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Rationale for a dissemination plan for a research

Westat, Rockville, MD Address correspondence to: Abstract Investigation in patient safety improvement is constantly yielding new research results, yet efforts to put the results into practice are inconsistent. Therefore, a pragmatic tool is needed. It was designed to help researchers consider major areas in dissemination: Developing the tool included several stages, beginning with adapting Rogers' seminal diffusion theory.

Literature was reviewed from health care, sociology, organizational development, psychology, and social sciences, thus providing a breath of dissemination theory and practices. Tools currently used in field-specific instances were reviewed.

Rationale for a Dissemination Plan Essay

All of these sources were synthesized through a process of refinement, expert review, and testing. Introduction New research results regularly provide an abundance of information to improve health care. Unfortunately, putting these results into practice often falls short of their envisioned potential. Even when research results are successfully disseminated, diffusion of the innovation occurs slowly, if at all. An exception is the Agency for Healthcare Research Quality AHRQ —a division of the Department of Health and Human Services—which is committed to helping bridge the time gap between discovering scientific evidence and improving patient care.

For example, through their Translating Research into Practice TRIP initiative, AHRQ aims to accelerate the impact of research on patient care to improve clinical outcomes and enhance cost effectiveness and efficiency using partnerships between researchers and health care organizations.

As with its TRIP initiative, AHRQ is committed to disseminating the research results from this portfolio to improve patient care practices, thus ultimately helping to make the health care system safer. Dissemination and implementation are complex processes, involving many disciplines and players within an organization. No one approach or strategy universally applies in every situation. Researchers, therefore, need to use multiple methods and tools to navigate their dissemination course Figure 1.

Diffusion is defined as a passive process by which an innovation is communicated through channels over time in a social system. Both constructs are embodied in the development rationale for a dissemination plan for a research this planning tool to guide dissemination of research results. Purpose of the tool The Dissemination Planning Tool was designed to help researchers create a dissemination plan that reaches beyond the traditional ways of getting the message out e. Research shows that employing only traditional methods is ineffective.

In a systematic review of 102 controlled trials examining the effectiveness of strategies for changing behavior, Oxman 7 found that passive approaches to sharing information, such as conference presentations, were less effective than social influencing interventions, such as having respected opinion leaders promote the innovation. The planning tool encourages researchers to think through the dissemination process and to assemble the building blocks needed to construct a formal dissemination plan specific to their particular research and their intended users' needs and interests.

Dissemination plans created by using this tool highlight ways that researchers can attain their unique project goals and reach target user audiences. The tool also helps researchers evaluate the best ways to distribute patient safety information by emphasizing the benefits of working with intermediaries and dissemination partners to amplify the reach to, and receptivity of, user communities.

The planning tool is useful at various points in the research process. One obvious time to complete it is toward the end of a research project, when findings are known or the research efforts have produced a product, tool, or program. Having the research results with associated evidence and pilot information on implementation can provide a compelling case for dissemination partners and end-users.

The tool also is applicable at the early stage of the research proposal process—it can help determine user needs and dissemination partner interests. This information will refine research questions to address the users' practical questions. Using this tool will also plant the seeds of interest of both users and partners, enlisting their support throughout the project. Development rationale for a dissemination plan for a research early testing Developing the tool involved several stages, beginning with adapting Rogers' work on the theory of diffusion.

The key processes in his first two stages involve understanding the innovation, including its importance and cost benefit; and identifying key adopters, their values and culture, and how to reach them. The aim of these processes is to convince the user of the merit of the innovation. Additional research that was applied in designing the tool was Lavis' 10 organizing approach for transferring knowledge, which includes specifying the message, the target audience, the messenger, how the message should be transferred, and how to evaluate the effect.

We further reviewed relevant literature from health care, sociology, organizational development, change management, psychology, and social sciences, all of which provided a wide breadth of knowledge in dissemination theory and practices.

We also searched for existing dissemination self-assessment tools for researchers in the public domain. Although much literature has been produced on the implementation of research results, a pragmatic assessment tool that prepares patient safety researchers to effectively put their results into practice has yet to be developed.

The NCDDR inventory is specifically aimed at disability researchers' dissemination efforts in the assessment of four areas: We then developed draft questions to assess each of these key areas and invited expert reviews of the draft tool from a variety of disciplines.

Reviewers included experienced health services researchers involved in patient safety research, national and international experts in dissemination research, professors involved in dissemination theory, knowledge management professionals, leaders in research dissemination organizations, and professionals who are responsible for developing and maintaining dissemination partnerships. Based on their feedback, the tool transitioned through a series of iterations.

For example, experts recommended that the questions be open-ended in order to help educate and stimulate researchers' thoughts about dissemination. Experts also wanted to include additional content to account for the human and financial resources needed for dissemination and to specify tactical activities and individuals responsible for achieving the activities.

They also noted the importance of considering informal user networks, where, as evidence suggests, vital opportunities for dissemination exist. Patient safety researchers within the Patient Safety Portfolio also were recruited to complete the draft tool with their own research in mind. In line with the expert feedback, researchers also recommended adding an action planning section to help the respondent consider practical next steps to help make the plan operational.

Description of the tool The tool is intended to produce a working document that requires several iterations to fully complete. Changes are made as additional information emerges.

While an individual such as the principal investigator may coordinate completing the tool, he or she should expect to consult with other members of the research team to fully capitalize rationale for a dissemination plan for a research their knowledge and, importantly, to gain their support of the plan. The planning tool serves as a discussion structure for the team, with every member providing his or her unique perspective.

The tool is structured into six sections: Each section builds on another to help researchers create their comprehensive plan. A construct rationale and overview for each section is briefly discussed below.

Research findings and products—what is going to be disseminated? This section helps researchers specifically identify what they want to disseminate and how to craft the value statement for the user. To define the product, the tool helps researchers consider ways to bundle or package their research. For example, if the research results include an event reporting system, the researcher could choose to disseminate it as a package, or separately disseminate the taxonomy or data analytic methods that were developed as a component of the reporting system.

For each product that the researcher develops, an evaluation of its readiness for dissemination is vital. The planning tool helps researchers consider if the finding or product is ready for immediate use by assessing its track record of success in practice, the strength of scientific evidence that supports the results, and whether it conforms to established procedures.

This evaluation of product-implementation readiness helps the researcher create a compelling value proposition to influence user interest.

  1. Nurses carrying out EBP should categorically choose the people to use the research Target audiences.
  2. This information will refine research questions to address the users' practical questions.
  3. Communication—how do you convey the research outcomes? Agency for Healthcare Research and Quality; 2005.
  4. Final evaluation of the system is a prerequisite when disseminating plan to benchmark the effort of the project and research Canadian Health Services Research Foundation.

End-users—who will apply it in practice? End-users are individuals or organizations that could benefit by applying the research results. Specifying end- users focuses the dissemination plan and targets the message. Change programs often do not work because they fail to involve formal structures and systems. The Dissemination Planning Tool prompts the researcher to think about the users' consumers' needs and values, and why the research is important to them e.

User needs are often driven by external forces in the environment, such as regulatory pressures. The tool invites the researcher to think about related events that may help or hinder users' interest in their research. For example, a standard issued from the Joint Commission on Accreditation in Healthcare Organizations JCAHO on assessing organizational leadership responsibility in creating a nonpunitive culture may prompt a hospital administrator to seek a patient safety culture-assessment instrument.

The Dissemination Planning Tool also prompts the researcher to think about barriers of user implementation and how to mitigate them. End-users share information in both formal and informal social networks. Dissemination is not a linear effort, but is often a fluid storytelling process. Informal spread of innovation—through networking, between users, or tapping into existing networks—is a powerful means of dissemination.

The tool prompts researchers to list organizations with existing networks that can influence target users through their credibility, expertise, and power of their distribution capacity.

By partnering with key intermediaries or connector organizations, researchers can capitalize on the organization's reach to tailor and amplify their message to users. A key strategy in implementing innovations in organizations involves aligning the innovation with organizational goals and values. Communication—how do you convey the research outcomes? Effective dissemination relies on using varied channels. Bero 18 found that multifaceted rationale for a dissemination plan for a research were consistently effective in promoting change.

While many communication strategies can influence provider practice, e. Furthermore, it is important to match the complexity of the research with the right medium. This section of the tool helps researchers to identify ways that users get their information and, importantly, to recognize those channels that are available through identified connector organizations, such as Web sites and newsletters. User feedback about their information-seeking behavior also can provide insight into the best ways to promote the research.

Evaluation—how do you determine what worked? While the ultimate measure of success is improved patient care, this section of the tool helps the researcher think about interim process measures of success, such as the number of physicians who request additional information following a product demonstration.

Evaluating the success of the dissemination plan is an iterative process. Dissemination is not a one-time activity, but a process that involves a long-term relationship with users and partners. Continuous feedback helps researchers appraise the effectiveness of their messages, such as what method or approach worked best or which method was most cost-effective. Researchers can use the feedback to improve their dissemination plan. Moreover, a working dialogue among the researchers, partners, and users can improve how the research is applied and mitigate potential barriers, such as those categorized by TRIP grantees behavioral, structural, process, human subjects, partner, study site, and costs.

In addition to helping develop the dissemination plan, the tool further provides a final section to begin accounting for resources, both human and financial, that will realistically make it happen. Dissemination plans often fall short in two places. Second, no lead person is identified who would be responsible for ensuring that the tasks planned are actually performed. The work plan also prompts the researcher to consider what resources are needed to implement the dissemination plan.

  1. The Dissemination Planning Tool prompts the researcher to think about the users' consumers' needs and values, and why the research is important to them e.
  2. The NCDDR inventory is specifically aimed at disability researchers' dissemination efforts in the assessment of four areas.
  3. The key processes in his first two stages involve understanding the innovation, including its importance and cost benefit; and identifying key adopters, their values and culture, and how to reach them. This evaluation of product-implementation readiness helps the researcher create a compelling value proposition to influence user interest.
  4. One obvious time to complete it is toward the end of a research project, when findings are known or the research efforts have produced a product, tool, or program.

Conclusion and future developments In their review, experts confirmed the need for a planning tool. This is especially true as researchers strive to bring patient safety innovations into practice. In consideration of these dynamics, we recognize the need to further develop a dissemination toolkit that would provide additional self-help aids—such as detailed workbooks, project management templates, and resource tracking grids—to further advance the adoption and practice of worthy patient safety innovations.

Researchers traditionally have not been expected to think about dissemination of research results for use in practice. With the recent and ongoing importance given by funding agencies to translating research into practice, researchers will benefit by understanding the dissemination process and its practical application.