Helpful article from INTEGRATION AND IMPLEMENTATION INSIGHTS for front line mental health workers trying to work in advancing… practices for the communities we serve. The authors put substance to the idea of thinking beyond the individual, ringing true of the breadth involved with care system change that aims for “the long term” instead of “quick changes.”
” move from a focus on separate dramatic events to a focus on the persistent, often almost continuous, pressures giving rise to the discrete events we see.”
Our mental health care system feels like a super tanker on the ocean that is trying to turn direction – but it needs a lot more than high level planners thinking of the long term. Anyone in eenetconnect world had any experience with the kind of approach Richardson and Anderson offer to help groups map out decisions to advance practice change?
The fields of systems thinking and system dynamics modelling bring four important patterns of thought to such a group decision and negotiation:
- thinking dynamically;
- thinking in stocks and flows;
- thinking in feedback loops; and,
- thinking endogenously.
See the article here: https://i2insights.org/2019/07…for-group-decisions/
I realize for system planners, my question about how people approach understanding systems may be a basic question, I am curious how from a front line practice perspective, as a cog in the system workers are:
- engaging in framing systems in their minds
- acting and interacting with planners on long term system change
- bridging our everyday care within a system model
An example — gaps, unmet needs, planned actions, goals are embedded in our organizations and systems focus of care to advance the recovery model . The Ontario Common Assessment of Need (OCAN) is framed as a key activity with individuals (clients) and posited by our care system to advance system change and measure performance. http://eenet.ca/tags/ocan
Karin Ingold’s post explains the role of scientific knowledge brokering in coalitions in Integration and Implementation Insights https://i2insights.org/ In Ottawa, we have had various examples of this, be it the Alliance to End Homelessness or harm reduction networks. I find it useful to reflect on Ingold’s point that suggests that the loss of neutrality in Adversarial advocacy results in, ” no possibility for knowledge brokerage exists.” and need to become “non neutral actors.”
What roles can science and scientific experts adopt in policymaking? One way of examining this is through the Advocacy Coalition Framework (Sabatier and Jenkins-Smith 1993). This framework highlights that policymaking and the negotiations regarding a political issue—such as reform of the health system, or the introduction of an energy tax on fossil fuels—is dominated by advocacy coalitions in opposition. Advocacy coalitions are groups of actors sharing the same opinion about how a policy should be designed and implemented. Each coalition has its own beliefs and ideologies and each wants to see its preferences translated into policies.
There are many challenges in delivering and evaluating knowledge for healthcare, but the lack of clear routes from knowledge to practice is a root cause of failures in safety within healthcare. Various types and sources of knowledge are relevant at different levels within the healthcare system. These need to be delivered in a timely way that is useful and actionable for those providing services or developing policies. How knowledge is taken up and used through networks and relationships, and the difficulties in attributing change to knowledge-based interventions, present challenges to understanding how knowledge into action (K2A) work influences healthcare outcomes. …
See the article here: https://link.springer.com/article/10.1186/s12913-018-2930-3
Health Evidence www.healthevidence.org shares tools that guide practice evidence, developed in collaboration with local public health organizations. While targeted at public health some of the tools provide useful approaches for emerging front line projects.
Looking for tools to help you find and use research evidence? Use the Health Evidence™ practice tools to help you work through the evidence-informed decision making process; search for evidence, track your search, and share lessons learned with your public health organization.
Example of tools:
- Evidence-Informed Decision Making (EIDM) Checklist
- Developing an Efficient Search Strategy Using PICO
- Levels & Sources of Public Health Evidence
- Resources to Guide & Track Your Search
- Keeping Track of Search Results: A Flowchart
- Briefing Note: Decisions, Rationale and Key Findings Summary
- Improving Future Decisions: Optimizing the Decision Process from Lessons Learned
See the current tools at their site here: http://www.healthevidence.org/practice-tools.aspx
From the journal of Implementation Science, https://implementationscience.biomedcentral.com/articles/10.1186/s13012-017-0607-7
…In this paper, we propose the use of architectural frameworks to develop LHSs that adhere to a recognized vision while being adapted to their specific organizational context. Architectural frameworks are high-level descriptions of an organization as a system; they capture the structure of its main components at varied levels, the interrelationships among these components, and the principles that guide their evolution.
This paper shared as one of the resources was found by Vicky Ward https://kmbresearcher.wordpress.com/, who was at the Canadian Knowledge Mobilization Forum, http://www.knowledgemobilization.net/event/2017-canadian-knowledge-mobilization-forum/
PUT SIMPLY: According to an intersectionality perspective, inequities are never the result of single, distinct factors. Rather, they are the outcome of intersections of different social locations, power relations and experiences.
paper by Olena Hankivsky, PhD of https://www.sfu.ca/iirp/
see the paper here: https://www.sfu.ca/iirp/documents/resources/101_Final.pdf