Abstract
BackgroundCanada is among the most prosperous nations in the world, yet the health and wellness outcomes of Canadian children are surprisingly poor. There is some evidence to suggest that these poor health outcomes are partly due to clinical practice variation, which can stem from failure to apply the best available research evidence in clinical practice, otherwise known as knowledge translation (KT). Surprisingly, clinical practice variation, even for common acute paediatric conditions, is pervasive. Clinical practice variation results in unnecessary medical treatments, increased suffering, and increased healthcare costs. This study focuses on improving health outcomes for common paediatric acute health concerns by evaluating strategies that improve KT and reduce clinical practice variation.Design/MethodsUsing a multiple case study design, qualitative and quantitative data will be collected from four emergency departments in western Canada. Data sources will include: pre- and post-implementation focus group data from multidisciplinary healthcare professionals; individual interviews with the local champions, KT intervention providers, and unit/site leaders/managers; Alberta Context Tool (ACT) survey data; and aggregated patient outcome data. Qualitative and quantitative data will be systematically triangulated, and matrices will be built to do cross-case comparison. Explanations will be built about the success or lack of success of the clinical practice guidelines (CPG) and clinical pathways (CPs) uptake based upon the cross-case comparisons.SignificanceThis study will generate new knowledge about the potential causal mechanisms and factors which shape implementation. Future studies will track the impact of the CPG/CPs implementation on children's health outcome, and healthcare costs.
Highlights
Canada is among the most prosperous nations in the world, yet the health and wellness outcomes of Canadian children are surprisingly poor
Data types and collection The following data types will be collected for each case: pre-and post-implementation focus group data with representation from all relevant health professional groups; individual interviews with the local champions, intervention providers and managers of each study site; Alberta Context Tool (ACT) [42] survey data from health professionals at each study sites; survey data on the extent of clinical practice guidelines (CPG)/clinical pathways (CPs) use and knowledge translation (KT) intervention effectiveness; and documentation on KT intervention delivery
Systematically studying CPG/CP implementation processes is integral to improving future child health and system outcomes
Summary
Canada is among the most prosperous nations in the world, yet the health and wellness outcomes of Canadian children are surprisingly poor. Even for common acute child health conditions, continues to be pervasive, despite guidance from research evidence [2]. Despite the billions annually spent globally and the hundreds of millions spent in Canada [21] on high-quality health research, research transfer is a slow and haphazard process [22]. It often takes 10 to 20 years for research findings to be ‘translated’ into conventional healthcare delivery [23]. The literature highlights that the effectiveness of KT interventions, such as CPG/CPs, to facilitate the transfer of research into clinical practice varies by condition, professional group, and context; the processes and factors shaping the implementation processes are not well studied
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