Abstract
There is a significant gap between what is known and what is implemented by key stakeholders in practice (the evidence to practice gap). The primary purpose of knowledge translation is to address this gap, bridging evidence to clinical practice. The knowledge to action cycle is one framework for knowledge translation that integrates policy makers throughout the research cycle. The knowledge to action cycle begins with the identification of a problem (usually a gap in care provision). After identification of the problem, knowledge creation is undertaken, depicted at the center of the cycle as a funnel. Knowledge inquiry is at the wide end of the funnel, and moving down the funnel, the primary data is synthesized into knowledge products in the form of educational materials, guidelines, decision aids, or clinical pathways. The remaining components of the knowledge to action cycle refer to the action of applying the knowledge that has been created. This includes adapting knowledge to local context, assessing barriers to knowledge use, selecting, tailoring implementing interventions, monitoring knowledge use, evaluating outcomes, and sustaining knowledge use. Each of these steps is connected by bidirectional arrows and ideally involves health-care decision makers and key stakeholders at each transition.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Straus S, Tetroe J, Graham I (2010) Knowledge translation in health care: moving from evidence to practice. Wiley-Blackwell, Chichester
Graham ID, Logan J, Harrison MB, Strauss SE, Tetroe J, Caswell W, Robinson N (2006) Lost in knowledge translation: time for a map? J Contin Educ Heal Prof 26:13–24
Canadian Institutes of Health Research (2014) More about knowledge translation. http://cihr-irsc.gc.ca/e/39033.html#Definition
Baker R, Camosso-Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S, Robertson N (2010) Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 3:CD005470
Improvement IfH (2003) The breakthrough series: IHI’s collaborative model for achieving breakthrough improvement. http://www.ihi.org/knowledge/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchievingBreakthroughImprovement.aspx. Accessed 5 Aug 2012
Sood MM, Manns B, Nesrallah G (2014) Using the knowledge-to-action framework to guide the timing of dialysis initiation. Curr Opin Nephrol Hypertens 23:321–327
National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis 39:S1–S266
Rosansky S, Clark WF, Eggers P, Glassock R (2009) Initiation of dialysis at higher GFRs: is the apparent rising ride of early dialysis harmful or helpful? Kidney Int 76:257–261
Manns B, Barrett B, Evan M et al (2014) Establishing a national knowledge translation and generation network in kidney disease: the CAnadian KidNey KNowledge TraNslation and GEneration NeTwork. Can J Kid Health Dis 1:2. https://doi.org/10.1186/2054-3581-1181-1182
Kinsman L, Rotter T, James E, Snow P, Willis J (2010) What is a clinical pathway? Development of a definition to inform the debate. BMC Med 8:31
Rotter T, Kinsman L, James E et al (2010) Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs. Cochrane Database Syst Rev (3):CD006632
Whittle C, Hewison A (2007) Integrated care pathways: pathways to change in health care? J Health Organ Manag 21:297–306
Scott S, Grimshaw J, Klassen T, Nettel-Aguirre A, Johnson D (2011) Understanding implementation processes of clinical pathways and clinical practice guidelines in pediatric contexts: a study protocol. Implement Sci 6:133
Allen D, Gillen E, RIxson L (2009) Systematic review of the effectiveness of integrated care pathways: what works, for whom, in which circumstances? Int J Evid Based Healthc 7:61–74
Sulch D, Perez I, Melbourn A, Kalra L (2008) Evaluation of an integrated care pathway for stroke unit rehabilitation. Age Ageing 29:87
Cunningham S, Logan C, Lockerbie L, Dunn M, McMurray A, Prescott R (2008) Effect of an integrated care pathway on acute asthma/wheeze in children attending hospital: cluster randomized trial. J Pediatr 152:315–320
Manns B, Braun T, Edwards A et al (2013) Identifying strategies to improve diabetes care in Alberta, Canada, using the knowledge-to-action cycle. Can Med Assoc J Open 1(4):E142–E150
Fervers B, Burgers JS, Haugh MC et al (2006) Adaptation of clinical guidelines: a review of methods and experiences. Int J Health Care 18:167–176
ADAPTE Collaboration (2009) Guideline adaption: a resource toolkit. https://g-i-n.net/document-store/working-groups-documents/adaptation/adapte-resource-toolkit-guideline-adaptation-2-0
Grol R, Grimshaw J (2003) From best evidence to best practice: effective implementation of change in patients’ care. Lancet 362:1225–1230
Forsetlund L, Bjørndal A, Rashidian A et al (2009) Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database Syst Rev (2):CD003030
Flodgren G, Parmelli E, Doumit G et al (2007) Local opinion leaders: effects on professional practice and health care outcomes. Cochrane Database Syst Rev (1):CD000125
Stacey D, Légaré F, Lewis K et al (2017) Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev (4):CD001431
Kawamoto K, Houlihan CA, Balas EA, Lobach DF (2005) Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. Br Med J 330:765–768E
Ivers N, Jamtvedt G, Flottorp S et al (2012) Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev (6):CD000259
Brimble KS, Rabbat CG, McKenna P, Lambert K, Carlisle EJ (2003) Protocolized anemia management with erythropoietin in hemodialysis patients: a randomized controlled trial. J Am Soc Nephrol 14:2654–2661
To LL, Stoner CP, Stolley SN, Buenviaje JD, Ziegler TW (2001) Effectiveness of a pharmacist-implemented anemia management protocol in an outpatient hemodialysis unit. Am J Health Syst Pharm 58:2061–2065
Tricco AC, Ivers NM, Grimshaw JM et al (2012) Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis. Lancet 379:2252–2261
Clark WF, Na YB, Rosansky SJ et al (2011) Association between estimated glomerular filtration rate at initiation of dialysis and mortality. Can Med Assoc J 183:47–53
Cooper BA, Branley P, Bulfone L et al (2010) A randomized, controlled trial of early versus late initiation of dialysis. N Engl J Med 363:609–619
Lee H, Manns B, Taub K et al (2002) Cost analysis of ongoing care of patients with end-stage renal disease: the impact of dialysis modality and dialysis access. Am J Kid Dis 40:611–622
Nesrallah GE, Mustafa RA, Clark WF et al (2014) Canadian Society of Nephrology 2012 Clinical Practice Guidelines for timing the initiation of chronic dialysis. Can Med Assoc J 186:112–117
Grading Recommendations Assessment DaEGWG (2012) GRADE Working Group. http://www.gradeworkinggroup.org/
Harris A, Cooper BA, Li JJ et al (2011) Cost-effectiveness of initiating dialysis early: a randomized controlled trial. Am J Kid Dis 57(5):707–715
Mann B, Manns B, Dart A et al (2014) An assessment of dialysis provider’s attitudes towards timing of dialysis initiation in Canada. Can J Kid Health Dis 1:3
Chau EM, Manns BJ, Garg AX et al (2016) Knowledge translation interventions to improve the timing of dialysis initiation: protocol for a cluster randomized trial. Can J Kid Health Dis 3:2054358116665257
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Science+Business Media, LLC, part of Springer Nature
About this protocol
Cite this protocol
Manns, B.J. (2021). Evidence-Based Decision Making 5: Knowledge Translation and the Knowledge to Action Cycle. In: Parfrey, P.S., Barrett, B.J. (eds) Clinical Epidemiology. Methods in Molecular Biology, vol 2249. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-1138-8_25
Download citation
DOI: https://doi.org/10.1007/978-1-0716-1138-8_25
Published:
Publisher Name: Humana, New York, NY
Print ISBN: 978-1-0716-1137-1
Online ISBN: 978-1-0716-1138-8
eBook Packages: Springer Protocols