Table 1 Definitions of KT activities [6] and KT interventions [8]

KT Activities [6]

KT activities are those used in the process of using research evidence (stroke recommendations) in practice such as conducting a needs assessment, assessing barriers and facilitators, disseminating the handbook and, developing partnerships.

 Knowledge tools

Refining knowledge for decision-making (e.g., clinical practice guidelines, decision aids, algorithms)

 Identify problem/ identify, review, select knowledge

Identification of the knowledge-to-action gaps (knowledge needs) as a starting point of knowledge implementation. Involves rigorous methods and engagement with relevant stakeholders

 Adapt knowledge to local context

Adapting the knowledge to the local settings to make sure it is relevant and feasible (e.g., customizing clinical practice guideline for a particular organization)

 Assess barriers/facilitators to knowledge use

Assessing areas that impede and facilitate the uptake of knowledge

 Select, tailor, implement interventions - implementation planning

Plans to select and tailor interventions to the identified barriers and facilitators

 Select, tailor, implement interventions - implementation

Selecting and tailoring interventions to the identified barriers and facilitators

 Monitor knowledge use

Defining what constitutes knowledge use so it can be measured (i.e., conceptual, instrumental, strategic)

Determining the extent to which the interventions have been successful in bringing about change

 Evaluate outcomes

Determining the impact of using the knowledge using explicit, rigorous methods

 Sustain knowledge use

Continued implementation of evidence over time, can include

assessing barriers to knowledge sustainability; tailoring interventions to these barriers; monitoring ongoing knowledge use; evaluating initial and sustained use

 Other – dissemination

The purposeful spreading or distribution of knowledge or research to a specific audience, such as is done in scientific journals and at scientific conferences.

 Other – stakeholder engagement

Actively engaging key stakeholders throughout the implementation process, and forming and sustaining positive and productive collaborations.

KT interventions [8]

KT interventions are the interventions (e.g. education, reminders, audit and feedback) used to change behaviour to align with the best practices (e.g., the QBP).

 Accreditation

Process of review to demonstrate the ability to meet predetermined criteria and standards of accreditation established by a professional accrediting agency (e.g., Stroke Distinction)

 Changes in physical structure, facilities, and equipment

A change of location of clinical work stations, inclusion of equipment where technology in question is used in a wide range of problems and is not disease specific

 Changes in quality monitoring system

Presence and organization of quality monitoring mechanisms

 Changes in setting/site of delivery

A change in care delivery location (e.g., moving a family planning service from a hospital to a school)

 Skill mix changes

Changes in numbers, types or qualifications of staff

 Audit and feedback

Any summary of clinical performance of health care over a specified period of time. The summary may also have included recommendations for clinical action. The information may have been obtained from medical records, computerized databases, or observations from patients

 Champion/opinion leader

Use of providers nominated by their colleagues as being influential in changing behaviour

 Continuity of stroke care

An intervention which includes one or many episodes of care for inpatients or outpatients. Continuity of care also includes arrangements for follow-up and case management, including co-ordination of assessment, treatment and arrangement for referrals

 Educational meetings

Participation in conferences, lectures, workshops or traineeships

 Local consensus processes

Inclusion of participating providers in discussion to ensure that they agreed that the chosen clinical problem was important and the approach to managing the problem was appropriate

 Multidisciplinary teams

Creation of a new team of health professionals of different disciplines or additions of new members to the team who work together to care for patients

 Patient educational materials

Distribution of published or printed recommendations for patients, including clinical practice guidelines, audio-visual materials and electronic publications.

 Reminders

Patient or encounter specific information, provided verbally, on paper or on a computer screen, which is designed or intended to prompt a health professional to recall information. This would usually be encountered through their general education; in the medical records or through interactions with peers, and so remind them to perform or avoid some action to aid individual patient care. Computer aided DS is included

 Revision of professional roles

Also known as ‘professional substitution’, specialist role’ or ‘boundary encroachment’, this includes the shifting of roles among health professionals and expansion of role to include new tasks. See also revision of professional roles – nursing and revision of professional roles – pharmacy intervention categories for specified nursing or pharmacy led care

 Staff educational materials

Distribution of published or printed recommendations for staff, including clinical practice guidelines, audio-visual materials and electronic publications.