Toronto • May 28-29, 2010 • Student Day and Workshops: May 27
Paper: Context, evidence and facilitation: Adapting a knowledge transfer framework from the health-care system to the construction sector
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Session : 7. Knowledge exchange in OHS
Day/Time: Friday at 15:15
Room: Ballroom, 2nd Floor
Objectives:
The PARiHS model (Promoting Action on Research Implementation in Heath Services) is a knowledge transfer conceptual framework initiated over a decade ago that focuses on the dissemination of guidelines within the health-care sector 1, 2. It says that the choice of KT implementation strategy should depend on the strength of the evidence, and the receptivity of the context. This study explores the possibility of adapting the framework to a Diffusion of Innovation study in the construction sector.
Methods:
This study is now in its fifth year. Our evidence is made up of innovative ideas, processes and tools to reduce the risk of MSDs. We have identified 125 potential innovations and assessed many of them. Ultimately the team identified, through negotiation and a shared understanding about the benefits and risks of the new ideas over the traditional ways of doing things, 16 companies that used 20 innovations 3. Secondly, we have studied the construction sector as our context. It is a unique environment that is different from both health care and manufacturing – the sectors that have the largest body of research on diffusion of innovations. We have conducted extensive interviews with key stakeholders in the sector to clarify the characteristics of this sector that may help determine the knowledge transfer strategies that we will adopt and the facilitation techniques that we should attempt.
Results:
The construction sector has a very male-dominated culture that seems to accept that hard work and pain is part of the job. The only dependable characteristic of this context is that it is in constant change – the environment, the materials, the tools, and the employment contracts. Supervisors and co-workers change between and within every project. It has a non-linear, non-hierarchical reporting structure and there is no clear top-down decision-making. This mitigates against traditional dissemination strategies such as supervisor-training, train-the-trainer, or continuing professional development. On the other hand, it is a very networked and linked sector, with multiple across-company, across-project, within union and trade communication channels.
Conclusions:
The three-pronged PARiHS model seems to be helpful in planning our KT interventions in construction. We have determined the evidence we plan to disseminate, and we have gained a good knowledge of the construction sector as our chosen context, we are still determining which facilitation techniques to adopt. What we have learned has told us we need to be very creative in our thinking when it comes to facilitating the knowledge transfer/implementation of innovative ideas in the construction sector, but suggests that using opinion leaders within the existing networks may be an effective way to facilitate the adoption of innovations.
References:
1. Kitson, A.L., Rycroft-Molone, J., Harvey, G., McCormack, B., Seers, K., and Titchen, A., 2008. Evaluating the successful implementation of evidence into practice using the PARiSH framework: theoretical and practical challenges. Implementation Science, 3:1
2. Kitson, A., Harvey, G., McCormack, B. 1998. Enabling the implementation of evidence-based practice: a conceptual framework. Quality in Health Care, 7(3), 49-158.
3. Desre M. Kramer, Philip Bigelow, Niki Carlan, Richard Wells, Enzo Garritano, Peter Vi, Marek Plawinski. (2009). Searching for a Needle in a Haystack: Identifying innovations to prevent MSDs in the construction sector. Applied Ergonomics. (In Press)
