Health Transition Fund
National Synthesis and Dissemination Strategy

Background

The Health Transition Fund (1997-2001) was created to generate evidence which governments and others can use in making health policy and program decisions. To this end, it supported 140 pilot and evaluation projects dealing with a range of health services topics, each of which related to at least one of the four priority areas agreed to by all FPT governments in 1997 - home care, primary health care, pharmacare/pharmaceutical issues, and integrated service delivery.

Clearly, evidence must reach decision makers and other health sector stakeholders in a useful and timely manner. Accordingly, this strategy was prepared to guide the analysis and communication of what was learned through HTF projects, individually and in aggregate. It was based on consultations to find out from target audiences what they want, and to find out from dissemination/research transfer experts what works.

Principles Underlying the Strategy

1. Proponents were responsible for producing and disseminating project-specific results to appropriate target audiences. To this end, evaluation and dissemination plans were mandatory (and funded) elements of project proposals. In addition, efforts were taken over the life of the HTF to foster richer and more meaningful activity by proponents. All other HTF activity complemented and enhanced proponents' efforts.

2. The HTF concentrated its own dissemination efforts on lessons learned/analytical material/results of multiple projects at an aggregate level. The HTF fostered the dissemination of individual, project-specific results only under exceptional circumstances.

3. The HTF concentrated on communicating results of national or regional interest, rather than more locally-based project results.

4. The HTF recognized that research uptake is an ongoing process and not a single shot at a moving target, and its activities recognized the need to: link results and decision makers dealing with the same issues; add to the growing stock of health services research so that information is readily available when needed; and pique the interest of target audiences so they know of and can find results when needed.

5. The HTF emphasized the availability of information and how to access it, rather than engaging in mass distribution of unsolicited information. To this end, efforts were made to publicize the various HTF products, including targeted distribution plans and advertising. It also used a layered approach to information, so that individuals can choose a level of detail appropriate to their needs.

6. The HTF sought to focus or highlight results to keep the amount of information realistic and manageable. This was done by by commissioning 10 synthesis documents across various theme areas (see "Key Activities" below).

7. The HTF maximized electronic means of dissemination, to facilitate broad access to results. Final reports from most projects are available on the HTF website, in addition to paragraph-length summaries and factsheets.

8. The HTF used direct and tailored communications between those doing the research and those using the results (i.e., workshops, briefings, conference presentations, etc.).

9. Media-related activities focussed on aggregate activities (such as the analytical syntheses, and events) rather than on individual project results.

Key Activities

1.  Analytical Syntheses of Results

In addition to having access to the findings of individual projects, the Fund wanted to know what the projects said, collectively, about broad reform directions or models for delivering services, in terms of what works generally, not just what works in a particular city, with a specific population.

Accordingly, the HTF commissioned an overarching consolidation and analysis of results to identify lessons learned and individual noteworthy findings. In addition, analyses were conducted according to each of the four priority areas (home care, primary health care, pharmacare/pharmaceutical issues, and integrated service delivery) as well as several other themes (seniors, Aboriginal, rural health, mental health, and children).

These syntheses reflect the elements of the HTF Evaluation Framework -- relating to quality, access, integration, health impacts, cost-effectiveness, and transferability. They are intended to emphasize the practical lessons learned through the HTF: what worked and what didn't, and why, and the conditions for and barriers to success. They also emphasize transferability issues - which lessons can be applied in other sites, regions, services and jurisdictions.

When consolidated and analysed, the entire pool of project results offers much potential for generating useful evidence and policy-relevant lessons that should be applicable in a number of provinces and territories, and for a range of services.

Hollander Analytical Services Ltd. of Victoria was contracted to manage the synthesis process, and in turn sub-contracted with subject-matter experts in each of 10 topic areas to write the synthesis documents.The authors are:

Hard copies of the synthesis documents are available on request from Health Canada Publications at (613) 954-5995.

2.   Program Analysis/Evaluation

While most of the "evidence" generated by the HTF was in the form of project experiences, results, and aggregate analyses, there was nevertheless much to be learned from the Program experience too. Accordingly, the HTF was subjected to a variety of evaluations to identify, from a program perspective, what worked well, what did not, etc., to inform future government and stakeholder decisions about funding programs. The HTF was part of a larger audit by the Auditor General of Canada on federal support to health care delivery; reflections on the HTF's first two years' experiences were noted in the Mid-Term Report; and a formal interim program evaluation was completed in 2001. A final program evaluation will take place in 2003-2004.

3.  Publications to Communicate Results and their Availability

The HTF produced selected publications to make audiences aware that results and analyses are available and how to obtain them. All HTF products are available in French and English, and in hard copy and electronically.

Consistently formatted, bilingual fact sheets were prepared for all projects and are posted on the HTF website. Finally, the synthesis documents, which provide focussed, useful information for decision-makers, are key dissemination products.

4.  Events to Share and Discuss Results

In-person briefings have been shown to be an effective way to communicate information and foster its use. In the spring of 2001, a series of regional workshops was held to share results of HTF projects. These took place in Toronto (April 11), Montreal (April 23), Winnipeg (May 7-8), Vancouver (May 27-28), and Moncton (June 18-19). Although the audiences at these events were regionally-based, results were presented from a range of projects across the country, enabling regional audiences to learn of a range of projects without incurring significant travel time or expense.

In addition to hosting its own events, the HTF used stakeholder-sponsored events, such as decision-maker meetings, conferences, workshops, etc. to disseminate project results and syntheses (over and above widespread use of these events by individual proponents). Finally, several projects organized their own events to share their results - for example, the Alberta Primary Health Care Project Showcase Conference (Calgary, November 2000) and the British Columbia Primary Care Demonstration Project conference (Vancouver, October 2001). Le colloque Jean-Yves-Rivard focussed on innovation at its session in Montreal (November 2001) and devoted a session to HTF projects in Quebec.

5.  Web Site

The HTF made maximum use of electronic means of disseminating results. The HTF website provides a search capacity across projects, allowing users to do tailored searches. All HTF publications are available electronically, and the HTF site also provides hot links to both project-specific sites and includes final reports for most projects. Users are able to choose from several layers of detail on individual projects (i.e. paragraph-length summary, factsheet, report).