Rethinking capacity building for knowledge mobilisation: developing multilevel capabilities in healthcare organisations

Implementation Science

Ruth Boaden¹  Gill Harvey²  Heather Waterman³  Roman Kislov¹ 

[1] Manchester Business School, The University of Manchester, Room D38 MBS East, Booth Street West, Manchester M15 6PB, UK;School of Nursing, The University of Adelaide, Level 3, Eleanor Harrald Building, Adelaide 5005, SA, Australia;School of Nursing, Midwifery and Social Work, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK

关键词: Facilitation;    Service improvement;    Implementation;    Knowledge transfer;    Knowledge translation;    Knowledge mobilisation;    Organisational learning;    Organisational capabilities;    Capability development;    Capacity building;   

Others  :  1139487
DOI  :  10.1186/s13012-014-0166-0

 received in 2014-06-16, accepted in 2014-09-19,  发布年份 2014

【 摘 要 】

Background

Knowledge mobilisation in healthcare organisations is often carried out through relatively short-term projects dependent on limited funding, which raises concerns about the long-term sustainability of implementation and improvement. It is becoming increasingly recognised that the translation of research evidence into practice has to be supported by developing the internal capacity of healthcare organisations to engage with and apply research. This process can be supported by external knowledge mobilisation initiatives represented, for instance, by professional associations, collaborative research partnerships and implementation networks. This conceptual paper uses empirical and theoretical literature on organisational learning and dynamic capabilities to enhance our understanding of intentional capacity building for knowledge mobilisation in healthcare organisations.

Discussion

The discussion is structured around the following three themes: (1) defining and classifying capacity building for knowledge mobilisation; (2) mechanisms of capability development in organisational context; and (3) individual, group and organisational levels of capability development. Capacity building is presented as a practice-based process of developing multiple skills, or capabilities, belonging to different knowledge domains and levels of complexity. It requires an integration of acquisitive learning, through which healthcare organisations acquire knowledge and skills from knowledge mobilisation experts, and experience-based learning, through which healthcare organisations adapt, absorb and modify their knowledge and capabilities through repeated practice. Although the starting point for capability development may be individual-, team- or organisation-centred, facilitation of the transitions between individual, group and organisational levels of learning within healthcare organisations will be needed.

Summary

Any initiative designed to build capacity for knowledge mobilisation should consider the subsequent trajectory of newly developed knowledge and skills within the recipient healthcare organisations. The analysis leads to four principles underpinning a practice-based approach to developing multilevel knowledge mobilisation capabilities: (1) moving from `building¿ capacity from scratch towards `developing¿ capacity of healthcare organisations; (2) moving from passive involvement in formal education and training towards active, continuous participation in knowledge mobilisation practices; (3) moving from lower-order, project-specific capabilities towards higher-order, generic capabilities allowing healthcare organisations to adapt to change, absorb new knowledge and innovate; and (4) moving from single-level to multilevel capability development involving transitions between individual, group and organisational learning.

【 授权许可】

   
2014 Kislov et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Cooper A, Levin B: Some Canadian contributions to understanding knowledge mobilisation. Evid Policy 2010, 6(3):351-369.
• [2]Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: time for a map? J Contin Educ Health Prof 2006, 26(1):13-24.
• [3]Greenhalgh T, Wieringa S: Is it time to drop the `knowledge translation¿ metaphor? A critical literature review. JRSM 2011, 104(12):501-509.
• [4]Bate SP, Robert G: Knowledge management and communities of practice in the private sector: lessons for modernizing the National Health Service in England and Wales. Public Adm 2002, 80(4):643-663.
• [5]Kislov R, Harvey G, Walshe K: Collaborations for Leadership in Applied Health Research and Care: lessons from the theory of communities of practice. Implementation Sci 2011, 6:64.
• [6][http://www.clahrcpp.co.uk/] webcite CLAHRC Partnership Programme..
• [7]Ward V, House A, Hamer S: Knowledge brokering: the missing link in the evidence to action chain? Evid Policy 2009, 5(3):267-279.
• [8]Bate P, Robert G, Bevan H: The next phase of healthcare improvement: what can we learn from social movements? Qual Safety Health Care 2004, 13(1):62-66.
• [9]Dobbins M, Robeson P, Ciliska D, Hanna S, Cameron R, O¿Mara L, DeCorby K, Mercer S: A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implementation Sci 2009, 4:23.
• [10]Mitton C, Adair CE, McKenzie E, Patten SB, Perry BW: Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q 2007, 85(4):729-768.
• [11]Bevan H: How can we build skills to transform the healthcare system? J Res Nurs 2010, 15(2):139-148.
• [12]Berta W, Teare GF, Gilbart E, Ginsburg LS, Lemieux-Charles L, Davis D, Rappolt S: Spanning the know-do gap: understanding knowledge application and capacity in long-term care homes. Soc Sci Med 2010, 70(9):1326-1334.
• [13]Hamel N, Schrecker T: Unpacking capacity to utilize research: a tale of the Burkina Faso public health association. Soc Sci Med 2011, 72(1):31-38.
• [14]Nutley S, Davies HTO: Making a reality of evidence-based practice: some lessons from the diffusion of innovations. Public Money Manage 2000, 20(4):35-42.
• [15]Nutley S, Walter I, Davies HTO: From knowing to doing: a framework for understanding the evidence-into-practice agenda. Evaluation 2003, 9(2):125-148.
• [16]Nutley SM, Davies HTO: Developing organizational learning in the NHS. Med Educ 2001, 35(1):35-42.
• [17]Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol 2005, 58(2):107-112.
• [18]Grol RPTM, Bosch MC, Hulscher MEJL, Eccles MP, Wensing M: Planning and studying improvement in patient care: the use of theoretical perspectives. Milbank Q 2007, 85(1):93-138.
• [19]Oborn E, Barrett M, Racko G: Knowledge translation in healthcare: incorporating theories of learning and knowledge from the management literature. J Health Organ Manag 2013, 27(4):412-431.
• [20]Ferlie E, Crilly T, Jashapara A, Peckham A: Knowledge mobilisation in healthcare: a critical review of health sector and generic management literature. Soc Sci Med 2012, 74(8):1297-1304.
• [21]Lavis JN, Robertson D, Woodside JM, McLeod CB, Abelson J: How can research organizations more effectively transfer research knowledge to decision makers? Milbank Q 2003, 81(2):221-248.
• [22]Lomas J: Using `linkage and exchange¿ to move research into policy at a Canadian foundation. Health Aff 2000, 19(3):236-240.
• [23]van Kammen J, de Savigny D, Sewankambo N: Using knowledge brokering to promote evidence-based policy-making: the need for support structures. Bull World Health Organ 2006, 84(8):608-612.
• [24]A Review of Conditions and Context for Success. Ottawa, ON, Canadian Health Services Research Foundation; 2012.
• [25]Wales A, Graham S, Rooney K, Crawford A: Scotland¿s knowledge network: translating knowledge into action to improve quality of care. Scott Med J 2012, 57(4):221-224.
• [26]Phipps DJ, Shapson S: Knowledge mobilisation builds local research collaborations for social innovation. Evid Policy 2009, 5(3):211-227.
• [27]Harvey G, Fitzgerald L, Fielden S, McBride A, Waterman H, Bamford D, Kislov R, Boaden R: The NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester: Combining empirical, theoretical and experiential evidence to design and evaluate a large-scale implementation strategy. Implementation Sci 2011, 6:96.
• [28]Rowley E, Morriss R, Currie G, Schneider J: Research into practice: Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Nottinghamshire, Derbyshire, Lincolnshire (NDL). Implementation Sci 2012, 7:40.
• [29]Baker R, Robertson N, Rogers S, Davies M, Brunskill N, Khunti K, Steiner M, Williams M, Sinfield P: The National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Leicestershire, Northamptonshire and Rutland (LNR): a programme protocol. Implementation Sci 2009, 4:72.
• [30]Walshe K, Davies HT: Health research, development and innovation in England from 1988 to 2013: from research production to knowledge mobilization. J Health Serv Res Policy 2013, 18(S3):1-12.
• [31]Hinchcliff R, Greenfield D, Braithwaite J: Is it worth engaging in multi-stakeholder health services research collaborations? Reflections on key benefits, challenges and enabling mechanisms. Int J Qual Health Care 2014, 26(2):124-128.
• [32]Crisp BR, Swerissen H, Duckett SJ: Four approaches to capacity building in health: consequences for measurement and accountability. Health Promot Int 2000, 15(2):99-107.
• [33]Harrow J: `Capacity building¿ as a public management goal¿myth, magic or the main chance? Public Manage Rev 2001, 3(2):209-230.
• [34]Paul S: Capacity Building for Health Sector Reform. World Health Organization, Geneva; 1995.
• [35]Trostle J: Research capacity building in international health: definitions, evaluations and strategies for success. Soc Sci Med 1992, 35(11):1321-1324.
• [36]Cooke J: A framework to evaluate research capacity building in health care. BMC Fam Pract 2005, 6:44.
• [37]Cooksey D: A Review of UK Health Research Funding. The Stationery Office, London; 2006.
• [38]Ferlie E, Dopson S, Fitzgerald L, Locock L: Renewing policy to support evidence-based health care. Public Adm 2009, 87(4):837-852.
• [39]Condell SL, Begley C: Capacity building: a concept analysis of the term applied to research. Int J Nurs Pract 2007, 13(5):268-275.
• [40]Shediac-Rizkallah MC, Bone LR: Planning for the sustainability of community-based health programs: conceptual frameworks and future directions for research, practice and policy. Health Educ Res 1998, 13(1):87-108.
• [41]Virani T, Lemieux-Charles L, Davis DA, Berta W: Sustaining change: once evidence-based practices are transferred, what then? Healthc Q 2009, 12(1):89-96.
• [42]Dopson S, Fitzgerald L, Ferlie E, Gabbay J, Locock L: No magic targets! Changing clinical practice to become more evidence based. Health Care Manage Rev 2002, 27(3):35-47.
• [43]Fitzgerald L, Ferlie E, Wood M, Hawkins C: Interlocking interactions: the diffusion of innovations in health care. Human Relations 2002, 55(12):1429-1449.
• [44]Dopson S, Fitzgerald L: The role of the middle manager in the implementation of evidence-based health care. J Nurs Manag 2006, 14(1):43-51.
• [45]Locock L, Dopson S, Chambers D, Gabbay J: Understanding the role of opinion leaders in improving clinical effectiveness. Soc Sci Med 2001, 53(6):745-757.
• [46]Dopson S, Fitzgerald L, Ferlie E: Understanding change and innovation in healthcare settings: reconceptualizing the active role of context. J Change Manage 2008, 8(3):213-231.
• [47]Fitzgerald L, Ferlie E, Addicott R, Baeza J, Buchanan D, McGivern G: Service improvement in healthcare: understanding change capacity and change context. Clin Manage 2007, 15(2):61-74.
• [48]Harvey G, Loftus-Hills A, Rycroft-Malone J, Titchen A, Kitson A, McCormack B, Seers K: Getting evidence into practice: the role and function of facilitation. J Adv Nurs 2002, 37(6):577-588.
• [49]Stetler C, Legro M, Rycroft-Malone J, Bowman C, Curran G, Guihan M, Hagedorn H, Pineros S, Wallace C: Role of `external facilitation¿ in implementation of research findings: a qualitative evaluation of facilitation experiences in the Veterans Health Administration. Implementation Sci 2006, 1:23.
• [50]Wang CL, Ahmed PK: Dynamic capabilities: a review and research agenda. Int J Manage Rev 2007, 9(1):31-51.
• [51]Ambrosini V, Bowman C: What are dynamic capabilities and are they a useful construct in strategic management? Int J Manage Rev 2009, 11(1):29-49.
• [52]Barreto I: Dynamic capabilities: a review of past research and an agenda for the future. J Manage 2010, 36(1):256-280.
• [53]Eisenhardt KM, Martin JA: Dynamic capabilities: what are they? Strateg Managet J 2000, 21(10¿11):1105-1121.
• [54]Zollo M, Winter SG: Deliberate learning and the evolution of dynamic capabilities. Organization Sci 2002, 13(3):339-351.
• [55]Winter SG: Understanding dynamic capabilities. Strateg Manage J 2003, 24(10):991-995.
• [56]Teece DJ, Pisano G, Shuen A: Dynamic capabilities and strategic management. Strateg Manage J 1997, 18(7):509-533.
• [57]Amit R, Schoemaker PJH: Strategic assets and organizational rent. Strateg Manage J 1993, 14(1):33-46.
• [58]Humphreys J, Harvey G, Coleiro M, Butler B, Barclay A, Gwozdziewicz M, O¿Donoghue D, Hegarty J: A collaborative project to improve identification and management of patients with chronic kidney disease in a primary care setting in Greater Manchester. BMJ Qual Saf 2012, 21:700-708.
• [59]Kislov R, Walshe K, Harvey G: Managing boundaries in primary care service improvement: a developmental approach to communities of practice. Implementation Sci 2012, 7:97.
• [60]Zahra SA, Sapienza HJ, Davidsson P: Entrepreneurship and dynamic capabilities: a review, model and research agenda. J Manage Stud 2006, 43(4):917-955.
• [61]Keil T: Building external corporate venturing capability. J Manage Stud 2004, 41(5):799-825.
• [62]Zahra SA, Nielsen AP, Bogner WC: Corporate entrepreneurship, knowledge, and competence development. Entrepreneurship Theory Pract 1999, 23(3):169-189.
• [63]Tsoukas H, Vladimirou E: What is organizational knowledge? J Manage Stud 2001, 38(7):973-993.
• [64]Brown JS, Duguid P: Organizational learning and communities-of-practice: toward a unified view of working, learning and innovation. Organization Sci 1991, 2(1):40-57.
• [65]Lave J, Wenger E: Situated Learning: Legitimate Peripheral Participation. Cambridge University Press, Cambridge; 1991.
• [66]Cooke J, Nancarrow S, Dyas J, Williams M: An evaluation of the `Designated Research Team¿ approach to building research capacity in primary care. BMC Fam Pract 2008, 9:37.
• [67]Peirson L, Ciliska D, Dobbins M, Mowat D: Building capacity for evidence informed decision making in public health: a case study of organizational change. BMC Public Health 2012, 12:137.
• [68]Cooke J, Nancarrow S, Hammersley V, Farndon L, Wesley V: The `Designated Research Team¿ approach to building research capacity in primary care. Primary Health Care Res Dev 2006, 7(1):78-86.
• [69]Golenko X, Pager S, Holden L: A thematic analysis of the role of the organisation in building allied health research capacity: a senior managers¿ perspective. BMC Health Serv Res 2012, 12:276.
• [70]Pablo AL, Reay T, Dewald JR, Casebeer AL: Identifying, enabling and managing dynamic capabilities in the public sector. J Manage Stud 2007, 44(5):687-708.
• [71]Fitzgerald L, Ferlie E, McGivern G, Buchanan D: Distributed leadership patterns and service improvement: evidence and argument from English healthcare. Leadersh Q 2013, 24(1):227-239.
• [72]Walshe K: Pseudoinnovation: the development and spread of healthcare quality improvement methodologies. Int J Qual Health Care 2009, 21(3):153-159.
• [73]Barney J: Firm resources and sustained competitive advantage. J Manage 1991, 17(1):99-120.
• [74]Whitelaw S, Graham N, Black D, Coburn J, Renwick L: Developing capacity and achieving sustainable implementation in healthy `settings¿: insights from NHS Health Scotland¿s Health Promoting Health Service project. Health Promot Int 2012, 27(1):127-137.
• [75]Newell S, Bresnen M, Edelman L, Scarbrough H, Swan J: Sharing knowledge across projects: limits to ICT-led project review practices. Manage Learn 2006, 37(2):167-185.
• [76]Scarbrough H, Swan J, Laurent S, Bresnen M, Edelman L, Newell S: Project-based learning and the role of learning boundaries. Organization Stud 2004, 25(9):1579-1600.
• [77]Swan J, Scarbrough H, Newell S: Why don¿t (or do) organizations learn from projects? Manage Learn 2010, 41(3):325-344.
• [78]Bowen S, Martens P: Demystifying knowledge translation: learning from the community. J Health Serv Res Policy 2005, 10(4):203-211.
• [79]Kislov R: From a project team to a community of practice? An exploration of boundary and identity in the context of healthcare collaboration. In Patient-Centred Health Care: Achieving Co-ordination, Communication and Innovation. Edited by Keating MA, McDermott AM, Montgomery K. Palgrave Macmillan, Basingstoke; 2013:103-118.
• [80]Tierney S, Kislov R, Deaton C: A qualitative study of a primary-care based intervention to improve the management of patients with heart failure: the dynamic relationship between facilitation and context. BMC Fam Pract 2014, 15:153.
• [81]Farmer E, Weston K: A conceptual model for capacity building in Australian primary health care research. Aust Fam Physician 2002, 31(12):1139-1142.
• [82]Levinthal DA, March JG: The myopia of learning. Strateg Manage J 1993, 14(S2):95-112.
• [83]Cook SD, Brown JS: Bridging epistemologies: the generative dance between organizational knowledge and organizational knowing. Organization Sci 1999, 10(4):381-400.
• [84]Wenger E: Communities of Practice: Learning, Meaning and Identity. Cambridge University Press, Cambridge; 1998.
• [85]Gabbay J, le May A: Practice-Based Evidence for Healthcare: Clinical Mindlines. Routledge, Oxon; 2011.
• [86]Argote L, McEvily B, Reagans R: Managing knowledge in organizations: an integrative framework and review of emerging themes. Manage Sci 2003, 49(4):571-582.
• [87]Huber GP: Organizational learning: the contributing processes and the literatures. Organization Sci 1991, 2(1):88-115.
• [88]Crossan MM, Lane HW, White RE: An organizational learning framework: from intuition to institution. Acad Manage Rev 1999, 24(3):522-537.
• [89]Kislov R: Boundary discontinuity in a constellation of interconnected practices. Public Adm 2014, 92(2):307-323.
• [90]Szulanski G: Exploring internal stickiness: impediments to the transfer of best practice within the firm. Strateg Manage J 1996, 17:27-43.
• [91]Powell AE, Davies HTO: The struggle to improve patient care in the face of professional boundaries. Soc Sci Med 2012, 75(5):807-814.
• [92]Newell S: Enhancing cross-project learning. Eng Manage J 2004, 16(1):12-20.
• [93]March JG: Exploration and exploitation in organizational learning. Organization Sci 1991, 2(1):71-87.
• [94]Tsang EWK, Zahra SA: Organizational unlearning. Human Relations 2008, 61(10):1435-1462.
• [95]Rushmer R, Davies HTO: Unlearning in health care. Qual Safety Health Care 2004, 13(suppl 2):ii10-ii15.
• [96]McMurray R: Our reforms, our partnerships, same problems: the chronic case of the English NHS. Public Money Manage 2007, 27(1):77-82.
• [97]Kislov R, Boaden R: Hybrid professionals as institutionalised knowledge brokers: limited managerial authority in a constraining context. In 9th International Organisational Behaviour in Healthcare Conference (OBHC). Copenhagen Business School, Copenhagen; 2014.
• [98]Newell S, Edelman LF: Developing a dynamic project learning and cross-project learning capability: synthesizing two perspectives. Inf Syst J 2008, 18(6):567-591.
• [99]Waring J, Currie G, Crompton A, Bishop S: An exploratory study of knowledge brokering in hospital settings: facilitating knowledge sharing and learning for patient safety? Soc Sci Med 2013, 98:79-86.
• [100]Currie G, White L: Inter-professional barriers and knowledge brokering in an organizational context: the case of healthcare. Organization Stud 2012, 33(10):1333-1361.
• [101][http:/ / www.nihr.ac.uk/ about/ collaborations-for-leadership-in-ap plied-health-research-and-care.htm] webcite Collaborations for Leadership in Applied Health Research and Care (CLAHRCs)..
• [102][http://www.nhsinnovationsnorth.org.uk/ahsn/] webcite Academic health science networks..
• [103]Braithwaite J, Westbrook J, Johnston B, Clark S, Brandon M, Banks M, Hughes C, Greenfield D, Pawsey M, Corbett A, Georgiou A, Callen J, Øvretveit J, Pope C, Suñol R, Shaw C, Debono D, Westbrook M, Hinchcliff R, Moldovan M: Strengthening organizational performance through accreditation research¿a framework for twelve interrelated studies: the ACCREDIT project study protocol. BMC Res Notes 2011, 4:390.
• [104][http://ktclearinghouse.ca/ktcanada] webcite Knowledge translation Canada..
• [105]Potter C, Brough R: Systemic capacity building: a hierarchy of needs. Health Policy Plan 2004, 19(5):336-345.
• [106]Cousins JB, Goh SC, Elliott CJ, Bourgeois I: Framing the capacity to do and use evaluation. In Organizational Capacity to Do and Use Evaluation. Edited by Cousins JB, Bourgeois I. Jossey-Bass, San Francisco, CA; 2014:7-23.