Knowledge Transfer Initiatives Research Articles

Evaluation of CT and MRI scanning among cancer patientsin Ontario

Background Computed tomography (CT) and magnetic resonance imaging (MRI) utilization in Ontario increased drastically since the early 1990s. The effect of an increased number of cancer diagnoses, and an increase in indications for scans has not been assessed. This study was conducted to determine trends in utilization of CT and MRI in cancer patients in Ontario over a period of 9 years. Methods Using Ontario Health Insurance Plan billing data linked to the Ontario Cancer Registry, rates of CT and MRI were analyzed by region, year, scan type and socioeconomic status. Results CT in cancer patients increased 2.3-fold and accounted for approximately 24% of these scans. MRI in cancer patients increased by 4.2-fold and accounted for approximately 10% of these scans. Imaging rates for cancer patients increased more gradually than that of the general population. Substantial variation in the rate of both scans by region of patient residence existed. Even greater variation by the location of the scanner was demonstrated, indicating that many cancer patients traveled outside their region for imaging. There was little evidence of variation in scanning rates by socioeconomic status. Conclusion A minority of CT and MRI performed in Ontario are for cancer care. Regional variation in imaging rates suggest that utilization guidelines be developed or knowledge transfer initiatives improve compliance to existing guidelines are needed. A significant number of cancer patients travel outside their region for diagnostic imaging; this should influence decisions about the location of new scanners.

Key characteristics of knowledge transfer and exchange in healthcare: integrative literature review

This paper presents the results of a review of literature relating to knowledge transfer and exchange in healthcare. Treatment, planning and policy decisions in contemporary nursing and healthcare should be based on sound evidence wherever possible, but research knowledge remains generally underused. Knowledge transfer and exchange initiatives aim to facilitate the accessibility, application and production of evidence and may provide solutions to this challenge. This review was conducted to help inform the design and implementation of knowledge transfer and exchange activities for a large healthcare organization. Databases: ASSIA, Business Source Premier, CINAHL, PsychInfo, Medline and the Cochrane Database of Systematic Reviews. An integrative literature review was carried out including an extensive literature search. English language systematic reviews, literature reviews, primary quantitative and qualitative papers and grey literature of high relevance evaluating, describing or discussing knowledge transfer or exchange activities in healthcare were included for review (January 1990-September 2009). Thirty-three papers were reviewed (four systematic reviews, nine literature reviews, one environmental scan, nine empirical studies and ten case studies). Robust research into knowledge transfer and exchange in healthcare is limited. Analysis of a wide range of evidence indicates a number of commonly featured characteristics but further evaluation of these activities would benefit their application in facilitating evidence-based practice in nursing.

1862 SURGEON VOLUME-OUTCOME RELATIONSHIPS IN THE TREATMENT OF RENAL MASSES

You have accessJournal of UrologyKidney Cancer: Localized1 Apr 20111862 SURGEON VOLUME-OUTCOME RELATIONSHIPS IN THE TREATMENT OF RENAL MASSES Robert Abouassaly, Shabbir M.H. Alibhai, George A. Tomlinson, David R. Urbach, and Antonio Finelli Robert AbouassalyRobert Abouassaly Cleveland, OH More articles by this author , Shabbir M.H. AlibhaiShabbir M.H. Alibhai Toronto, Canada More articles by this author , George A. TomlinsonGeorge A. Tomlinson Toronto, Canada More articles by this author , David R. UrbachDavid R. Urbach Toronto, Canada More articles by this author , and Antonio FinelliAntonio Finelli Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1909AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Volume-outcome relationships have been noted in a number of major surgical procedures. Outcomes of these complex procedures tend to be better for high volume hospitals and providers. The aim of our study was to determine the relationship between provider volume, and partial nephrectomy (PN) use and morbidity in the treatment of renal masses. METHODS Using data from a national discharge abstract database, we performed a population-based, retrospective, observational study. Data were available on 24,579 patients treated surgically for a renal mass from April 1998 to March 2008. Surgeon volume quartiles were created using the total number of nephrectomies during the 10-year observation period. In-hospital complications and comorbidity were identified using specific ICD-9 and 10 diagnosis and procedure codes. The Charlson-Deyo Index was used to adjust for comorbidity. PN use, complication rates, and 30-day mortality were compared between surgeon volume quartiles using the Chi-square test. The effect of surgeon volume on our outcome variables was determined using multivariable logistic regressions, adjusted for covariates (including hospital volume). RESULTS Overall, PN use, in-hospital complications and mortality occurred in 4,292 (17.5%), 8,406 (34.2%) and 295 (1.2%) patients, respectively. PN use occurred in 10.9% of low volume, compared with 24.7% of very high volume surgeons (p<.0001). A modest decrease in complications was observed with increasing surgeon volume (37.6% among low vs. 34.5% among very high volume, p<.0001). The effect of in-hospital mortality was more dramatic, with rates of 1.71%, 1.20%, 0.97% and 0.92% observed among low, intermediate, high and very high volume surgeons, respectively (p<.0001). After adjusting for covariates, compared with low volume surgeons, patients treated by very high volume surgeons had 1.54 the odds of being treated with PN (95% CI 1.37–1.72, p<.0001), 0.84 the odds of experiencing an in-hospital complication (95% CI 0.77–0.92, p<.0001), and 0.69 the odds of dying in-hospital (95% CI 0.47–1.01, p=0.16). CONCLUSIONS Our large, population-based study suggests that surgeon volume-outcome relationships exist in kidney surgery for renal masses. Higher volume surgeons use PN more often, experience lower complication rates, and may have lower in-hospital mortality rates than lower volume surgeons. Understanding the factors contributing to these differences would facilitate knowledge transfer initiatives, and would likely improve surgical outcomes. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e747 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Robert Abouassaly Cleveland, OH More articles by this author Shabbir M.H. Alibhai Toronto, Canada More articles by this author George A. Tomlinson Toronto, Canada More articles by this author David R. Urbach Toronto, Canada More articles by this author Antonio Finelli Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

The Relationship Between National Policy and Industrial Development in the UK and South Korea, 1940s–2000s

Introduction As design has increasingly become regarded as a strategic tool that makes a critical contribution to enhancing competitiveness and economic success,1 a growing number of businesses now consider the use of design as a means of achieving their business goals. Governments, too, have embraced policies that encourage businesses to develop and implement new products and services through the use of design.2 Yet, despite the efforts of companies to expand their business into overseas markets with government support, achieving their goals in the rapidly changing competitive environment of the global marketplace and economy is becoming increasingly difficult.3 Researchers have proposed that the purpose of a national design policy is to ensure that the appropriate design support is provided for businesses to become globally competitive.4 Such research has analyzed the influence of design on global competitiveness;5 however, few researchers have addressed the influence of national design policy on global competitiveness either longitudinally or in relation to indigenous industry. In this paper we examine in two different countries (i.e., the U.K. and South Korea) the relationship between national design policies and industrial development, as evidenced through a government-supported design center’s strategy, activities, and industrial support. We also compare the two cases to understand national design policy and how it influences indigenous industry. These two countries have been selected because of the difference in the level of maturity in their “design” support (i.e., United Kingdom has a very mature Design Council, while the Korea Institute of Design Promotion (KIDP), in South Korea, is relatively new); yet similar in their design and innovation index ranking in the Global Competitiveness Report.6 Both countries also have been described as having a clear and effective design policy7 and have applied government design policy and design promotion programs that have intensified the role of design in international competition.8 It has also been suggested that the United Kingdom has a strong

Enhancing the contribution of research councils to the generation of evidence to inform policy making

Over the last 10 years, UK government funding for research channelled through the UK’s seven research councils has substantially increased. Over the same time period there has been a renewed emphasis on the more effective use of evidence in UK policy making. Concerns remain, however, that these two initiatives have not been sufficiently well linked, and that the research councils could be more effective in supporting the development and communication of the evidence base for UK policy making. This paper examines the current ‘state of play’, concludes that many of the knowledge transfer initiatives that have been put in place do not reach sufficiently deeply into the research funding system, and recommends 10 changes to the planning, management and structure of research funding in order to enhance the policy value of UK research. A brief review of research funding issues in other countries points to the potential relevance of these conclusions and recommendations.

Knowledge transfer to partners: a firm level perspective

PurposeFirms at the center of an organizational network may benefit from educating and building up competencies of their partners. For that reason, centers often seek to transfer knowledge from the center to partner firms. They even set up systems of inter‐organizational knowledge transfer to plan, to coordinate, and to control such transfers on a firm level instead of managing single knowledge transfer projects individually. However, little systematic attention has yet been paid to such systems on a firm level. This paper seeks to analyze the managerial mechanism to decide what knowledge to transfer to what partners.Design/methodology/approachTo address this gap, data were gathered on nine leading multinational center firms. An explorative approach was adopted using case study research to look at the characteristics of network centers, network partners, knowledge, transfer channels, and programmes.FindingsIt was found that center firms offered knowledge transfer products to partners and set up portfolios of knowledge transfer programmes targeted at specific partner groups. There is further elaboration on fundamental decisions on the programmes' design, communication, access, and pricing.Originality/valueThe research contributes to shed light on how center firms manage knowledge transfer activities from the center to partners on the firm level and how they structure it in the form of programmes. Therefore, the paper does not focus on the management of knowledge transfer in particular partnerships or networks, but also considers interdependencies between individual knowledge transfer initiatives.

Positions of Power

This article discusses the reasons behind shortage of engineers and engineering jobs in the United States. Power generation faces shortages of people at all levels with the skills required to get big new projects designed, approved, funded, and built, which is largely the result of three decades of little new investment. With the anticipated workload, it is little wonder that power-generation industry leaders are deeply worried about the supply of engineers between roughly 2015 and 2040. Research shows that the utility companies reduced their engineering staffs in the 1990s, and vital skills have gone away. Those engineers took jobs with contractors and consulting firms, moved to other industries, or retired. The disappearance of traditional energy–industry career paths has worsened a long-term US educational problem—the shift away from science and math by students and educators. Experts suggest that industry’s answers to job shortage challenges include persuading engineers of the older generation to work past normal retirement age and developing knowledge transfer initiatives for engineers entering the workforce.

Using Logic Analysis to Evaluate Knowledge Transfer Initiatives

Models that shift more responsibility onto researchers for the process of incorporating research results into decision-making have greatly gained in popularity during the past two decades. This shift has created a new area of research to identify the best ways to transfer academic results into the organizational and political arenas. However, evaluating the utilization of information coming out of a knowledge transfer (KT) initiative remains an enormous challenge. This article demonstrates how logic analysis has proven to be a useful evaluation method to assess the utilization potential of KT initiatives. We present the case of the evaluation of the Research Collective on the Organization of Primary Care Services, an innovative experiment in knowledge synthesis and transfer. The conclusions focus not only on the utilization potential of results coming out of the Research Collective, but also on the theoretical framework used, in order to facilitate its application to the evaluation of other knowledge transfer initiatives.

CT, MRI and ultrasound scanning rates: Evaluation of cancer diagnosis, staging and surveillance in ontario

To examine practice patterns and rates of computed tomography (CT), magnetic resonance imaging (MRI), and abdominal ultrasound (AUS) during staging, treatment and surveillance for cancer patients. Using Ontario Health Insurance Plan billing data linked to the Ontario Cancer Registry, we determined rates of CT, MRI, and AUS by body site for breast, colorectal, lung, lymphoma, and prostate cancer, from 1998 to 2002. Rates of scans were additionally examined by region of patient residence and time from cancer diagnosis. The frequency of imaging increased in nearly all scans and tumors over the study period. Rates of peri-diagnosis scans varied substantially by region, ranging from 1.7-fold variation (CT for lung cancer) to 50-fold variation (MRI for breast cancer). For breast cancer, there is possible over-utilization of CT, but overall rates of scanning appear reasonable for the other four cancers. Considerable regional variation in imaging rates suggests utilization guidelines should be developed or knowledge transfer initiatives are needed to improve compliance to existing guidelines. In breast cancer, there appears to be over-utilization of imaging. Further studies are necessary to determine utilization for each stage, the reason scans were obtained, and the impact of scans on patient outcomes.

Evaluating Interventions Aimed at Promoting Information Utilization in Organizations and Systems

This paper presents a theoretical and practical framework for evaluating interventions aimed at promoting information utilization in organizational decision-making. The framework integrates three distinct yet complementary theoretical perspectives on information utilization in politico-administrative systems: (1) the literature on evaluation utilization, (2) current thinking on knowledge transfer (KT) in the health policy field and (3) approaches derived from the analysis of lobbying in political science. Our analysis calls into question the relevance of effect analysis in evaluating organizational or policy-level KT initiatives, but also suggests dimensions that should be explored when evaluating KT initiatives. We conclude that there are probably trade-offs to be made between the effectiveness of KT and the scientific robustness and validity of the information transmitted.

Measuring ICT‐based agricultural knowledge transfer under a sender advantage asymmetric information structure

Knowledge transfer (KT) has received increasing attention in recent years. This is evident from many knowledge transfer initiatives and projects reported in the literature. However, how to measure the success of knowledge transfer projects still remains a challenge because knowledge transfer is a very complex process. This paper focuses on agricultural knowledge transfer facilitated by information and communication technologies (ICT). It attempts to develop a conceptual model for identifying the causal factors affecting the success of ICT‐based knowledge transfer. Drawing from relevant literature it also proposes a set of associated measures for each dimension in the model. The success model of ICT‐KT is based on a modification of a Delong & Mclean (2003) information system success model. Six dimensions in the model are developed, these being: knowledge quality; system quality; service quality (with sub‐dimensions of e‐service quality and extension quality); use; user satisfaction; and net benefits. Preliminary measures associated with each dimension are discussed and directions for future research are identified.

Knowledge Transfer Process Cycle: Between Factory Floor and Middle Management

Factory floor workers can add value to their firm from new knowledge they may discover whilst performing their daily tasks. The transfer of that knowledge to middle managers can improve process efficiencies, if they can utilise it. Researchers and practitioners perceive value in understanding a range of knowledge transfer strategies and initiatives, yet there is little empirical evidence on ground level knowledge discovery and bottom-up knowledge transfers in a manufacturing environment. Our results show that factory workers do not codify their knowledge and only articulate it personally. Thus firms must provide an environment that supports knowledge exchanges within the factory worker community and upwards to middle managers whom act as knowledge facilitators rather than knowledge creators between factory workers and upper management.

Knowledge transfer initiative between molecular biologists and environmental researchers and regulators

A Natural Environment Research Council (NERC) funded Knowledge Transfer (KT) workshop was held in the United Kingdom (UK) to identify the needs and opportunities in the application of molecular biology and 'omics' techniques to environmental monitoring and risk assessment. Attendees highlighted a lack of effective communication between end-users and researchers as well as difficulties with data interpretation as reasons behind the slow uptake of molecular biology and omics techniques. A number of promising areas in which new techniques could be implemented at a practical level in the very near future were identified, thereby raising the profile of these recent technologies and providing vital proof of concept work. Molecular taxonomy, bacterial source tracking and pre-screening of chemicals for potential toxicities were all viewed as areas in which omics and molecular techniques could have immediate value, with the aim of reducing cost, increasing efficiency and providing more comprehensive data of improved quality.

Do we have a knowledge transfer and translation plan at Teratogen Information Services?

Recently, a new field in science is emerging, which addresses the issue of ensuring that information that is generated from research, reaches the right people in the right format. This has been coined as knowledge transfer and translation and public health leaders worldwide are finding out ways to carry this out effectively. Ultimately, this should ensure greater investment in knowledge syntheses and transfer initiatives, that involve potential users of research to improve the quality of health for everyone. In this brief review/comment, an attempt will be made to help the readers understand the meaning of this new terminology and how it impacts Teratogen Information Services.

Managing Trade-offs and Tensions between Knowledge Management Initiatives and Expertise Development Practices

This article explores the trade-offs and tensions between knowledge management initiatives and expertise development practices. While studies of knowledge management and expertise development are abundant, there is no research that has addressed the inter-relationships between these two organizational practices. This article, therefore, addresses the following question: How does the introduction and implementation of a knowledge management initiative affect the development of engineer’s expertise within a firm? An in-depth case study of a company introducing new practices to promote knowledge transfer between projects in a fast-changing project environment is analysed. Based on the findings, we conclude that the introduced knowledge transfer initiative has upset the past harmony between expertise development and knowledge management practices.

Fostering evidence-based decision-making in Canada: examining the need for a Canadian population and public health evidence centre and research network.

In early 2002, the Canadian Institutes of Health Research, Institute of Population and Public Health (CIHR-IPPH), with the advice of a multi-agency working group, embarked on a review of the literature to examine the issues and barriers related to Canadian population and public health (PPH) knowledge generation, dissemination and exchange, and uptake. The literature review was complemented by interviews with more than 30 Canadian, American, and United Kingdom organizations that are active in PPH research, especially synthesis research. Research organizations were asked about the mechanisms they use to support PPH research generation, synthesis, transfer, and exchange, as well as their impressions of the need for new Canadian organizational structures to encourage a more integrated approach to these tasks, including challenges to be addressed. This research project complements and builds on previous work of the CIHR-IPPH* (in partnership with the Canadian Institute for Health Information, Canadian Population Health Initiative (CIHI-CPHI)), which consulted PPH researchers, practitioners, and policy-makers to identify research and knowledge transfer and exchange priorities in population and public health. During these consultation sessions, a number of challenges and opportunities were raised in relation to the synthesis, exchange and transfer of the knowledge acquired through research initiatives. Participants identified three priorities for action: 1) research on the factors contributing to effective knowledge transfer by policy-makers and practitioners; 2) effective ways of communicating PPH knowledge to key stakeholder groups and the public, including effective and innovative use of various media and accessible language for different audiences; and 3) greater investment in knowledge synthesis, diffusion and transfer initiatives, such as the development of highquality synthesis and meta-analysis on population and public health interventions. The current project was undertaken in response to these identified gaps in the existence of, access to, and uptake of easily usable, high-quality, practice-relevant PPH research evidence. Specifically, these investigations revealed a number of critical issues around the incorporation of PPH research evidence into policy and program planning: • Issues of the Evidence Base† – beyond a lack of primary research in the PPH field, there are issues of evidence synthesis: – identification of Canadian research and synthesis priorities, including more congruence between the needs of research users and the research questions that are investigated and evidence that is produced, – coordination and enhanced efficiency of a Canadian PPH research agenda,

Knowledge transfer and dissemination: insights from the dairy sector in the UK and India

‘Knowledge transfer’ and ‘uptake’ are high on the agenda of government departments and research institutes. In the U.K., the Department for Environment, Food and Rural Affairs (DEFRA) is concerned that new knowledge generated by publicly funded research is not being taken up by the industry and has funded a series of knowledge transfer initiatives. On the international front, the Department for International Development (DFID) is pressing managers of its various research programmes to demonstrate that the outputs of research are being used by farmers in developing countries and are having an impact on their livelihoods. International institutes are increasing the proportion of their resources devoted to technology transfer and dissemination programmes. These concerns and initiatives raise important conceptual, institutional and methodological issues.