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What supports do health system organizations have in place to facilitate evidence-informed decision-making? a qualitative study

Moriah E Ellen1234, Gregory Léon5, Gisèle Bouchard5, John N Lavis12678*, Mathieu Ouimet59 and Jeremy M Grimshaw1011

Author Affiliations

1 Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main Street West, CRL 209, Hamilton, ON, Canada L8S 4K1

2 Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, CRL 209, Hamilton, ON, Canada L8S 4K1

3 Jerusalem College of Technology, Hava’ad Haleumi 21, Jerusalem, Israel 93721

4 Israeli Center for Technology Assessment in Health Care, Tel Hashomer 52621, Israel

5 Department of Political Science, Université Laval, Pavillon Charles-De Koninck, 1030 avenue des Sciences humaines, office 4453, Quebec, QC G1V 0A6, Canada

6 McMaster Health Forum, McMaster University, 1280 Main Street West, MML-417, Hamilton, ON, Canada L8S 4L6

7 Department of Political Science, McMaster University, 1280 Main Street West, CRL 209, Hamilton, ON, Canada L8S 4K1

8 Department of Global Health and Population, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115-6018, USA

9 Research Axis of Public health and practice-changing research, Centre Hospitalier Universitaire de Québec Research Centre, Hôpital Saint-François d’Assise, 10 rue de l’Espinay, office D6-726, Quebec, QC G1L 3L5, Canada

10 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa Hospital - General Campus, Centre for Practice-Changing Research (CPCR), 501 Smyth Road, Room 1286, Ottawa, Canada K1H 8L6

11 Department of Medicine, University of Ottawa, Ottawa Hospital - General Campus, Centre for Practice-Changing Research (CPCR), 501 Smyth Road, Room 1286, Ottawa, Canada K1H 8L6

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Implementation Science 2013, 8:84  doi:10.1186/1748-5908-8-84

Published: 6 August 2013

Abstract

Background

Decisions regarding health systems are sometimes made without the input of timely and reliable evidence, leading to less than optimal health outcomes. Healthcare organizations can implement tools and infrastructures to support the use of research evidence to inform decision-making.

Objectives

The purpose of this study was to profile the supports and instruments (i.e., programs, interventions, instruments or tools) that healthcare organizations currently have in place and which ones were perceived to facilitate evidence-informed decision-making.

Methods

In-depth semi-structured telephone interviews were conducted with individuals in three different types of positions (i.e., a senior management team member, a library manager, and a ‘knowledge broker’) in three types of healthcare organizations (i.e., regional health authorities, hospitals and primary care practices) in two Canadian provinces (i.e., Ontario and Quebec). The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software.

Results

A total of 57 interviews were conducted in 25 organizations in Ontario and Quebec. The main findings suggest that, for the healthcare organizations that participated in this study, the following supports facilitate evidence-informed decision-making: facilitating roles that actively promote research use within the organization; establishing ties to researchers and opinion leaders outside the organization; a technical infrastructure that provides access to research evidence, such as databases; and provision and participation in training programs to enhance staff’s capacity building.

Conclusions

This study identified the need for having a receptive climate, which laid the foundation for the implementation of other tangible initiatives and supported the use of research in decision-making. This study adds to the literature on organizational efforts that can increase the use of research evidence in decision-making. Some of the identified supports may increase the use of research evidence by decision-makers, which may then lead to more informed decisions, and hopefully to a strengthened health system and improved health.