Translating research into practice and policy is an international priority. [1] However, despite our best efforts, research findings often fail to be translated into practice. Translating knowledge into clinical care can also take a very long time. One estimate shows that, on average, it takes 17 years for a discovery in health care to be translated into practice.
But, for patients with palliative needs, 17 years is too long to wait.
So what can help us translate knowledge into practice in palliative care more quickly?
Knowledge translation can. Knowledge translation is a relatively new field. It is a field that can help the palliative care sector respond to this challenge. In essence, knowledge translation is when evidence (research findings) becomes a practical reality for the benefit of others. Internationally, it is referred to by many names, including knowledge mobilisation, knowledge transfer and knowledge exchange.
In clinical contexts, knowledge is translated when evidence helps improve the ways we work with patients and their carers, and also clinical outcomes. In relation to service delivery, it is when evidence is used to increase the likelihood of a service producing good outcomes for all, helping to reduce unwarranted variation in outcomes. In policy, it is when evidence is translated into policy priorities and measures to improve health outcomes and health system efficiencies.
How then will we know when knowledge has been translated into practice?
In part, we can answer this question through harnessing the power of palliative care outcomes. This is because palliative care outcomes are one of the critical indicators to help establish whether knowledge translation has taken place. In other words, an improved outcome can act as a proxy for knowledge being successfully translated. This can be done at an individual level, at the level of service delivery, and also at a systems-level.
In Australia, the Palliative Care Outcomes Collaboration (PCOC) is a national program that uses standardised clinical assessment tools to measure and benchmark patient outcomes in palliative care. PCOC works with service providers to help translate evidence into practice through attention to real-world settings, which, in reality, includes many different contexts, local challenges, complexities, opportunities and sometimes competing priorities.
PCOC aids knowledge translation in various ways. PCOC co-produces evidence with those in the field in order to ensure key priorities are advanced. It aids accessibility to evidence, and it builds capacity through national and jurisdictional workshops. It advocates for palliative care funding and policy development, informed by analysis of national outcomes, collaborations with services and the peer-reviewed literature. PCOC also helps establish sustainability in knowledge translation through building outcomes infrastructure over time (e.g., workforce capabilities, technological systems infrastructure).
Historically, many knowledge translation frameworks and approaches have primarily focussed on ‘the doing’ of knowledge translation. However, frameworks and approaches are more recently beginning to address the complex relationship of context, evidence and implementation in order to improve knowledge translation. PCOC’s practice aligns well with these new developments. Indeed, the PCOC national program aligns with goals of knowledge translation, as established by the Cochrane Collaboration [2], which are to:
- Produce evidence, in collaboration with those in the field;
- Ensure that evidence is accessible;
- Advocate for the use of evidence to ensure evidence-informed, decision-making and a climate that supports evidence-based decisions; and
- Establish sustainable infrastructure to support knowledge translation over time. [2]
Knowledge is of little value unless it is translated into practice and policy. Knowledge translation requires a process of engagement and action, progressed through a series of interactions and events over time, and ultimately, knowledge translation is a shared experience between researchers, healthcare professionals, policy makers and consumers (i.e., patients, their carers and the broader society).
In November 2019, PCOC will host its international inaugural PCOC Outcomes & Benchmarking Conference. The conference will bring together key audiences in palliative care to help systematically improve outcomes, and realise new possibilities for knowledge translation. The theme for the conference is: Using evidence on patient outcomes to improve the future of palliative care. Please join us at this important conference.
References
- Grimshaw J, Eccles MP. Knowledge Translation Of Research Findings. In: Jonson E, editor. Effective Dissemination of Findings from Research. Edmonton: Institute of Health Economics; 2008.
- The Cochrane Collaboration. Cochrane Knowledge Translation Framework (557kb pdf). London: The Cochrane Collaboration; 2017 Apr.