Marie Prothero RN, MSN, FACHE
PhD Student University of Utah College of Nursing
What is a Knowledge Broker?
Do you
believe there is a gap between practice and research? Do you wonder if your patients are receiving
the most clinically relevant care? If you answered yes to either of these
questions then you may need a knowledge broker.
A knowledge broker is an intermediary between the people who produce
research (scientist) and those who use it (policy makers, general public and
people working in healthcare). A
knowledge broker works to bridge the gap that exists between these two groups.
Close to two
million research papers are published each year in 28,000 journals. Last year the Food and
Drug Administration approved 41 drugs and in 2013 27 new drugs were
approved. When you start to compound
these numbers year and after year it’s no wonder healthcare providers are
unable to keep up with current research. Synthesizing, analyzing and translating
relevant research findings are complex and require a specific set of skills. One strategy that might resolve this dilemma
is the implementation of a Knowledge Broker.
Knowledge
brokering is the process of bringing people together for the purpose of moving
knowledge forward. Knowledge Brokers
work to let end users know about current research and work with researchers to
make their work more accessible and meaningful to healthcare providers and policy
makers. This translates to transferring
knowledge from one group to another in order to foster implementation of
clinical research and at times, create new knowledge.
Examples of successful implementation
In 1996 the
Canadian government founded The Canadian Health
Services Research Foundation with the purpose of establishing a knowledge
broker group. This organization has
individuals with expertise in healthcare and research. Their goals include bringing researchers and
decision makers together to identify gaps in research and fund the researchers
who investigate those gaps. The final
outcome of this work was to bring healthcare leaders, patients and families, and
researchers together in a collaboration to find optimum solutions to current
healthcare issues.
Another
successful example includes Healthcare Improvement
Scotland. This organization uses
apps to help guide physicians and other providers to sift through the large
number of research articles and find the most cost effective solutions. They scrutinize research to establish
clinical evidence to solve some of their most pressing issues to improve patient
care. This organization also
provides regulatory oversight to the hospitals in Scotland.
What does it take to be a successful Knowledge Broker?
- Opinion leader and an entrepreneurial spirit
- Credibility in research and practice settings
- Excellent communicator, must be able to translate research into easy to understand practical information
- Negotiator of both the research and decision making environments
- Be able to see and think about the big picture
- Build relationships and ask researchable questions
- Problem solver, innovator and change agent
- Be able to present one-on-one and in large groups
Driving forces to push this paradigm shift forward
The need to
identify and implement evidence based practice continues to be a top
priority. Effective knowledge exchange
depends on groups of individuals with common concerns, values and a desire to
work together. There is an increased need for research to
reach all levels and have a big impact to society and the economy. In a highly competitive world market knowledge
has become increasingly important.
Passive
dissemination of research has not been as successful as one would hope (Haynes & Haines, 1998). Hospitals continue to struggle with full
implementation of CMS
core measures in the care of stroke, anterior myocardial infarction,
pneumonia and venous thrombosis prevention.
Researchers
and users do not speak the same language nor do they have the same
incentives. A Knowledge Broker could
facilitate the lack of common language, culture, unspoken rules to bring both
parties together.
Barriers to adoption/Why has this concept not been more widely accepted?
One barrier
to adoption is finding the right person for the job. Most experts in research stay in research and
experts in the practice setting often are lacking skills to analyze and
synthesize research. Additional barriers
could be funding of the position and the need to develop the skills and
credibility to maneuver between both settings?
Organizations
must also commit and support research implementation. This can be difficult without support from
all levels of management in an organization.
Many organizations struggle to implement change particularly in practice
settings where evidence base practice implementation is not embedded in the
culture of the organization.
Academic
structure promotes grant procurement and academic publication over engagement
with health service. Researcher to
researcher collaboration is well organized while the opposite of researcher to
practitioner interchanges about implementation of research findings is
sporadic. Structures and incentives in
healthcare organizations do not do any better in advancing scientific research. Most healthcare organizations are focused on
market share, cost reduction and containment, and regulatory compliance. Unless the healthcare setting is part of a
large academic setting they are not equipped to translate the plethora of
research into practice. The lack of understanding
and recognition from both sides continue to push both parties apart.
Do Knowledge Brokers have a future?
The
practicality of KB is still being scrutinized.
There are examples in the literature that suggest they play a role in
assisting with knowledge dissemination and implementation. However an important note in the literature
is the credibility of the KB with both groups and their ability to promote
collaborative relationships and networks.
A continued focus on designing implementing and evaluating solutions may
further the need for KB or it may eliminate the need.
Individuals
who are facilitating this work may not always be called a “knowledge
brokers”. Often they are called change
agents, facilitators, technology transfer officers, knowledge translators and
innovative brokers.
Nurses at
all levels of an organization must take all opportunities to engage with
researchers to solve problems and generate new knowledge whenever
possible. The nursing profession must
also identify research needs and lobby for an active role in the research
process.
When an
organization decides to utilize a KB they must commit financial resources and
personnel time in order to create a positive change. Many organizations may want to move in this
direction but simply don’t know how.
Knowledge brokers will need to continue to market their value to
researchers and healthcare providers.
K* (Star)
Initiative was established in the United Kingdom to help knowledge brokers
organize and create a support system.
This organization is facilitating knowledge brokers with the tools they
need to be successful in their jobs. Most
examples of knowledge brokering are in countries with a single payer model
(socialized medicine). This may be one
reason why coordination of resources and implementation of evidence based
practice has become some important.
Future Implications: Is it right for me?
Knowledge
brokering is somewhat new and seems to be gaining momentum in healthcare to
fast-track the exchange of knowledge between research, practice and policy
environments. Working as a nurse, nurse
administrator, hospital administrator and quality director has given me skills
to communicate and mediate at all levels of a healthcare organization. My next endeavor is to build my skills as a
nurse researcher. Could combining my new
research skills with my previous skills facilitate my role as a knowledge
broker? My desire to advance science
where it matters most is at the bedside.
This new and exciting role as a knowledge broker could be my next
career.
References:
Clark, G., & Kelly, L. (2005). New directions for knowledge
transfer and knowledge brokerage in Scotland: Scottish Executive Social
Research.
Haynes, B., & Haines, A. (1998).
Getting research findings into practice: Barriers and bridges to evidence based
clinical practice. BMJ: British Medical
Journal, 317(7153), 273.
Holgate, S. (2008). Emerging professions: Knowledge broker. Science.
Lomas, J. (2007). The in-between world of knowledge brokering. BMJ:
British Medical Journal, 129-132.
Meyer, M. (2010). The rise of the knowledge broker. Science
Communication, 32(1), 118-127.
Ward, V., House, A., & Hamer, S. (2009). Knowledge brokering:
the missing link in the evidence to action chain? Evidence & Policy: a
Journal of Research, Debate and Practice, 5(3), 267.
Ward, V. L., House, A. O., & Hamer, S. (2009). Knowledge
brokering: exploring the process of transferring knowledge into action. BMC
Health Services Research, 9(1), 12.
Wright, N. (2013). First-time knowledge brokers in health care: the
experiences of nurses and allied health professionals of bridging the
research-practice gap. Evidence & Policy: a Journal of Research, Debate
and Practice, 9(4), 557-570.
Links to Resources
Canadian
Health Services Research Foundation http://www.chsrf.ca/
Healthcare
Improvement Scotland http://www.healthcareimprovementscotland.org
Knowledge
Broker by PHCRIS: https://www.youtube.com/watch?v=knUj6HjsHro
This work is by Marie Prothero and is licensed under a Creative
Commons Attribution 4.0 International License
Great Blog posting Marie. I am testing the comments option.
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