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

From: Supporting the implementation of stroke quality-based procedures (QBPs): a mixed methods evaluation to identify knowledge translation activities, knowledge translation interventions, and determinants of implementation across Ontario

  Definitions
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.