Exploring the impact of a tailored knowledge translation approach on uptake of EBP in routine practice across five outpatient children’s occupational therapy sites.
The evidence base supporting children’s occupational therapy practice is dynamic and rapidly growing, with an increased emphasis on evidence-based practice (EBP). While EBP is generally accepted as an important aspect of clinical work by occupational therapists, there is a gap between what the evidence states and what is implemented in practice. This lag is commonly referred to as the 'evidence-to-practice gap'. By bridging this gap, it is anticipated health services delivered will be safer, more effective, patient centered, timely, efficient and equitable which suggests a bidirectional benefit to both services and service users.
In response to the evidence-to-practice gap and its significant implications to clinical care, there has been increasing knowledge translation research emerging in the literature. Knowledge translation can be understood as “the exchange, synthesis and ethically sound application of knowledge – within a complex system of interactions among researchers and users – to accelerate the capture of the benefits of research for patients through improved health, more effective services and products, and a strengthened health care system”.
Research in knowledge translation in children’s occupational therapy is in its infancy. Much still needs to be learned about what the key ingredients and processes are that support meaningful, longstanding change in clinical practice.
This study is a longitudinal mixed methods study. 5 NHS sites will be recruited across the UK. One site will act as a comparison site.
Participants will be occupational therapists working in the community with children and young people who have disabilities and their families. An initial needs analysis will be conducted at each site to understand the barriers and facilitators to evidence based practice, and the extent to which evidence based practice already occurs at each site. This information will act as baseline data as well as to inform the knowledge translation intervention. Based on the outcome of this needs analysis, each site will co-design their own knowledge translation intervention that will support the uptake of evidence in practice. This may include such transfer strategies as communities of practice, education sessions, report pro formas, introducing new clinical activities e.g. implementing outcome measures, or replacing non-evidence based practices with evidence based practices. The comparison group will not have a knowledge translation intervention designed for them, rather the comparison group will decide on what targeted education-based professional development opportunities they would like to engage in.
The intervention will occur over a 6 month timeframe for all sites, with the research team supporting the delivery of the knowledge translation intervention. Post intervention data collection will be repeated immediately post intervention and then 6 months post intervention to ascertain whether changes in clinical behaviour have occurred and/or have been maintained.
Focus groups will provide qualitative information regarding the experiences of the clinicians throughout the research process which will create further depth and complexity to the quantitative information collected through file audits, questionnaires and a knowledge quiz. The clinical impact of the knowledge translation intervention will be examined through comparing service user clinical outcome measure data before and after the study where possible.
This research aims to contribute to the growing knowledge translation literature relating to clinical research and clinical practice. This research seeks to support changes in various levels of the workplace context to support and empower all working clinicians, particularly children's occupational therapists working in community NHS sites. It is anticipated that clinical practice that is aligned with evidence based practice will improve both service and service user experiences and outcomes.