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Knowledge sharing between general and pediatric emergency departments: connections, barriers, and opportunities

  • Leah K. Crockett (a1) (a2), Carly Leggett (a1) (a2), Janet A. Curran (a3), Lisa Knisley (a2), Gwenyth Brockman (a1), Shannon D. Scott (a4), Lisa Hartling (a5) (a6), Mona Jabbour (a7) (a8) and Terry P. Klassen (a1) (a2) (a9)...

Abstract

Objective

Translating Emergency Knowledge for Kids (TREKK) is a national network aimed at improving emergency care for children by increasing collaborations and knowledge sharing between general and pediatric emergency departments (EDs). This study aimed to determine patterns of knowledge sharing within the network and to identify connections, barriers, and opportunities to obtaining pediatric information and training.

Methods

We conducted 22 semi-structured interviews with health care professionals working in general EDs, purposefully sampled to represent connected and disconnected sites, based on two previous internal quantitative social network analyses (SNA). Data were analyzed by two independent reviewers.

Results

Participants included physicians (59%) and nurses (41%) from 18 general EDs in urban (68%) and rural/remote (32%) Canada. Health care professionals sought information both formally and informally, by using guidelines, talking to colleagues, and attending pediatric related training sessions. Network structure and processes were found to increase connections, support practice change, and promote standards of care. Participants identified personal, organizational and system level barriers to information and skill acquisition, including resources and personal costs, geography, dissemination, and time. Providing easy access to information at the point of care was promoted through enhancing content visibility and by embedding resources into local systems. There remains a need to share successful methods of local dissemination and implementation across the network, and to leverage local professional champions such as clinical nurse liaisons.

Conclusions

These findings reinforce the critical role of ongoing network evaluation to improve the design and delivery of knowledge mobilization initiatives.

Objectif

Translating Emergency Knowledge for Kids (TREKK) est un réseau national qui vise à améliorer les soins d’urgence aux enfants en favorisant la collaboration entre les services des urgences générales (SUG) et les services des urgences pédiatriques ainsi que la mise en commun des connaissances. L’étude avait donc pour buts, d’une part, de déterminer les différentes formes de mise en commun des connaissances au sein du réseau et, d’autre part, d’examiner certains aspects liés à l’obtention de l’information en pédiatrie et à la formation, soit les relations, les obstacles et les possibilités.

Méthodes

Vingt-deux entretiens semi-dirigés ont été réalisés avec des professionnels de la santé travaillant dans des SUG et échantillonnés à dessein afin que soient représentés des services des urgences en relation ou non avec des établissements-ressources, d’après des données internes et quantitatives, recueillies dans deux analyses de réseaux sociaux menées antérieurement. Les données ont été analysées par deux examinateurs indépendants.

Résultats

Ont participé à l’étude des médecins (59 %) et des infirmières (41 %) provenant de 18 SUG situés en milieu urbain (68 %) ou encore en milieu rural ou en région éloignée (32 %), au Canada. La recherche d’information par les professionnels de la santé se faisait de manière tant structurée que non structurée, par exemple la consultation de lignes directrices, les échanges de points de vue avec des collèges, la participation à des séances de formation en pédiatrie. Il s’est révélé que la structure du réseau et ses processus amélioraient les relations, soutenaient les changements de pratique et favorisaient l’application des normes de soins. Les participants ont soulevé des obstacles personnels, organisationnels et systémiques à l’acquisition de l’information et de compétences, notamment le coût des ressources et les coûts personnels, la distance, la diffusion de l’information et le manque de temps. L’obtention de l’information au point de prestation des soins a été facilitée par une amélioration de la visibilité du contenu et par l’intégration des ressources dans les systèmes locaux. Il reste toutefois à trouver des méthodes efficaces de diffusion locale de l’information et d’application des connaissances dans tout le réseau ainsi qu’à former des guides professionnels à l’échelle locale comme les infirmières cliniciennes de liaison.

Conclusions

Les résultats de l’étude viennent renforcer le rôle crucial de l’évaluation continue du réseau afin d’améliorer la conception et la réalisation d’initiatives de mobilisation des connaissances.

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Copyright

Corresponding author

Correspondence to: Leah Crockett, 374-1 753 McDermot Avenue, Winnipeg MB R3E 0T6, Canada; Email: lcrockett@hsc.mb.ca

References

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