A Review and Synthesis of Literature Examining Healthcare Managers' Use of Knowledge in Their Practice

Sunday, 30 July 2017: 8:30 AM

Greta G. Cummings, PhD1
Kaitlyn C. Tate, BScN1
Sarah J. Hewko, MHA1
Patrick B. McLane, PhD2
Pamela E. Baxter, PhD3
Susan Armijo-Olivo, PhD4
Carole A. Estabrooks, PhD, CM1
(1)Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
(2)Emergency Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada
(3)Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada
(4)University of Alberta, Edmonton, AB, Canada

Background. Despite acceptance of the merits of evidence-based practice, healthcare managers are frequently cited as discounting the value of research evidence to inform management practice. We identified and evaluated the effectiveness of interventions implemented to enhance healthcare managers’ use of research in their management practice.

Methods . We searched ten online bibliographic databases. Articles eligible for inclusion reported on interventions targeted to healthcare managers for enhancing research utilization in their practice. Two reviewers independently screened all titles, abstracts and manuscripts using predefined inclusion and exclusion criteria and independently conducted quality reviews on all manuscripts meeting inclusion criteria. Four research team members employed Hoon’s (2013) approach to meta-synthesis of qualitative studies to synthesize review results. We validated our findings in two semi-structured focus groups with 16 healthcare managers.

Results . Our database search yielded 15, 715 potentially relevant records. After duplicates were removed, a total of 14, 227 unique references remained. These references were screened and 178 titles moved forward to full text screening. Seven studies of variable quality (reported in 11 articles) met inclusion criteria. Three were case studies with primarily qualitative results. Interventions employed to enhance research use among healthcare managers’ included: informal and formal training, a computer-based/desktop application; meeting based, executive-level knowledge translation activities; and a formal residency program. Meta-synthesis yielded four themes including organizational culture/context, prioritization, time as a resource, and capacity building. An additional perspective was identified after reviewing focus group data. Awareness relates to participant’s lack of awareness that literature exists to inform management practice in health care or participants’ prematurely concluding that there is no relevant research in a particular area.

Conclusions . Methods employed to study interventions to enhance management research use among healthcare managers are primarily qualitative. Qualitative results can inform future studies, with study designs that can demonstrate causation and the relative effectiveness of specific components of an intervention in this area. The small number of studies available in the literature and the diverse strategies employed hindered our ability to identify one intervention or strategy as superior to any other.

Registration: PROSPERO (CRD42013005628)