From access to evidence to practice ready resources
A blog post written by Professor Jennifer Tieman
Evidence has always been core to CareSearch’s activities. When it was released in 2008, CareSearch set a new standard in connecting health professionals to palliative care evidence. It did this by providing a consolidated evidence base with synthesised clinical evidence, links to systematic reviews, and PubMed searches connecting users to primary studies with one-click. Underlying the website was a knowledge translation framework before knowledge translation became a buzzword. Graham and Tetroe’s Knowledge to Action framework provided an architecture for considering Knowledge Creation surrounded by an Action Cycle.
The Knowledge Creation funnel outlined a drive from knowledge inquiry to synthesis and then to tools and products while recognising the need for tailored information. This device inspired the development of PubMed Searches and the Review Collection as ways to shorten the distance to evidence. The Action Cycle outlines a process that represents the activities needed for knowledge to be applied in practice. This involves adapting knowledge for the local context and assessing and addressing barriers and facilitators knowledge use. Involving of stakeholders to tailor knowledge to the needs of people who are going to use it and monitoring use were also key steps. This simple cycle has driven the CareSearch Quality processes which acknowledge the context of practice in terms of setting and health discipline as well as the virtual environment that deployed the knowledge for access. Over time the participation of expert reviewers has grown to acknowledge the role of expert advisory groups and user working groups. Together they ensure not just the quality of the evidence but the relevance of the content for the intended user.
Information needs and information users have not diminished over time. As the evidence base for palliative care has grown so too has the range of knowledge needs and knowledge users. Increasingly we recognise that evidence by itself does not change practice. Individuals and organisations need to have resources that have meaning in the context of the need for evidence. CareSearch has responded by creating different products and different pathways for distributing this knowledge to the location for practice or decision. Learning modules, data management systems, interactive forms are just some of the different resources that have been made available.
Most recently we have consolidated our evidence resource into a broader knowledge centre that brings evidence and translation together. This architecture allows us to interlink the needs of two types of users - those providing palliative care (health professionals) and those requiring palliative care (community). Beyond this, the Evidence Centre enables us to address the use of evidence in an individual’s practice and the translation of evidence into teams, organisations, and services. It also enables us to create practice ready resources that can be picked up for immediate use in the care setting. We have not just expanded our evidence resources but reconceptualised how to consider evidence as the core of CareSearch.
Professor Jennifer Tieman
Director, Research Centre for Palliative Care, Death and Dying, and CareSearch Director
College of Nursing and Health Sciences, Flinders University