Implementation Strategies

Last modified by Lisa Stromquist on 2017/09/15 15:55

Welcome to the toolkit about implementing best practice resources in a healthcare setting. This toolbox can be used to find theories, frameworks, strategies and practical tools from the knowledge translation (KT) literature to move the acute pain assessment recommendations into practice.


KT is about “bringing the right information, in the right format, to the right people, at the right time to influence decision making” (Ontario Neurotrauma Foundation, 2003.  Retrieved from: . Like other areas of study, KT has a body of research evidence that helps to support and guide how an individual, committee, organization or healthcare system can plan for the use of best evidence in practice. 


In this kit you’ll find:

  • Casebooks that detail how to do integrated and end of grant KT with tangible examples
  • Knowledge Translation Frameworks including  articles outlining the literature to support different theories, frameworks and strategies to move evidence into practice.
  • KT Planning Tools such as toolkits and planning templates to help you develop and execute a plan for moving one or more of the acute pain recommendations into practice, monitor its use and sustain its use over time
  • Websites to help you learn more about KT, connect you to resources and/or KT practitioners
  • If KT has piqued your interest, we have included a list of KT courses  that you can take to further your learning 

If you have any comments, questions or additions for the box, please contact CAPHC at 

Thank you for supporting the CAPHC Pain Community of Practice’s mission to improve health outcomes for infants and children by reducing pain experienced during medical procedures, healthcare interventions and chronic conditions, disease or disability. 

Thank you to Evidence to Care, the Knowledge Translation team at Holland Bloorview Kids Rehabilitation Hospital for providing this comprehensive list of resources. 

 Casebooks  A Knowledge Translation Casebook on Improving Pediatric Pain Practices Widger, K., Stevens, B., & Barwick, M. (Eds.) (2013). Stories from the Floor: A Knowledge Translation Casebook on Improving Pediatric Pain Practices. Toronto, ON: CIHR Team in Children’s Pain. 
 In this publication, you will learn about some very diverse and interesting KT initiatives. They run the gamut from working to make Canadian children safer by banning baby walkers (Case study 6) to ensuring that a Saturday night out at the bar is less likely to be a violent occasion (Case study 8), to helping some of the world’s poorest children receive the nutrients they need to grow and thrive (Case study 3). This series of KT cases provides valuable insights into the real world of researchers and knowledge users as they do knowledge translation.  Canadian Institutes of Health Research (CIHR).  (2008). Knowledge to action: A knowledge translation casebook.  Retrieved from
  The compilation of case studies found in this publication concerns itself with the second and equally important category of knowledge translation, end-of-grant KT. End-of-grant KT refers to the dissemination of findings generated from research once a project is completed, depending on the extent to which there are mature findings appropriate for dissemination. Researchers who undertake traditional dissemination activities such as publishing in peer-reviewed journals and presenting their research at conferences and workshops are engaging in end-of-grant knowledge translation. Canadian Institutes of Health Research (CIHR).  (2010). Knowledge to action: An end of grant knowledge translation casebook.  Retrieved from
Knowledge Translation Frameworks  
Knowledge to Action Cycle Guiding framework to define and describe KT, and outline strategies for enhancing KT capacity and facilitating the implementation of KT activities.Graham, I.D., Logan, J., Harrison, M.B., Straus, S.E., Tetroe, J., Caswell, W., & Robinson, N. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26(1), 13-24. 
Promoting Action on Research Implementation in Health Services (PARIHS) FrameworkThe PARiHS (Promoting Action on Research Implementation in Health Services) framework provides a way to implement research into practice. With case studies of teams implementing evidence, it examines the interactions between three key elements for knowledge translation. Three factors determine research use:• Evidence (E)• Context (C)• Facilitation (F)Significantly, this framework argues that successful implementation (SI) of evidence into practice had as much to do with the context or setting where the new evidence was being introduced and how that new evidence was introduced (facilitated into practice) as it had to do with the quality of the evidence. Kitson, A. L., Rycroft-Malone, J., Harvey, G., McCormack, B., Seers, K., & Titchen, A. (2008). Evaluating the successful implementation of evidence into practice using the PARiHS framework: Theoretical and practical challenges. Implementation Science, 3(1), 1-12.
Producer Push – User Pull – Exchange Framework  • Framework to help plan your KT activities, taking into consideration: • Push: o producers of knowledge plan and implement approaches to push (disseminate) knowledge toward audiences who they believe need to receive it• Pull: o knowledge users plan and implement strategies to pull knowledge from sources they identify as producing knowledge that is useful to their decision making Lavis, J. (2006). Research, public policymaking, and knowledge-translation processes: Canadian efforts to build bridges. The Journal of Continuing Education in the Health Professions, 26(1), 37-45.
KT Planning Resources/Toolkits
Knowledge Translation Planning (broad)Use to help guide knowledge translation planning from start to finishBarwick, M. (2013). Knowledge translation planning template. Ontario: The Hospital for Sick Children. Retrieved from 
 This Toolkit is offered primarily to researchers on issues related to LMICs and takes its inspirations from the field of health systems research. readers will come away with new ideas and methods to get started right now, along with thoughts about whom else to include, how to learn more, and renewed commitment and confidence to try something challenging, new, and important.Bennett, G., & Jessani, N. (Eds.). (2011). The knowledge translation toolkit - Bridging the know-do gap: A resource for researchers.  New Delhi: SAGE; Ottawa: International Development Research Centre. Retrieved from
  Our Knowledge Mobilization toolkit: Doing more with what you know will help you mobilize valuable knowledge and information in your community. It’s designed to inform and equip you with the knowledge and tools you need to mobilize knowledge, and ultimately improve outcomes for children, youth and families. You’ll also find inspiring stories from the field.Ontario Centre of Excellence for Child and Youth Mental Health. (2014). Knowledge mobilization toolkit.  Retrieved from 
  This guide teaches the nuts and bolts of knowledge transfer by taking the user through a set of practical thinking exercises.Reardon, R., Lavis, J., & Gibson, J. (2006).  From research to practice: A knowledge transfer planning guide.  Toronto, ON: Institute for Work & Health. Retrieved from 
 This guide has been developed to support knowledge translation components of the health research grant application and funding process. The purpose of this guide is to:1. Provide peer reviewers of health research grants with the conceptual tools they need to conduct fair assessments of the knowledge translation components of these grants.2. Provide grant applicants with information about how the knowledge translation components of their grant applications will be assessed  Ross, S., Goering, P., J acobson, N., & Butterill, D. (2007).  A guide for assessing health research knowledge translation (KT) plans: Towards more effective peer review of knowledge translation plans in research grant proposals.  Retrieved from
Implementation The I2I is a practical, step-by-step guide to achieving successful KT. It highlights the importance of bringing a wide range of participants to the table, respecting both diversity and uniqueness, where knowledge is jointly identified, created or applied. It also stresses the importance of incorporating various knowledge perspectives. Bilsker, D., Petermann, L., & Goldner, E. M. (2012). Innovation to implementation: A practical guide to knowledge translation in health care.  Calgary, AB: Mental Health Commission of Canada.  Retrieved from 
  This Toolkit was designed to assist health care settings in maximizing the potential of Best Practice Guidelines, through systematic and well-planned implementation.Registered Nurses’ Association of Ontario. (2012). Toolkit: Implementation of best practice guidelines (2nd ed.). Toronto, ON: Registered Nurses’ Association of Ontario. Retrieved from
  The workbook follows a revised framework called the ‘health systems guidance contextualization framework’, which addresses: 1) selecting the topic, identifying the venue for decision making, and clarifying the problem and its causes; 2) framing  options for addressing the problem; 3) identifying implementation considerations; 4) considering the broader health system context; 5) considering the broader political system context; 6) refining the statement of the problem, options and implementation considerations in light of health system and political system factors; 7) anticipating monitoring and evaluation needs; and lastly, 8) making national or subnational policy recommendations or decisions and developing advocacy and dissemination strategies Alvarez E, Lavis J. Implementing health systems guidance: A workbook to support the contextualization of recommendations at the national or subnational level. Hamilton, Canada: McMaster Health Forum, April 2016. Retreived from:
Sustainability In an attempt to substantially increase the sustainability of improvements for healthcare services and patients, a NHS Sustainability Model and Guide have been developed for use by individuals and teams who are involved in local improvement initiatives. The sustainability model can be used to predict the likelihood of sustainability and guide teams to things they could do to increase the chances that the change for improvement will be sustained. The guide provides practical advice on how you might identify opportunities to increase the likelihood of sustainability for your improvement initiative. National Health Service Institute for Innovation and Improvement. (2010). Sustainability Model and Guide. Retrieved from: 
EvaluationThis toolkit contains resources for planning, doing and using program evaluation. These worksheets can assist your team in focusing on what is important and feasible as you begin to formulate and implement your evaluation project. Ontario Centre for Excellence for Child and Youth Mental Health. (2013). Program evaluation toolkit — Tools for planning, doing and using evaluation. Retrieved from:
  The toolbox aims to provide a one-stop-site for the evaluation of community sustainability engagement projects that aim to change household behaviours.The toolbox brings together a number of best-practice evaluation methods packaged into a comprehensive, user-friendly, how-to format. The information contained in this resource covers:• What is evaluation?• How to plan a monitoring and evaluation system?• Evaluation tools and techniques• How to present evaluation results? Pacific Research and Evaluation Associates . (2010). Community Sustainability Engagement Evaluation Toolbox .  Retrieved from:
 The tools cited in this resource could be used to evaluate knowledge translation activities in a public health setting. For example, instruments could be used to measure changes in practitioners' work and capacity to use research evidence in their practice National Collaborating Centre for Methods and Tools (2012). Evaluating knowledge translation interventions: A systematic review. Hamilton, ON: McMaster University. (Updated 25 January, 2012) Retrieved from:
Effectiveness of ToolkitsThe aim of this systematic review was to evaluate the effectiveness of toolkits as a knowledge translation (KT) strategy for facilitating the implementation of evidence into clinical care. Toolkits include multiple resources for educating and/or facilitating behaviour change. Yamada. J., Shorkey, A., Barwick M., Widger, K., & Stevens, B. J., (2015). The effectiveness of toolkits as knowledge translation strategies for integrating evidence into clinical care: a systematic review. BMJ Open, 5, e006808. doi:10.1136/bmjopen-2014-006808
Effectiveness of printed educational materials   Printed educational materials (PEMs) are commonly used simple interventions that can be used alone or with other interventions to disseminate clinical evidence. They have been shown to have a small effect on health professional behaviour. However, we do not know whether they are effective in primary care. We investigated whether PEMs improve primary care physician (PCP) knowledge, behaviour, and patient outcomes. Grudniewicz, A., Kealy, R., Rodseth, R. N., Hamid, J., Rudoler, D., & Straus, S. E. (2015). What is the effectiveness of printed educational materials on primary care physician knowledge, behaviour, and patient outcomes: a systematic review and meta-analyses. Implementation Science, 10, 164. DOI 10.1186/s13012-015-0347-5. 
 Creating Lay Summaries Lay summaries are short accounts of research that are targeted at a general audience. They play a significant role in most research grant applications and can also be useful in supporting wider public engagement with research. This guide will help you to understand what lay summaries are, how they are used and why they are important. It describes some general guidelines for writing lay summaries and explores some issues and challenges with lay summary provision. Duke, M. (2012). ‘How to Write a Lay Summary’. DCC How-to Guides. Edinburgh: Digital Curation Centre. Available online: .
Creating Data VisualizationData visualisation is the presentation of data or information in a graphical format. It is a way of visually communicating information – often quantitative in nature – in an accurate and compelling format. Data visualisations, ranging from simple line charts to elaborate interactive maps, have become an increasingly popular approach used by researchers to communicate complex information and reach audiences outside the research community. Effective visualisations can communicate large amounts of information clearly, and have the potential to alter perceptions, influence people and bring about change.  Wolfe, R. (2014). DATA VISUALISATION: A practical guide to producing effective visualisations for research communication. Retrieved from: 
 Knowledge brokering  Knowledge brokering is a strategy to support collaborations and partnerships within and across clinical, research, and policy worlds to improve the generation and use of research knowledge. Knowledge brokers function in multiple roles to facilitate the use of evidence by leveraging the power of these partnerships. The objectives of this special interest article are (1) to describe the context for knowledge brokering in health care, (2) to provide an overview of knowledge translation theories applied to knowledge brokering, and (3) to propose a model outlining the role domains assumed in knowledge brokering Glegg, S. M., & Hoens, A. (2016). Role Domains of Knowledge Brokering: A Model for the Health Care Setting. Journal of Neurologic Physical Therapy(40(2), 115-23
 WebsitesThe KT Clearinghouse website is funded by the Canadian Institute of Health Research (CIHR) to serve as the repository of Knowledge Translation resources for individuals who want to learn about the science and practice of KT, and access tools that facilitate their own KT research and practices. KT Clearinghouse (
The National Collaborating Centre for Methods and Tools (NCCMT) is one of six National Collaborating Centres for Public Health in Canada. The NCCMT provides leadership and expertise in evidence-informed decision making to Canadian public health organizations.
 National Collaborative Centre for Methods and Tools (NCCMT) (
 The Canadian Knowledge Transfer and Exchange Community of Practice (KTECOP) is a network of KTE practitioners and researchers who share KTE practices and experience, build peer relationships for information exchange and support, build KTE capacity, advance knowledge of KTE effectiveness, and share KTE events, job opportunities and other related KTE activities. Knowledge Translation and Exchange Community of Practice (
  An Ontario network promoting the use of research in education Knowledge Network of Applied Education Research ( 
 This channel provides educational supports and resources related to the implementation of evidence based practices in child and youth mental health, education, health, and global health.   Implementation YouTube Channel (
KT CoursesThe three Modules within this KT Curriculum serve as an in-depth introduction to knowledge translation (KT). (Self-directed). Campbell, S. (2012).  Knowledge translation curriculum. Ottawa, ON: Canadian Coalition for Global Health Research.  Retrieved from
  The SKTT workshop is a two-day training course intended for health science researchers across all four scientific pillars (basic, clinical, health services, population health), who have an interest in sharing research knowledge with audiences beyond the traditional academic community, as appropriate and in increasing the impact potential of their research.  The course is also appropriate for KT professionals, policy and decision-makers, and educators.Title: Scientist knowledge translation training workshop Location: Toronto, ON: The Hospital for Sick Children Developed by: Barwick, M., Butterill, D., Lockett, D. M., Buckley, L., & Goering, P. (2005).  
  The Knowledge Translation Professional Certificate (KTPC™) is a five-day professional development course and the only course of its kind in North America. The curriculum, presented as a composite of didactic and interactive teaching, exemplars, and exercises, focuses on the core competencies of KT work in Canada, as identified by a survey of KT Practitioners (Barwick et al., 2010). This is a one-of-a-kind opportunity for professional development and networkingTitle: Knowledge translation professional certificate.  Location: Toronto, ON: The Hospital for Sick Children.Developed by: Barwick, M., Bovaird, S., & McMillen, K.  (2010). 
Created by Lisa Stromquist on 2016/05/13 18:00