Paper
Wednesday, July 13, 2005
This presentation is part of : CalNOC Partners to Reduce Patient Falls Project--Leveraging Partnerships, Performance, and Evidence Through Coaching for Excellence
1 Leveraging Nursing’s Quality Measurement Infrastructure to Expedite Evidence-based Practice: Conceptual Foundations
Nancy E. Donaldson, RN, DNSc, FAAN, Center for Research & Innovation in Patient Care, UCSF School of Nursing, San Francisco, CA, USA

Aim. This paper will present an overview of the CalNOC Partners to Reduce Patient Falls Linker Model which adapts Havelock's (1986) Linkage Model and postulates how CalNOC, as a source of knowledge generation and synthesis, linked to hospitals through coaching contacts, catalyzes and support institutional demand for evidence-based solutions to drive performance improvement. Havelock's Linkage Model posits reciprocal and interdependent relationships between the knowledge generation subsystem and the knowledge user subsystem, with human “linkers” playing a key role in transmitting new knowledge and in enabling feedback. Havelock's model is grounded in the assumption that research-based knowledge diffusion and utilization is fundamentally an act of communication between resource systems producing new knowledge and user systems that apply and use knowledge to attain societal goals. Methods. This project used Havelock's conceptualization of effective knowledge communication by providing designated “Coaches” to provide outreach from the “source of knowledge generation”, identifying “Linkers” for each hospital site, and by providing participating hospital “users” with access to and synthesis of research-based evidence to support their strategic falls reduction efforts. This paper also describes the cycle of nursing quality data capture, aggregation, review, analysis and subsequent query that has emerged from CalNOC sites over 9 years of database development and collaboration. CalNOC experience suggests the infrastructure emerging from this and similar efforts is vibrant and may be invaluable in expediting dissemination, translation, adoption, diffusion and evaluation of evidence-based innovation. Illustrative qualitative exemplars of the cycle in action, gleaned from CalNOC sites will be presented. The integrating conceptual framework underlying the content and actions of the coaching intervention will be presented. Results. The conceptual foundations for this project may be generalizable to others with infrastructure and evidence-based opportunity to expedite performance improvement in healthcare.