CIHR Team in Frailty and Aging  

RP #6 : Knowledge exchange (KE), Information Technology (IT), and Geriatrics

PH.D. STUDENTS: S Akhlaghpour , TBA.

OBJECTIVES: 1) To identify the spectrum of IT impacts in elderly care, in particular knowledge exchange (KE), quality of care, best practices, productivity etc. 2) To derive a model of knowledge exchange including a) its various impacts in elderly care b) the role and specificities of different stakeholders. 3) To assess impacts of IT on various dimensions of the healthcare delivery process in geriatrics, more particularly on the knowledge exchange process. 4) To evaluate the knowledge exchange process between stakeholders so as to maximize intervention usefulness for all stakeholders involved.

METHODS: Phase 1 and 2 : Typology of impacts and model building: We will first conduct a systematic review of IT impacts so as to better identify the underlying constructs linked to the use of IT and its link with effective and efficient interventions and practices. Also, following the efforts of Lavis et al., we will strive to enhance existing IT impact and knowledge exchange frameworks, so as to adapt them to the specific context of programs and policies development for frail elderly. Indeed, though it is generally acknowledged that it is imperative to improve opportunities for research organizations to improve care through knowledge exchange, it is also recognized that transferring research results into interventions, practices and policies can be extremely challenging.

Phase 3 : We will use a case methodology with embedded units of analysis to document IT impacts, particularly on the knowledge exchange process. The selection of the three sites will be based on similarities and variations (setting, intervention type, participants). Since all three sites are already affiliated to the project, they are different by definition, which allows for comparison. To ensure internal validity, three sources of evidence will be used: direct observation, documentation and in-depth interviews. Data gathered from documentation and observation will be used to corroborate, validate and complement the interview data. Data will be analyzed in two stages using analytic induction. First, within-case analysis will allow the emergence of unique patterns and provided a rich understanding of each case. Second, common as well as unique patterns will be revealed through cross-case analysis.

Phase 4 : We will use a participatory action research strategy that will involve, in collaboration with the different stakeholders, systematic observation, reflection and then re-planning as needed. In collaboration with all the stakeholders involved, we will follow up the knowledge exchange process with all the partners involved, so as to monitor, adjust, and improve it as needed and ultimately lead to more timely and efficient interventions for frail elderly persons. Programs and policies are not always adopted or developed to their full capabilities due to stark resistance from stakeholders. When implementing new programs, practices or interventions such as the ones proposed in research project #4 and # 5, it thus becomes crucial to identify resistant behaviours, as well as the sources of resistance, and to understand how resistance evolves with time. As per the objectives of the study, we will also monitor resistance among stakeholders and, as indicated by prior theorizing of resistance, we will ensure their involvement as prior research indicates that while managing resistance sometimes means overcoming resistance behaviours, in other instances it also means acting strategically by involving stakeholders collaboratively.

EXPECTED RESULTS: This research project will allow for a better understanding of the role of IT and of factors and processes that lead to successful bi-directional knowledge exchange between stakeholders. The mutual adjustments it involves will ultimately lead to the successful implementation of more timely and efficient interventions for frail elderly persons.

TIMELINE: October 2007 - January 2008: Preparation; January 2008-June 2008 : Phase 1; July 2008-December 2008 – Phase 2; 2009-2010: Phase 3; 2010-2011: Phase 4.

INSTITUTIONAL SETTING: Since the project will involve graduate students from the Faculty of Management of McGill University , part of the research activities will be conducted on the Faculty premises. Also, to facilitate overall coherence and exchange of information, participants will spend one day a week at the Solidage office to work on the project.


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Updated February 11, 2013