility, administrative
questions about timeframes and budgets, application formatting
and content, the review process, and terms and conditions of the HPRP should
be directed to Elizabeth Maddocks (tel: 613- 954-8557; fax: 613-954-7363;
e-mail: elizabeth_maddocks@hc-sc.gc.ca ).
References
Key reports (See reference #s 1, 2, 3, 4)
1 Baumann, A., O'Brien-Pallas, L.,
Armstrong-Stassen, M., Blythe, J., Bourbonnaias, R., Cameron, S.,
Irvine Doran, D., Kerr, M., McGillis Hall, L., Zian, M., Butt,
M., Ryan, L. (2001). Commitment and Care: The benefits of a
healthy workplace for nurses, their patients and the system.
Report submitted to the Canadian Health Services Research Foundation,
Ottawa, ON. Retreived from the WWW on September 16, 2002. (http://www.chsrf.ca/docs/finalrpts/pscomcare_e.pdf)
2 Koehoorn, M., Lowe, G.S., Rondeau,
K.V., Schellenberg, G., and Wagar, T.H. (2002). Creating High
Quality Health Care Workplaces. Discussion paper. Canadian
Policy Research Networks, Inc. (http://www.cprn.ca/cprn.html)
3 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, Retrieved from the WWW on September
16, 2002 (http://www.hc-sc.gc.ca/english/for_you/nursing/cnac_report/index.html)
4 Canadian Policy Research Networks,
Inc. (2002). Health Human Resource Planning in Canada - Physician
and Nursing Work Force Issues, Summary Report submitted to
the Commission on the Future of Health Care in Canada. (http://www.cprn.ca/cprn.html
)
5 Health Canada. Business Line Relationship
to Organizational Structure. (Available at : http://www.hc-sc.gc.ca/english/about/bus_lines.html)
6 CHSRF. (2001). Listening for Direction
- A National Consultation on Health Services and Policy Issues,
Retrieved from the WWW on September16, 2002. (http://www.chsrf.ca/docs/pconsult/frpt_e.shtml)
7 National Forum on Health. (1997).
Canada Health Action: Building on the Legacy. Final Report of
the National Forum on Health. Ottawa: Minister of Public Works
and Government Services. (Electronic copy available from HPRP Program
Officer)
8 Landry, Réjean, Lamari, Moktar
and Nabil Amara (2000). Évaluation de l'utilisation de
la recherche sociale subventionnée par le CQRS - Deuxième
partie: La demande de recherche sociale : La perspective des utilisateurs.
Report prepared for the Ministère de la Santé et
des Services sociaux du Québec. (http://kuuc.chair.ulaval.ca/english/pdf/apropos/publication7.pdf)
9 Database on knowledge utilization
- CHSRF/CIHR Chair on Knowledge Transfer and Innovation : http://kuuc.chair.ulaval.ca/
10 Program in Policy Decision-Making
(affiliated with Centre for Health Economics and Policy Analysis)
: http://www.researchtopolicy.ca/
Other Reports
Standing Senate Committee on Social Affairs, Science and Technology.
(2002). The Health of Canadians - The Federal Role. Volume Six:
Recommendations for Reform. Ottawa: Government of Canada. (The
Kirby Report). Chapter 11. (http://www.parl.gc.ca/37/2/parlbus/commbus/senate/com-e/soci-e/rep-e/repoct02vol6-e.htm)
Commission of the Future of Health Care in Canada. (2002). Building
on Values: The Future of Health Care in Canada. Ottawa: The Commission.
(The Romanow Commission). Chapter 4. (http://www.healthcarecommission.ca/)
Provincial Reports
Worklife Task Force. (2001). Worklife Task force: Renewing
our Commitment to Nurses. A Report to the Minister of Health.
Workforce Policy and Planning Branch, Manitoba Health.(http://www.gov.mb.ca/health/documents/worklife.pdf)
Nursing Task Force. (1999). Good Nursing, Good Health: An Investment
for the 21st Century. Ontario. (http://www.gov.on.ca/health/english/pub/ministry/nurserep99/toc.html)
Commission d'étude sur les services de santé et
les services sociaux. (2000). Emerging Solutions. Report and
Recommendations of the Commission d`étude sur les services
de santé et les services sociaux. Quebec: government
of Quebec. (The Clair Commission) (http://www.cessss.gouv.qc.ca/pdf/en/01-109-01a.pdf)
Commission on Medicare. (2001). Caring for Medicare. Sustaining
a Quality System. Regina: Government of Saskatchewan. (The
Fyke commission) (http://www.health.gov.sk.ca/info_center_pub_commission_on_medicare-bw.pdf)
Ontario Health Services Restructuring Commission. (2000). Looking
Back, Looking Forward. A Legacy Report. Toronto: The Commission
(http://www.hsrc.gov.on.ca/HSRC.pdf)
Premier's Advisory Council on Health. (2001). A Framework for
Reform. Edmonton: the Council. (The Mazankowski Report) (http://www.gov.ab.ca/home/health_first/documents_maz_report.cfm)
Premier's Health Quality Council. (2002). Health Renewal.
Saint John: The Council. (http://www.gnb.ca/0089/cpqs/pdfs/health.pdf)
APPENDIX A
Knowledge Utilization Process (1)
*translation of original document
Knowledge Utilization Process (1)
*translation of original document
| Stage 1 |
Reception: Utilization begins with the
dissemination of new knowledge to the users concerned. This
stage begins when the relevant knowledge reaches the user rather
than becoming lost or being delayed in the hands of intermediaries.
The reception measure is formulated on a scale of frequency
in relation to the proposition: I have received the social
research relevant to my work on time. |
| Stage 2 |
Cognition: Once it is received, the new
knowledge is read and assimilated by users. Much new knowledge
which is considered unreadable and incomprehensible is discarded.
The cognition measure is formulated on a scale of frequency
in relation to the proposition: I have read and understood
the studies from the social research I have received. |
| Stage 3 |
Discussion: It may be imagined that doubts
and hesitations will persist about the results of the studies
that have been read. Discussion with colleagues and attendance
at explanatory meetings led by experts on the subject will
help users assimilate and take hold of the new knowledge. The
discussion measure is formulated on a scale of frequency in
relation to the proposition: I have attended explanatory
and discussion meetings on these studies from social research
projects. |
| Stage 4 |
Reference: To be truly effective, the
understanding of new uses must "give users ideas" and
show them a new "way of seeing things." The new references
replace the old ones, and users cite the new references in
their work. The reference measure is formulated on a scale
of frequency in relation to the proposition: I have cited
the results of social research as references in my own professional
work. |
| Stage 5 |
Adoption effort: To make a difference,
users interested in using this knowledge make an effort to
adopt it and adapt it to their purposes and the requirements
of their field of activity. The adoption effort measure is
formulated on a scale of frequency in relation to the proposition: I
have made efforts to promote the use of social research results. |
| Stage 6 |
Implementation of results: Adoption and
adaptation efforts are not sufficient to ensure that new knowledge
will be put into practice and have an impact. To be translated
into action and have an impact on decision making, new knowledge
must be implemented. The implementation of results measure
is formulated on a scale of frequency in relation to the proposition: The
results of social research have influenced practices and decisions
in my administrative unit. |
Adapted from Knott and Wildavsky (1980)
|
