The document discusses engaging with policy makers to conduct health services research. It describes challenges in applying research findings to policy, as complex forces compete with research for policy maker attention. It advocates for collaborative research where researchers and policy makers work together beginning early in the research process. Strategies to build research-policy linkages include policy placements, fellowships, knowledge translation courses, and training policy makers in evidence use. Engaged scholarship is described as a collaborative form of inquiry where researchers and policy makers leverage their different perspectives.

1. Inspire.
Engaging with Policy Makers to
Conduct Policy Informing Health
Services Research
Engage.
Alba DiCenso, RN, PhD
Professor
Nursing and Clinical Epidemiology and Biostatistics
Lead.
McMaster University
Hamilton, Canada

2. Application of Research Findings
“Unhealthy Medicine
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All Breakthrough, No Follow-Through”
By Steven H. Woolf
The Washington Post
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Sunday, January 8, 2006
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3. Application of Research Findings
Inspire.
Engage.
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4. Background
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Clinical research: research that is intended to
inform our clinical practice. Examples:
a clinical trial comparing two levels of closed
Engage.
system suction pressures in ICU patients
effects of a self-care program on quality of life in
patients with a permanent pacemaker
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5. Background
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Gap between research and clinical practice
persists:
– Strong need for nursing leadership in
organizations to support nurses in becoming
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evidence-based practitioners:
Create evidence-based culture
(e.g., Best Practice Spotlight Organizations)
http://rnao.ca/bpg/bpso
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6. Background
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Make available and encourage use of
evidence-based resources:
– e.g., up-to-date clinical practice guidelines
– http://rnao.ca/bpg/guidelines
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– Practice guideline implementation toolkit
– http://rnao.ca/bpg/resources/toolkit-
implementation-best-practice-guidelines-
second-edition
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8. Background
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Make available and encourage use of
evidence-based resources. Example:
Nursing + Best Evidence for Nursing Care
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–Free regular notification by email about
recent studies that have been pre-rated
for quality and are of clinical relevance
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to you

9. Welcome
McMaster University's Health Information Research Unit is
providing you with access to current best evidence from
research, tailored to your own health care interests, to support
evidence-based clinical decisions.
This service is unique: all citations (from over 120 premier
clinical journals) are pre-rated for quality by research staff,
then rated for clinical relevance and interest by at least 3
members of a worldwide panel of practicing nurses. Here's
what we offer:
A searchable database of the best evidence from the medical
literature
An email alerting system
Links to selected evidence-based resources
http://plus.mcmaster.ca/NP/Default.aspx

10. Objectives
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– To explore the challenges in applying health
services research findings to policy
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– To describe components of a training
program designed to prepare researchers to
engage with policy makers
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11. Policy Maker
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An individual charged with developing and
implementing policy at the local, regional,
provincial or national level (aka: decision
maker)
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e.g., Senior policy advisor in various government
branches – nursing, primary care, cancer care,
social services, education;
Chief executive officer of a regional health authority;
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Senior manager in a hospital or health care agency;
Administrator of a professional or regulatory body

12. Health Services and Policy
Research
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Research that is intended to inform policy
development and decision making regarding
the governance, organization, funding, and
delivery of health services, or the allocation
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of resources dedicated to improving health
e.g., how to best transition patients from cancer
care to primary care
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e.g., developing and evaluating a nurse case
management role

13. Health Services Research
Competencies
1.Understanding of the country’s healthcare system
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2.Ability to conduct health services research
3.Understanding of population health theories
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4.Understanding of theories of health and health
services knowledge production
5.Ability to effectively exchange knowledge and
develop research partnerships with
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stakeholders in the health field
.

14. Potential Contribution of
Research to Policy
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“In the world of research, completing the
study is just the first step…making the
research come alive and using it to build
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capacity for future science and scientists and
to tell stories that capture policy-maker’s
attention and ultimately lead to policy
changes, are what it is all about”
O’Brien-Pallas, 2003
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15. Challenges in Applying Research
Findings to Policy
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Complex forces compete with research for
the attention of policy makers:
– Interests of stakeholders
– Values of the public
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– Ideologies of governing parties
– Constraints of prior policy
Heavy work pressure with little time to read
research reports/journal articles
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16. Working with Policy Makers to
Move Research into Policy
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International emphasis on learning how to
enhance linkage and exchange between
researchers and policy makers
New world: decision maker partners want
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to base policy changes on evidence
Partnering with researchers on policy
relevant research
Engaging in training of future researchers
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Applying research findings to policy

17. Engaged Scholarship
“A collaborative form of inquiry in which
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academics and practitioners (policy makers)
leverage their different perspectives and
competencies to co-produce knowledge about a
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complex problem or phenomenon”
Leverages “the relative contributions and
conceptual frameworks of researchers and
practitioners (policy makers)”
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Van de Ven AH & Johnson PE. Knowledge for Theory and Practice, Academy of
Management Review. 2006;31(4):802-21.

18. Collaborative Research
(Denis & Lomas, 2003)
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“a deliberate set of interactions and processes
designed specifically to bring together those who
study societal problems and issues (researchers)
with those who act on or within those societal
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problems and issues (policy makers,
practitioners, citizens)
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Denis, J-L., Lomas, J. (2003). Convergent evolution: the academic and policy
roots of collaborative research. Journal of Health Services Research & Policy.
8(S2):1-6.

19. Strategies to Build Researcher –
Policy Maker Linkages
Engagement of policy maker in research beginning
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to end
Policy placements
Science policy fellowships
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Knowledge translation courses
Preparation of policy briefs to convey research
Involvement of policy makers in health services
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associations, conferences, journals, publications
Training of policy makers in evidence use

20. Engagement of Policy Makers in
Research Beginning to End
Early and ongoing involvement of policy makers
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in the research process is the best predictor of
its utilization (Lomas, 2000)
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Students required to partner with a policy maker
to help shape their question and to act as an ex
officio member of the thesis committee
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Lomas, J. (2000). Connecting research and policy. Canadian Journal
of Policy Research, Spring, 140-144.

21. Engagement of Policy Makers in
Research Beginning to End
CIHR's Partnerships for Health System
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Improvement Program
Supports teams of researchers and decision makers
interested in conducting policy-relevant health
services research that responds to the needs of
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health care decision makers and strengthens the
Canadian health system.
The program requires meaningful collaboration
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between researchers and decision makers likely to
make use of the results of the research.

22. Engagement of Policy Makers in
Research Beginning to End
Example: Improving Care in the Community for
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Cancer Survivors
Research Team includes:
– Cancer survivors
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– University researchers
– Clinicians
– Patient and citizen advocates
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– Primary care and cancer care government leaders
from 3 provinces

23. Policy Placements
Graduate students spend 200 hours in a policy setting
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to:
Gain understanding of the policy process
Identify factors that shape the policy-making
environment
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Gain practical experience by actively contributing to
an aspect of the policy process through collection,
analysis, synthesis, or evaluation of policy-relevant
information
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Gain skills in communicating relevant research
findings to policy makers

24. Science Policy Fellowships
Short-term policy assignments at Health Canada
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for academic researchers
– policy-makers have immediate access to
researchers to engage on a public policy issue
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– Researchers learn how government works and
how public policies are made
The assignment must be focused on a specific
policy project
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Fellowships are for a period of six months, full-time

25. Knowledge Translation Courses
Objectives:
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– To understand theoretical underpinnings of
knowledge transfer/translation (KT)
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– To identify creative KT interventions
– To learn scientific approaches to the evaluation
of KT interventions
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26. Policy Briefs
Short clear language documents that present
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findings and recommendations of research
projects to a non-specialized audience
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Focus on one topic and can include one or more
studies
1-2 pages in length
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27. Policy Brief Template
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The issue
The purpose
What did we do?
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What did we find?
How will this research help?
What’s next
Bottom line
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28. Lead. Engage. Inspire.
28

29. Involvement of Policy Makers in
Health Services Research Forums
Canadian Association for Health Services and
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Policy Research
Membership includes researchers, students and
policy makers
Attendance and presentation at annual conference
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by researchers, students and policy makers
Healthcare Policy Journal
Includes both researchers and policy makers as
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editors, editorial board members, peer reviewers,
and authors

30. Training of Policy Makers in
Evidence Use
Executive Training for
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Research Application
Objective:
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To provide health system senior executives across
Canada with the opportunity to learn and apply a
systematic approach to finding and applying
research evidence to inform complex decisions
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and change strategies in healthcare
organizations

31. Training of Policy Makers in
Evidence Use
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Supported by: Canadian Nurses Association, Canadian
Medical Association, Canadian Foundation for
Healthcare Improvement, Canadian College of Health
Leaders
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• 14-month program with protected blocks of time by
employer
• Mentorship by an academic and a decision-making
mentor
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• 4 weeks of away-from-home residency sessions on
research-based evidence, change management, and
systems thinking

32. Training of Policy Makers in
Evidence Use
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Completion of an Intervention Project to guide a
change strategy in their organization supported
by research. Examples:
• Innovative Nursing Schedule Practices
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Supported by an E-Scheduling System
• Implementing a “Navigator” Model in Emerging
Mental Illness
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• http://www.chsrf.ca/WhatWeDo/EducationandTraining/E
XTRA.aspx

33. Benefits of Engaged
Scholarship
– Opportunity to conduct policy relevant research
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– Achieving change in the health system
– Keeping the research “grounded in reality”
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– Funding possibilities
– Connecting of policy makers with common issues
– Opportunity for long term relationship over length
of a full research program
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– Creation of trusting relationship for future research
and consultation opportunities – develop reputation

34. Challenges of Engaged
Scholarship
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Policy makers change positions frequently
Policy maker position could remain vacant for
long time
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Policy maker priorities change as result of
political agenda
Timing issues (too short or too long):
– Policy maker wants answer yesterday
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– Takes time to navigate political process

35. A Policy Maker’s View
“Moving government policy from the realm of opinion to
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evidence-informed policy formation requires the
additive effect of scientists and policy makers
collaborating to explore: 1) the right question; and, 2)
the policy options that might address the question. The
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more knowledge we have, the better our ability to fully
explore the boundaries of any particular policy problem
and to propose a wider range of responses. This takes
many minds, seeing the problem through different
lenses, working together for a common purpose –
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formulating good, defensible public policy, founded on
the best available evidence.”

36. The Break-Even Point
Breakthrough (results of high quality research) =
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Follow-Through (successful application of
findings to practice or policy)
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