Volume 17, Issue 2 (4-2020)                   J Res Dev Nurs Midw 2020, 17(2): 36-41 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Roohi G, Mahmoodi G, Khoddam H. Barriers and Strategies for Implementing Knowledge in to Health System Management: A Qualitative Study. J Res Dev Nurs Midw. 2020; 17 (2) :36-41
URL: http://nmj.goums.ac.ir/article-1-1151-en.html
1- Department of Health Services Management, Sari Branch, Islamic Azad University, Sari, Iran
2- Hospital Administration Research Center, Sari branch, Islamic Azad University, Sari, Iran , ghahraman.mahmoodi@gmail.com
3- Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Iran
Abstract:   (376 Views)
Background: The gap between knowledge and practice is a global issue that reduces service quality by creating barriers to knowledge implementation, and thus strategies should be developed to resolve it. The present study aimed to explain barriers and strategies for implementing knowledge implementation into Iranian health system management.
Methods: This qualitative study was conducted on 53 managers and health management graduates in 2018. Participants were recruited through purposive sampling in Medical Sciences Universities in Iran. Data were collected by semi-structured interviews based on the "Promoting Action on Research Implementation (PARiHS)" framework, focus group discussions and Delphi technique. The PARiHS framework has three main elements including; evidence, context and facilitation. The Lincoln and Guba criterion was used to assess the rigor of the study. Data were analyzed in MAXQDA software version 10 using directional content analysis.
Results: After data analysis 9 subcategories and 3 main categories including; evidence, context, and facilitation were emerged. In addition to three subcategories including, culture, leadership and evaluation, the socio-political subcategory was a context for knowledge implementation main barrier in the organizational context. The systematic structural planning for the combined use of four sources of knowledge is the most important strategy.
Conclusion: The lack of context readiness in using knowledge and lack of efficient system impeded knowledge implementation in the health system management. Therefore, managers and policy makers need to design a comprehensive system based on current knowledge and successful experiences.               
Full-Text [PDF 708 kb]   (123 Downloads) |   |   Full-Text (HTML)  (38 Views)  

1. Sharifi A, Jalali R, Shahbazi N. Evaluation of awareness on the patient bill of rights and observing rate on the patient's perspective in Imam Reza Hospital in Kermanshah in 2012. Iranian Journal of Medical Law. 2013;6(23):125-35. [View at paplisher] [Google Scholar]
2. Bennett S, Whitehead M, Eames S, Fleming J, Low S, Caldwell E. Building capacity for knowledge translation in occupational therapy: learning through participatory action research. Bmc Medical Education. 2016;16(1):257. [View at paplisher] [DOI:10.1186/s12909-016-0771-5] [Google Scholar]
3. Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE. Knowledge translation of research findings. Implementation Science. 2012;7(1):50 [View at paplisher] [DOI:10.1186/1748-5908-7-50] [Google Scholar]
4. Rocha ESB, Nagliate P, Furlan CEB, Rocha Jr K, Trevizan MA, Mendes IAC. Knowledge management in health: a systematic literature review. Revista Latino-Americana De Enfermagem. 2012;20(2):392-400 [View at paplisher] [DOI:10.1590/S0104-11692012000200024] [Google Scholar]
5. Ellen ME, Lavis JN, Horowitz E, Berglas R. How is the use of research evidence in health policy perceived? A comparison between the reporting of researchers and policy-makers. Health Research Policy And Systems. 2018;16(1):64. [View at paplisher] [DOI:10.1186/s12961-018-0345-6] [Google Scholar]
6. Austin SB. Accelerating progress in eating disorders prevention: A call for policy translation research and training. Eating Disorders. 2016;24(1):6-19. [View at paplisher] [DOI:10.1080/10640266.2015.1034056] [Google Scholar]
7. Litvaj I, Stancekova D. Decision-making, and their relation to the knowledge management, use of knowledge management in decision-making. Procedia Economics And Finance. 2015;23:467-72. [View at paplisher] [DOI:10.1016/S2212-5671(15)00547-X] [Google Scholar]
8. Uzochukwu B, Onwujekwe O, Mbachu C, Okwuosa C, Etiaba E, Nyström ME, et al. The challenge of bridging the gap between researchers and policy makers: experiences of a Health Policy Research Group in engaging policy makers to support evidence informed policy making in Nigeria. Globalization And Health. 2016;12(1):67. [View at paplisher] [DOI:10.1186/s12992-016-0209-1] [Google Scholar]
9. Banja JD, Eisen A. Ethical perspectives on knowledge translation in rehabilitation. Archives Of Physical Medicine And Rehabilitation. 2013;94(1):S55-S60. [View at paplisher] [DOI:10.1016/j.apmr.2012.08.218] [Google Scholar]
10. Yousefi‐Nooraie R, Rashidian A, Nedjat S, Majdzadeh R, Mortaz‐Hedjri S, Etemadi A, et al. Promoting development and use of systematic reviews in a developing country. Journal Of Evaluation In Clinical Practice. 2009;15(6):1029-34. [View at paplisher] [DOI:10.1111/j.1365-2753.2009.01184.x] [Google Scholar]
11. Rosenbaum SE, Glenton C, Wiysonge CS, Abalos E, Mignini L, Young T, et al. Evidence summaries tailored to health policy-makers in low-and middle-income countries. Bulletin Of The World Health Organization. 2011;89:54-61. [View at paplisher] [DOI:10.2471/BLT.10.075481] [Google Scholar]
12. Graham ID, Kothari A, McCutcheon C. Moving knowledge into action for more effective practice, programmes and policy: protocol for a research programme on integrated knowledge translation. Implementation Science. 2018;13(1):22. [View at paplisher] [DOI:10.1186/s13012-017-0700-y] [Google Scholar]
13. Ellen ME, Panisset U, de Carvalho IA, Goodwin J, Beard J. A knowledge translation framework on ageing and health. Health Policy. 2017;121(3):282-91. [View at paplisher] [DOI:10.1016/j.healthpol.2016.12.009] [Google Scholar]
14. Visram S, Goodall D, Steven A. Exploring conceptualizations of knowledge translation, transfer and exchange across public health in one UK region: a qualitative mapping study. Public Health. 2014;128(6):497-503. [View at paplisher] [DOI:10.1016/j.puhe.2014.02.001] [Google Scholar]
15. Ward V, House A, Hamer S. Developing a framework for transferring knowledge into action: a thematic analysis of the literature. Journal Of Health Services Research & Policy. 2009;14(3):156-64. [View at paplisher] [DOI:10.1258/jhsrp.2009.008120] [Google Scholar]
16. Harvey G, Kitson A. PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice. Implementation Science. 2015;11(1):33. [View at paplisher] [DOI:10.1186/s13012-016-0398-2] [Google Scholar]
17. Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005;15(9):1277-88. [View at paplisher] [DOI:10.1177/1049732305276687] [Google Scholar]
18. Wildemuth BM. Applications of Social Research Methods to Questions in Information and Library Science. USA: Libraries Unlimited; 2016. 421 p. [View at paplisher] [Google Scholar]
19. Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. Qualitative content analysis: A focus on trustworthiness. SAGE Open. 2014;4(1):2158244014522633. [View at paplisher] [DOI:10.1177/2158244014522633] [Google Scholar]
20. Majdzadeh R, Sadighi J, Nejat S, Mahani AS, Gholami J. Knowledge translation for research utilization: design of a knowledge translation model at Tehran University of Medical Sciences. Journal of Continuing Education in the Health Professions. 2008;28(4):270-7. [View at paplisher] [DOI:10.1002/chp.193] [Google Scholar]
21. Norton TC, Rodriguez DC, Willems S. Applying the Theoretical Domains Framework to understand knowledge broker decisions in selecting evidence for knowledge translation in low-and middle-income countries. Health Research Policy And Systems. 2019;17(1):60. [View at paplisher] [DOI:10.1186/s12961-019-0463-9] [Google Scholar]
22. Atkins L, Francis J, Islam R, O'Connor D, Patey A, Ivers N, et al. A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implementation Science. 2017;12(1):77. [View at paplisher] [DOI:10.1186/s13012-017-0605-9] [Google Scholar]
23. Sharifkazemi K, Seyedin S, Jafari M. Dimensions of knowledge management in Health Network of Abyek city in 2015. Journal of Health Administration. 2016;19(64). [View at paplisher] [Google Scholar]
24. Jessani N, Kennedy C, Bennett S. The human capital of knowledge brokers: an analysis of attributes, capacities and skills of academic teaching and research faculty at Kenyan schools of public health. Health Research Policy And Systems. 2016;14(1):58. [View at paplisher] [DOI:10.1186/s12961-016-0133-0] [Google Scholar]
25. McGinty EE, Siddiqi S, Linden S, Horwitz J, Frattaroli S. Improving the use of evidence in public health policy development, enactment and implementation: a multiple-case study. Health Education Research. 2019;34(2):129-44. [View at paplisher] [DOI:10.1093/her/cyy050] [Google Scholar]
26. Gholami J, Ahghari S, Motevalian A, Yousefinejad V, Moradi G, Keshtkar A, et al. Knowledge translation in Iranian universities: need for serious interventions. Health Research Policy And Systems. 2013;11(1):43. [View at paplisher] [DOI:10.1186/1478-4505-11-43] [Google Scholar]
27. Laycock A, Harvey G, Percival N, Cunningham F, Bailie J, Matthews V, et al. Application of the i-PARIHS framework for enhancing understanding of interactive dissemination to achieve wide-scale improvement in Indigenous primary healthcare. Health Research Policy And Systems. 2018;16(1):117. [View at paplisher] [DOI:10.1186/s12961-018-0392-z] [Google Scholar]
28. Kernohan WG, Brown MJ, Payne C, Guerin S. Barriers and facilitators to knowledge transfer and exchange in palliative care research. BMJ Evidence-Based Medicine. 2018;23(4):131-6. [View at paplisher] [DOI:10.1136/bmjebm-2017-110865] [Google Scholar]
29. Ritchie LMP, Debebe F, Azazh A. Barriers to and facilitators of the development and utilization of context appropriate evidence based clinical algorithms to optimize clinical care and patient outcomes in the Tikur Anbessa emergency department: a multi-component qualitative study. BMC Health Services Research. 2019;19(1):181. [View at paplisher] [DOI:10.1186/s12913-019-4008-2] [Google Scholar]
30. Rumyantseva M, Gurgul G, Enkel E, Back A, Wirtschaftswissenschaftlerin SG. Knowledge integration after mergers & acquisitions: Institute of Management, University of St. Gallen (HSG); 2002. [View at paplisher] [Google Scholar]
31. Uneke CJ, Ezeoha AE, Uro-Chukwu H, Ezeonu CT, Ogbu O, Onwe F, et al. Promoting evidence to policy link on the control of infectious diseases of poverty in Nigeria: outcome of a multi-stakeholders policy dialogue. Health Promotion Perspectives. 2015;5(2):104. [View at paplisher] [DOI:10.15171/hpp.2015.013] [Google Scholar]
32. Mitton C, Adair CE, McKenzie E, Patten SB, Perry BW. Knowledge transfer and exchange: review and synthesis of the literature. The Milbank Quarterly. 2007;85(4):729-68. [View at paplisher] [DOI:10.1111/j.1468-0009.2007.00506.x] [Google Scholar]
33. Landeta J. Current validity of the Delphi method in social sciences. Technological Forecasting And Social Change. 2006;73(5):467-82 [View at paplisher] [DOI:10.1016/j.techfore.2005.09.002] [Google Scholar]
34. Ilesanmi R.E, Gillespie B.M, Adejumo, P.O, Chaboyer W. Tailoring International Pressure Ulcer Prevention Guidelines for Nigeria: A Knowledge Translation Study Protocol. Healthcare. 2015; 3: 619-629. [View at paplisher] [DOI:10.3390/healthcare3030619] [Google Scholar]
35. Rycroft-Malone J. The PARIHS framework-a framework for guiding the implementation of evidence-based practice. Journal Of Nursing Care Quality. 2004;19(4):297-304. [View at paplisher] [DOI:10.1097/00001786-200410000-00002] [Google Scholar]
36. Kreindler SA. Advancing the evaluation of integrated knowledge translation. Health Research Policy And Systems. 2018;16(1):104. [View at paplisher] [DOI:10.1186/s12961-018-0383-0] [Google Scholar]
37. Gervais M-J, Marion C, Dagenais C, Chiocchio F, Houlfort N. Dealing with the complexity of evaluating knowledge transfer strategies: Guiding principles for developing valid instruments. Research Evaluation. 2015;25(1):62-9. [View at paplisher] [DOI:10.1093/reseval/rvv034] [Google Scholar]
38. Uneke CJ, Sombie I, Keita N, Lokossou V, Johnson E, Ongolo-Zogo P. Improving maternal and child health policymaking processes in Nigeria: an assessment of policymakers' needs, barriers and facilitators of evidence-informed policymaking. Health Research Policy And Systems. 2017;15(1):48. [View at paplisher] [DOI:10.1186/s12961-017-0217-5] [Google Scholar]

Add your comments about this article : Your username or Email:

Send email to the article author

© 2021 All Rights Reserved | Journal of Research Development in Nursing and Midwifery

Designed & Developed by : Yektaweb