The Joanna Briggs Institute (JBI) has been in existence since 1996 and is one of several international collaborative organizations leading the advancement of evidence synthesis methodologies. However, JBI is unique among these organizations because the organization’s model envisions improving global health through a cycle of evidence generation, synthesis, transfer and implementation (Pearson et al, 2005; Jordan et al, 2016). Currently, more than 70 entities are associated with the Institute (Joanna Briggs Institute, 2017). As the Institute and number of international collaborating entities grew rapidly over the first two decades, it became evident that smaller, regional subgroups may be able to work more efficiently and effectively while maintaining the larger multi regional structure of the Joanna Briggs Collaboration. The Implementation Science and Synthesis Network of the Americas (ISSNA) emerged in 2012 as a formal collection of Joanna Briggs Collaborating Centers across North and South America.
Methods
We began with initial funding through the Canadian Institutes for Health Research (CIHR) to conduct the initial planning among centers from Canada, Brazil and the USA. This grant work itself was the product of international collaboration between scholars at Purdue University Northwest (formerly Purdue University Calumet) and Queen’s University in Kingston, Ontario. Our goal was: to develop an America’s community of practice to generate knowledge through the science of evidence synthesis and to promote uptake of this evidence in clinical practice.
Our major objectives for this initial planning meeting were to: 1) Develop a formal network of JBI collaborating centres in the Americas to advance the science of knowledge use, 2) Formulate a network plan to link and more effectively integrate existing/developing JBI centers, 3) Establish mechanisms to sustain the network’s efforts to serve as a JBI community of practice. We used a facilitation methodology (Pearce & Robinson, 2014) to produce an initial strategic plan. To build a sense of community, we used a brainstorming technique to help build team cohesion that ensured that all participants understood the aims and felt equally considered in the process of reaching consensus. A professional facilitator coordinated the large and small group activities to enable the group to generate ideas and answers to two overarching questions to form a community of practice:
- What are the things this group can better achieve collectively than as individual entities?
- What should be the initial strategic plan to begin the process?
During the first session, the group outlined their expectations, discussed the scope of the collaboration, established initial goals, brainstormed tangible outcomes and, in the end, determined next steps. Next, the group conducted a "PEST" analysis (political, economic, social and technological forces) (Pearce & Robinson, 2014). This type of analysis uncovers issues in the macro environment that could influence development of potential partnerships; it effectively allowed the group to discover shared and unique aspects of their regional and national contexts, providing a "big picture". Then the group used a SWOT (strengths, weaknesses, opportunities and threats) analysis to further delineate short and long-term priorities (KU Center for Community Health and Development, 2017). This analysis narrowed the focus and allowed us to form our strategic plan. When we completed these activities, the group articulated answers to the two over-reaching questions. These two approaches (PEST and SWOT) to environmental scanning/planning provided the methodological structure for the facilitation. At this initial two-day meeting, 15 participants from 7 centers across the three nations participated. We used an ecological development model to conceptualize our relationships and strategic initiatives at micro-, meso-, exo-, and macro-system levels (Brofenbrenner, 1977). We established a vision statement: “ISSNA will lead implementation science and synthesis to improve health care outcomes and health delivery systems, and inform health policy in the Americas”. Our mission aligned with that vision: “to generate and promote uptake of knowledge to improve quality, safety, outcomes and economics of healthcare through a community of practice”.
Outcomes
Since our original organization, our community of practice has grown to include additional centers in the US and Canada and the center in Brazil continues to flourish. We have accomplished the following outcomes:
- A collaborative governance structure
- An annual scholarly conference, generally held in conjunction with an entity’s research or anniversary celebration that leverages and broadens existing activities
- Co-authoring of systematic reviews across entities
- Collaborative grant work across national borders
- Collaborative systematic review training workshops across entities and borders
- Mentorship of new centers and entities
- Engagement of library scientists in synthesis work across borders
- Collaborative work on synthesis methods and publications
Conclusion
Our experience may be a useful guide to others in forming such an international collaboration. We will share the details of this guided approach and present the model we used to develop the community of practice as well as our lessons learned (Urquhart et al, 2013). Despite differences in our political, economic, social and to some degree, technological attributes and contexts, there is no doubt that our international collaboration provides the glue that allows us to “do better together than apart.”