Knowledge Utilization: Creating Quality Northern Rural Workplaces

Investigator Name: Dr. Ellen Rukholm

Project Completion Date: June 2006

Research Category: Primary Research

Institution: Laurentian University

Project Number: 6795-15-2003/5990004

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Summary

The purpose of this study was to determine how quality workplace environment recommendations from recent research and government health reports have been disseminated and implemented in acute and long-term care facilities within North Eastern Ontario. The study included facilities in small rural communities with large percentages of people of Francophone and Aboriginal origins within their population. The action research paradigm was used to maximize the relevance of the information gathered from health care professionals (nurses, physicians, social workers) and decision-makers at the local and regional level. This approach incorporated provisions for stakeholders' feedback on their perceptions of the types of factors that would hinder or facilitate the implementation and dissemination of quality workplace innovations garnered from governmental and academic research. In turn, their feedback was translated into specific information on workplace environments that formed the basis for discussions in the final phase of data collection.

The first stage of the research process used a cross-sectional survey to obtain demographic information and perceptions of CEOs and middle managers of health care institutions regarding dissemination and utilization of workplace recommendations published in government and professional reports. The next two stages involved separate focus groups for health care middle managers and CEOs. In the second stage, middle managers were asked about their perceptions of the barriers to and facilitators of dissemination and implementation of information within their institutions. In the third stage, information from the previous stage served as a stimulus for the CEO's thoughts about the dissemination process. The final stage of data collection consisted of a workshop with CEOs, middle managers and policy representatives.

The findings from both a preliminary survey and the focus groups suggested that the health reports were not disseminated by a mechanism or format conducive to uptake and implementation. Both CEOs and health care managers perceived similar barriers to implementation including issues of relevancy, insufficient resources, and competing priorities. These findings formed the basis for discussion during the final workshop. One important outcome of this workshop was a slate of suggestions for the development of the ways in which policies need to incorporate procedures that would support implementation. According to the participants, policies supporting implementation would: 1) be transferable to northern settings; 2) improve access to opportunities currently limited by distance; 3) build capacity; 4) promote sharing of resources; 5) link with local health networks; 6) support accreditation standards; 7) include an evaluative component; and 8) outline expectations of leaders. The next step for this project involves the development of a knowledge network portal that would serve as a mechanism for the uptake and implementation of recommendations. The knowledge network would include a forum for the discussion of workplace environment issues and co-construction of evidence informed solutions.

The research process used in this study has delivered information about on-site workplace environments potentially useful to collaborators and policy makers at the regional, provincial and national levels. Such an approach provided a basis for the development of policy recommendations that could be applied to situations/settings with similar demographics, health care access and health care human resource issues across Canada, particularly in rural areas.

The views expressed herein do not necessarily represent the views of Health Canada