Module 11
Knowledge Transfer (KT) in Healthcare
Start
Special Acknowledgement
Section 1: Foundations and Theories in KT
Section 2: Best Practices for Processes in KT
Index
Section 3: Dissemination Methods and Strategies for KT
Foundations and Theories in KT
Objectives
Section 1: Foundations and Theories in KT
By the end of this section, you will be able to:
Define the practice of Knowledge Transfer (KT) in the healthcare setting
Describe facilitators and barriers with KT
OBJECTIVES
Utilize various frameworks to assist in the planning, implementation, and evaluation of Knowledge Transfer
KNOWLEDGE TRANSFER
Create
Information
Know - How
Skill
Data
Share
Foundation and Theories
Research (to) Practice
Terminology
Research to Practice Terms
Healthcare Terms
- Knowledge Transfer (KT)
- Knowledge Translation
- Knowledge Exchange
- Knowledge Mobilization (KMb)
- Knowledge Dissemination
- Knowledge Brokering
- Knowledge Integration
- Knowledge Management
- Implementation Science
- Dissemination and Implementation (D&I)
- Evidence Translation
- Research Utilization
- Evidence-Informed Practice
- Evidence-Based Practice (EBP)
- Knowledge-to-Action
- Research Uptake
- Closing the Research-to-Practice Gap
Foundation and Theories
Knowledge Transfer (kT)
in Medicine
Why KT Matters?
What is it?
- Decrease time delays from research to practice
- New adoptions linked to better outcomes
- Improvements in quality, safety, and efficiency
- Transfer research into clinical practice
- Includes dissemination, adoption, and application
Purpose
Goal is to reduce "gap" from research to outcomes
Barriers & Facilitators
Click button
Consolidated framework for implementation research (CFIR)
Outer Setting
Implementation Process
- Critical Incidents
- Local Attitudes
- Local Conditions
- Partnerships & Connections
- Financing
- External Pressures
- Teaming
- Assessing Needs
- Assessing Context
- Planning
- Tailoring Strategies
- Engaging
- Doing
- Reflecting & Evaluating
- Adapting
Inner Setting
- Structural Characteristics
- Relational Connections
- Communications
- Culture
- Tension for Change
- Compatibility
- Relative Priority
- Incentive Systems
- Mission Alignment
- Available Resources
- Access to Knowledge & Entertainment
The THING (Innovation)
- Source
- Evidence-Base
- Relative Advantage
- Adaptability
- Triability
- Complexity
- Design
- Cost
Process
Individuals
- Opinion Leaders
- Implementation Facilitators
- Implementation Leads
- Implementation Team Members
- Other Implementation Support
- Innovation Deliverers
- Innovation Recipients
Roles
- High-level Leaders
- Mid-level Leaders
Consolidated framework for implementation research (CFIR)
CFIR Implementation Determinants
Innovation Determinants
Antecedent Assessments
Acceptability, Appropriateness, Feasibility Implementation Climate, Implementation Readiness
Implementation Outcomes
Innovation Outcomes
Anticipated
actual
Innovation Outcomes
Implementation Outcomes
Implementation Outcomes
Indicators of anticipated implementation success or failures
Indicators of actual implementation success or failures
Indicators of innovation success or failure: innovation impact on key constituents
Hover over the button
Hover over the button
Hover over the button
(Reardon, 2025)
Knowledge-to-action Framework
Action Cycle (Application)
(Graham, 2006)
PARIHS (i-PARIHS) FRAMEWORK
i-PARIHS Framework
PARIHS Framework
- SI = Facn(I + R + C)
- SI = successful implementation
- R = recipients (individual and collective)
- C = context (inner and outer)
- SI = ƒ(E,C,F)
- SI = successful implementation
Innovation
What is Innovation?
How is it related to KT?
Click below to hear more
Click below to hear more
ROGER'S THEORY OF DIFFUSION OF INNOVATION
Adoption Influences
CHANGE MANAGEMENT & ORGANIZATIONAL CHANGE
What is Change Management and Organizational Change?
How is it related to KT?
Click below to hear more
Click below to hear more
Establish a sense of urgency
Build a guiding coalition
KOTTER'S 8-STEP CHANGE MODEL
Form a strategic vision and initiatives
Enlist a volunteer army
Enable action by removing barriers
What is the process?
Generate short-term wins
Sustain acceleration
Institute change
Click on the + to learn more
Kurt Lewin's: Three-Step model
Change process
Unfreezing
Employee involvement in change
Knowledge sharing
Organizational change
Change process
Refreezing
Change process
Organizational change process showing different stages
Leadership
Implementation of change
Integration of theories
Evidence Generated
Knowledge Applied
Organizational Change
- CFIR
- KTA
- PARIHS, i-PARIHS
- Diffusion of innovation
- Research
- Systematic reviews
- Kotter's 8-Step
- Lewin's 3-Step
Knowledge Check
Knowledge Check
Knowledge Check
Best Practices and Processes for KT
Objectives
Section 2: Best Practices and Processes for KT
By the end of this section, you will be able to:
List at least five best practices for transferringknowledge into practice
Differentiate from data and people processes tosupport the transfer of Knowledge into practice
OBJECTIVES
Describe how context and organizational cultureare related to knowledge transfer
Evidence Synthesis
Studies into usable formats
Support guideline development
Systematic Reviews
Toolkits & Checklists
Promote consistency andadherence
Provide practical &usable suggestions
Simplify complexguidelines
Continuous Quality Improvement (CQI)
Act
Plan
- Plan-Do-Study-Act (PDSA)
- Feedback-Driven Improvements
- Feedback Loops
- Align with KT Goals
Study
Do
Evaluation: Feedback Loops
Distorts the true relationship
KT Processes
Knowledge with Stakeholders
Communities of Practice
Embedding KT into Organizational Culture
Role of Champion & Opinion Leaders
Info
Info
Info
Info
Review:Knowledge Transfer (3:14)
Knowledge Check
Knowledge Check
Knowledge Check
Dissemination Methods and Strategies for KT
Objectives
Section 2: Dissemination Methods and Strategies for KT
By the end of this section, you will be able to:
Describe various methods and strategies to actively transfer knowledge into practice
List potential advantages and challenges with each strategy within a hospital and community setting
OBJECTIVES
Analyze maternal health KT case studies for their successes and challenges
KT Methods & Strategies
Clinical Decision Support Systems (CDSS)
Audit and Feedback
Educational Outreach
Info
Info
Info
Policy Brief & White Papers
Digital Platforms & Mobile Apps
Train-the-Trainer Programs
Info
Info
Info
Storytelling & Case Studies
Interdisciplinary Collaboration
Info
Info
Governmental KT & Dissemination Tools
Maternal Health: KT Case Studies
Implementation Science in Maternity Care – Scoping Review
Implementation Processes in Maternal-Newborn Care (Ontario)
MCH Leadership Training Program – Implementation Science Framework
Knowledge Check
Knowledge Check
Knowledge Check
COMPLETED:
SUMMARY
- Define the practice of Knowledge Transfer (KT) in the healthcare setting
- Describe facilitators and barriers with KT
- Utilize various frameworks to assist in the planning, implementation, and evaluation of Knowledge Transfer
Section 1: Foundations and Theories in KT
Section 2: Best Practices and Processes for KT
- Insert List at least five best practices for transferring knowledge into practice
- Differentiate from data and people processes to support the transfer of Knowledge into practice
- Describe how context and organizational culture are related to knowledge transfer
Section 3: Dissemination Methods and Strategies for KT
- Describe various methods and strategies to actively transfer knowledge into practice
- List potential advantages and challenges with each strategy within a hospital and community setting
- Analyze maternal health KT case studies for their successes and challenges
REFERENCES
Bero, L. A., Grilli, R., Grimshaw, J. M., Harvey, E., Oxman, A. D., & Thomson, M. A. (1998). Closing the gap between research and practice: An overview of systematic reviews of interventions to promote implementation of research findings. BMJ, 317(7156), 465–468. https://doi.org/10.1136/bmj.317.7156.465 Bhutta, Z. A., Das, J. K., Rizvi, A., Gaffey, M. F., Walker, N., Horton, S., Webb, P., Lartey, A., & Black, R. E. (2014). Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost? The Lancet, 384(9950), 347–370. https://doi.org/10.1016/S0140-6736(13)60996-4 Burnes, B. (2004). Kurt Lewin and the planned approach to change: A re‐appraisal. Journal of Management Studies, 41(6), 977–1002. https://doi.org/10.1111/j.1467-6486.2004.00463.x Cargo, M., & Mercer, S. L. (2008). The value and challenges of participatory research: Strengthening its practice. Annual Review of Public Health, 29(1), 325–350. https://doi.org/10.1146/annurev.publhealth.29.091307.083824 Carman, K. L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C., & Sweeney, J. (2013). Patient and family engagement: A framework for understanding the elements and developing interventions and policies. Health Affairs, 32(2), 223–231. https://doi.org/10.1377/hlthaff.2012.1133 Chapman, E., Haby, M. M., Toma, T. S., de Bortoli, M. C., Illanes, E., Oliveros, M. J., & Barreto, J. O. M. (2020). Knowledge translation strategies for dissemination with a focus on healthcare recipients: an overview of systematic reviews. Implementation Science, 15(1), 14. Cook, D. A., Hamstra, S. J., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., Erwin, P. J., & Hatala, R. (2011). Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis. Medical Education, 45(8), 778–786. https://doi.org/10.1111/j.1365- 2923.2011.04025.x Dadich, A., Piper, A., & Coates, D. (2021). Implementation science in maternity care: A scoping review. Implementation Science, 16(1), 16. https://doi.org/10.1186/s13012-021-01083-6 Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(1), 50. https://doi.org/10.1186/1748-5908-4-50 Deming, W. E. (1986). Out of the crisis. MIT Press. Eccles, M. P., & Mittman, B. S. (2006). Welcome to Implementation Science. Implementation Science, 1(1), 1. https://doi.org/10.1186/1748-5908-1-1 Estabrooks, C. A., Thompson, D. S., Lovely, J. J., & Hofmeyer, A. (2006). A guide to knowledge translation theory. Journal of Continuing Education in the Health Professions, 26(1), 25–36. https://doi.org/10.1002/chp.48 Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, R. M. (2005). Implementation research: A synthesis of the literature. University of South Florida. Flodgren, G., Parmelli, E., Doumit, G., Gattellari, M., O’Brien, M. A., Grimshaw, J., & Eccles, M. P. (2011). Local opinion leaders: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews, 2011(8), CD000125. https://doi.org/10.1002/14651858.CD000125.pub4 Galli, B. J. (2018). Change management models: A comparative analysis and concerns. IEEE Engineering Management Review, 46(3), 124–132. https://doi.org/10.1109/EMR.2018.2866860 Geyman, J. P. (2018). Evidence-based clinical practice: Concepts and approaches. Radcliffe Publishing. Graham, I. D., Logan, J., Harrison, M. B., Straus, S. E., Tetroe, J., Caswell, W., & Robinson, N. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26(1), 13–24. https://doi.org/10.1002/chp.47
REFERENCES
Grimshaw, J. M., Eccles, M. P., Lavis, J. N., Hill, S. J., & Squires, J. E. (2012). Knowledge translation of research findings. Implementation Science, 7(1), 50. https://doi.org/10.1186/1748-5908-7-50 Harvey, G., & Kitson, A. (2015). PARIHS revisited: From heuristic to integrated framework for the successful implementation of knowledge into practice. Implementation Science, 11(1), 33. https://doi.org/10.1186/s13012-016-0398-2 Harvey, G., & Kitson, A. (2016). Implementing evidence-based practice in healthcare: A facilitation guide. Routledge. Haynes, A. B., Weiser, T. G., Berry, W. R., Lipsitz, S. R., Breizat, A. H., Dellinger, E. P., … Gawande, A. A. (2009). A surgical safety checklist to reduce morbidity and mortality in a global population. New England Journal of Medicine, 360(5), 491–499. https://doi.org/10.1056/NEJMsa0810119 Kitson, A., Harvey, G., & McCormack, B. (1998). Enabling the implementation of evidence-based practice: A conceptual framework. Quality in Health Care, 7(3), 149–158. https://doi.org/10.1136/qshc.7.3.149 Kotter, J. P. (1996). Leading change. Harvard Business School Press. Lewin, K. (1947). Frontiers in group dynamics: Concept, method and reality in social science; social equilibria and social change. Human Relations, 1(1), 5–41. https://doi.org/10.1177/001872674700100103 Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science, 10(1), 53. https://doi.org/10.1186/s13012-015-0242-0 Reardon CM, Damschroder LJ, Ashcraft LE, Kerins C, Bachrach RL, Nevedal AL, Domlyn AM, Dodge J, Chinman M, Rogal S. The Consolidated Framework for Implementation Research (CFIR) User Guide: a five-step guide for conducting implementation research using the framework. Implement Sci. 2025 Aug 16;20(1):39. doi: 10.1186/s13012-025-01450-7. PMID: 40819067; PMCID: PMC12357348. Reszel, J., Daub, O., Dunn, S. I., Cassidy, C. E., Hafizi, K., Lightfoot, M., … Graham, I. D. (2025). Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: A cross-sectional survey. BMC Nursing, 24, 10. https://doi.org/10.1186/s12912-024-02643-z Rogers, E. M. (2003). Diffusion of innovations (5th ed.). Free Press. Rycroft-Malone, J. (2004). The PARIHS framework—A framework for guiding the implementation of evidence-based practice. Journal of Nursing Care Quality, 19(4), 297–304. https://doi.org/10.1097/00001786-200410000-00002 Schein, E. H. (2010). Organizational culture and leadership (4th ed.). Jossey-Bass. Shirey, M. R. (2013). Lewin’s theory of planned change as a strategic resource. Journal of Nursing Administration, 43(2), 69–72. https://doi.org/10.1097/NNA.0b013e31827f20a9 Small, S., & Irvine, F. (2006). The application of Kotter’s change management model in the implementation of evidence‐based practice. Journal of Nursing Management, 14(4), 235–241. https://doi.org/10.1111/j.1365-2934.2006.00601.x Straus, S. E., Tetroe, J., & Graham, I. D. (2013). Knowledge translation in health care: Moving from evidence to practice (2nd ed.). Wiley-Blackwell. Straus, S. E., Tetroe, J., & Graham, I. D. (2019). Knowledge translation in health care: Moving from evidence to practice (3rd ed.). Wiley-Blackwell. Tabak, R. G., Khoong, E. C., Chambers, D. A., & Brownson, R. C. (2012). Bridging research and practice: Models for dissemination and implementation research. American Journal of Preventive Medicine, 43(3), 337–350. https://doi.org/10.1016/j.amepre.2012.05.024 Vamos, C. A., Thompson, E. L., Mason, S., Detman, L., Merrell, L., & Daley, E. M. (2023). MCH Leadership Training Program: An innovative application of an implementation science framework. Maternal and Child Health Journal, 27(4), 597–610. https://doi.org/10.1007/s10995-023-03607-6
MODULE 11 COMPLETED
Remember to review what you've learned!
Educational Outreach
- 1:1 Clinician education
- Tailored, interactive, feedback approach
- Incorporate into workflow
Refreeze
In this final step of refreezing, you are reinforcing and institutionalizing the new practices to ensure stability.
Implementation Science in Maternity Care – Scoping Review
- What they did:
- Reviewed 60+ studies applying implementation science in maternity care
- Mapped how frameworks, models, and theories were used in practice
What they found:
- Most studies referenced frameworks but few applied them rigorously
- Knowledge-to-Action (KTA) and PARIHS were the most commonly cited
- Highlighted gaps in consistency and depth of use of frameworks
APA Reference:Dadich, A., Piper, A., & Coates, D. (2021). Implementation science in maternity care: A scoping review. Implementation Science, 16(1), 16.https://doi.org/10.1186/s13012-021-01083-6
Barriers & Facilitators to KT
(overview here)
Storytelling & Case Studies
- Make evidence relatable and memorable
- Illustrate the patient impact and human outcomes
- Engage with emotional and rational reasoning
Clinical Decision Support Systems (CDSS)
- KT integrated into EHRs
- Use real-time, evidence-based prompts
- Reduces errors and increases adherence to guidelines
Audit and Feedback
- Compare performance to benchmarks
- Encourage reflection and QI
- Data for Change
Interdisciplinary Collaboration
- Connect researchers, practitioners, policymakers
- Build trust and understanding
- Translate evidence into usable formats
- Improves teamwork
- Enhances holistic, coordinated patient care
- Essential for complex system-wide KT efforts
Policy Brief & White Papers
- Summarize evidence for policymakers
- Science linked to policy options
- Influences systems and funding priorities
Digital Platforms & Mobile Apps
- Rapid dissemination of new guidelines and updates
- Provides reminders, checklists, and algorithms
- Scalable, accessible, and cost-effective
Unfreezing
In this unfreezing step, you are preparing the organization or individuals to accept that change is needed.
MCH Leadership Training Program – Implementation Science Framework
What they did:
- Developed a leadership training program for maternal & child health professionals
- Applied implementation science CFIR framework to guide program design and evaluation
What they found:
- Training improved knowledge, skills, and leadership confidence
- Using a structured framework helped embed evidence-based training practices
- Participants valued integration of theory with practice
APA Reference:Vamos, C. A., Thompson, E. L., Mason, S., Detman, L., Merrell, L., & Daley, E. M. (2023). MCH Leadership Training Program: An innovative application of an implementation science framework. Maternal and Child Health Journal, 27(4), 597–610. https://doi.org/10.1007/s10995-023-03607-6
Implementation Processes in Maternal-Newborn Care (Ontario)
What they did:
- Surveyed Ontario hospitals providing maternal-newborn care
- Assessed processes, confidence, and capacity for implementing practice changes
What they found:
- Wide variation in hospital readiness and confidence to implement new evidence
- Need for capacity-building and training in implementation methods
- Hospitals most familiar with the Knowledge-to-Action Framework
APA Reference:Reszel, J., Daub, O., Dunn, S. I., Cassidy, C. E., Hafizi, K., Lightfoot, M., … Graham, I. D. (2025). Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: A cross-sectional survey. BMC Nursing, 24, 10. https://doi.org/10.1186/s12912-024-02643-z
Train-the-Trainer Programs
- Build KT capacity
- Trainers cascade skills and evidence through networks
- Effective in resource-limited or decentralized systems
Change (move)
During the second change step, you are introducing new behaviors, processes, or ways of thinking.
Module 11
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Transcript
Module 11
Knowledge Transfer (KT) in Healthcare
Start
Special Acknowledgement
Section 1: Foundations and Theories in KT
Section 2: Best Practices for Processes in KT
Index
Section 3: Dissemination Methods and Strategies for KT
Foundations and Theories in KT
Objectives
Section 1: Foundations and Theories in KT
By the end of this section, you will be able to:
Define the practice of Knowledge Transfer (KT) in the healthcare setting
Describe facilitators and barriers with KT
OBJECTIVES
Utilize various frameworks to assist in the planning, implementation, and evaluation of Knowledge Transfer
KNOWLEDGE TRANSFER
Create
Information
Know - How
Skill
Data
Share
Foundation and Theories
Research (to) Practice
Terminology
Research to Practice Terms
Healthcare Terms
Foundation and Theories
Knowledge Transfer (kT)
in Medicine
Why KT Matters?
What is it?
Purpose
Goal is to reduce "gap" from research to outcomes
Barriers & Facilitators
Click button
Consolidated framework for implementation research (CFIR)
Outer Setting
Implementation Process
Inner Setting
The THING (Innovation)
Process
Individuals
Roles
Consolidated framework for implementation research (CFIR)
CFIR Implementation Determinants
Innovation Determinants
Antecedent Assessments
Acceptability, Appropriateness, Feasibility Implementation Climate, Implementation Readiness
Implementation Outcomes
Innovation Outcomes
Anticipated
actual
Innovation Outcomes
Implementation Outcomes
Implementation Outcomes
Indicators of anticipated implementation success or failures
Indicators of actual implementation success or failures
Indicators of innovation success or failure: innovation impact on key constituents
Hover over the button
Hover over the button
Hover over the button
(Reardon, 2025)
Knowledge-to-action Framework
Action Cycle (Application)
(Graham, 2006)
PARIHS (i-PARIHS) FRAMEWORK
i-PARIHS Framework
PARIHS Framework
- SI = Facn(I + R + C)
- SI = successful implementation
Innovation
What is Innovation?
How is it related to KT?
Click below to hear more
Click below to hear more
ROGER'S THEORY OF DIFFUSION OF INNOVATION
Adoption Influences
CHANGE MANAGEMENT & ORGANIZATIONAL CHANGE
What is Change Management and Organizational Change?
How is it related to KT?
Click below to hear more
Click below to hear more
Establish a sense of urgency
Build a guiding coalition
KOTTER'S 8-STEP CHANGE MODEL
Form a strategic vision and initiatives
Enlist a volunteer army
Enable action by removing barriers
What is the process?
Generate short-term wins
Sustain acceleration
Institute change
Click on the + to learn more
Kurt Lewin's: Three-Step model
Change process
Unfreezing
Employee involvement in change
Knowledge sharing
Organizational change
Change process
Refreezing
Change process
Organizational change process showing different stages
Leadership
Implementation of change
Integration of theories
Evidence Generated
Knowledge Applied
Organizational Change
Knowledge Check
Knowledge Check
Knowledge Check
Best Practices and Processes for KT
Objectives
Section 2: Best Practices and Processes for KT
By the end of this section, you will be able to:
List at least five best practices for transferringknowledge into practice
Differentiate from data and people processes tosupport the transfer of Knowledge into practice
OBJECTIVES
Describe how context and organizational cultureare related to knowledge transfer
Evidence Synthesis
Studies into usable formats
Support guideline development
Systematic Reviews
Toolkits & Checklists
Promote consistency andadherence
Provide practical &usable suggestions
Simplify complexguidelines
Continuous Quality Improvement (CQI)
Act
Plan
Study
Do
Evaluation: Feedback Loops
Distorts the true relationship
KT Processes
Knowledge with Stakeholders
Communities of Practice
Embedding KT into Organizational Culture
Role of Champion & Opinion Leaders
Info
Info
Info
Info
Review:Knowledge Transfer (3:14)
Knowledge Check
Knowledge Check
Knowledge Check
Dissemination Methods and Strategies for KT
Objectives
Section 2: Dissemination Methods and Strategies for KT
By the end of this section, you will be able to:
Describe various methods and strategies to actively transfer knowledge into practice
List potential advantages and challenges with each strategy within a hospital and community setting
OBJECTIVES
Analyze maternal health KT case studies for their successes and challenges
KT Methods & Strategies
Clinical Decision Support Systems (CDSS)
Audit and Feedback
Educational Outreach
Info
Info
Info
Policy Brief & White Papers
Digital Platforms & Mobile Apps
Train-the-Trainer Programs
Info
Info
Info
Storytelling & Case Studies
Interdisciplinary Collaboration
Info
Info
Governmental KT & Dissemination Tools
Maternal Health: KT Case Studies
Implementation Science in Maternity Care – Scoping Review
Implementation Processes in Maternal-Newborn Care (Ontario)
MCH Leadership Training Program – Implementation Science Framework
Knowledge Check
Knowledge Check
Knowledge Check
COMPLETED:
SUMMARY
Section 1: Foundations and Theories in KT
Section 2: Best Practices and Processes for KT
Section 3: Dissemination Methods and Strategies for KT
REFERENCES
Bero, L. A., Grilli, R., Grimshaw, J. M., Harvey, E., Oxman, A. D., & Thomson, M. A. (1998). Closing the gap between research and practice: An overview of systematic reviews of interventions to promote implementation of research findings. BMJ, 317(7156), 465–468. https://doi.org/10.1136/bmj.317.7156.465 Bhutta, Z. A., Das, J. K., Rizvi, A., Gaffey, M. F., Walker, N., Horton, S., Webb, P., Lartey, A., & Black, R. E. (2014). Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost? The Lancet, 384(9950), 347–370. https://doi.org/10.1016/S0140-6736(13)60996-4 Burnes, B. (2004). Kurt Lewin and the planned approach to change: A re‐appraisal. Journal of Management Studies, 41(6), 977–1002. https://doi.org/10.1111/j.1467-6486.2004.00463.x Cargo, M., & Mercer, S. L. (2008). The value and challenges of participatory research: Strengthening its practice. Annual Review of Public Health, 29(1), 325–350. https://doi.org/10.1146/annurev.publhealth.29.091307.083824 Carman, K. L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C., & Sweeney, J. (2013). Patient and family engagement: A framework for understanding the elements and developing interventions and policies. Health Affairs, 32(2), 223–231. https://doi.org/10.1377/hlthaff.2012.1133 Chapman, E., Haby, M. M., Toma, T. S., de Bortoli, M. C., Illanes, E., Oliveros, M. J., & Barreto, J. O. M. (2020). Knowledge translation strategies for dissemination with a focus on healthcare recipients: an overview of systematic reviews. Implementation Science, 15(1), 14. Cook, D. A., Hamstra, S. J., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., Erwin, P. J., & Hatala, R. (2011). Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis. Medical Education, 45(8), 778–786. https://doi.org/10.1111/j.1365- 2923.2011.04025.x Dadich, A., Piper, A., & Coates, D. (2021). Implementation science in maternity care: A scoping review. Implementation Science, 16(1), 16. https://doi.org/10.1186/s13012-021-01083-6 Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(1), 50. https://doi.org/10.1186/1748-5908-4-50 Deming, W. E. (1986). Out of the crisis. MIT Press. Eccles, M. P., & Mittman, B. S. (2006). Welcome to Implementation Science. Implementation Science, 1(1), 1. https://doi.org/10.1186/1748-5908-1-1 Estabrooks, C. A., Thompson, D. S., Lovely, J. J., & Hofmeyer, A. (2006). A guide to knowledge translation theory. Journal of Continuing Education in the Health Professions, 26(1), 25–36. https://doi.org/10.1002/chp.48 Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, R. M. (2005). Implementation research: A synthesis of the literature. University of South Florida. Flodgren, G., Parmelli, E., Doumit, G., Gattellari, M., O’Brien, M. A., Grimshaw, J., & Eccles, M. P. (2011). Local opinion leaders: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews, 2011(8), CD000125. https://doi.org/10.1002/14651858.CD000125.pub4 Galli, B. J. (2018). Change management models: A comparative analysis and concerns. IEEE Engineering Management Review, 46(3), 124–132. https://doi.org/10.1109/EMR.2018.2866860 Geyman, J. P. (2018). Evidence-based clinical practice: Concepts and approaches. Radcliffe Publishing. Graham, I. D., Logan, J., Harrison, M. B., Straus, S. E., Tetroe, J., Caswell, W., & Robinson, N. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26(1), 13–24. https://doi.org/10.1002/chp.47
REFERENCES
Grimshaw, J. M., Eccles, M. P., Lavis, J. N., Hill, S. J., & Squires, J. E. (2012). Knowledge translation of research findings. Implementation Science, 7(1), 50. https://doi.org/10.1186/1748-5908-7-50 Harvey, G., & Kitson, A. (2015). PARIHS revisited: From heuristic to integrated framework for the successful implementation of knowledge into practice. Implementation Science, 11(1), 33. https://doi.org/10.1186/s13012-016-0398-2 Harvey, G., & Kitson, A. (2016). Implementing evidence-based practice in healthcare: A facilitation guide. Routledge. Haynes, A. B., Weiser, T. G., Berry, W. R., Lipsitz, S. R., Breizat, A. H., Dellinger, E. P., … Gawande, A. A. (2009). A surgical safety checklist to reduce morbidity and mortality in a global population. New England Journal of Medicine, 360(5), 491–499. https://doi.org/10.1056/NEJMsa0810119 Kitson, A., Harvey, G., & McCormack, B. (1998). Enabling the implementation of evidence-based practice: A conceptual framework. Quality in Health Care, 7(3), 149–158. https://doi.org/10.1136/qshc.7.3.149 Kotter, J. P. (1996). Leading change. Harvard Business School Press. Lewin, K. (1947). Frontiers in group dynamics: Concept, method and reality in social science; social equilibria and social change. Human Relations, 1(1), 5–41. https://doi.org/10.1177/001872674700100103 Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science, 10(1), 53. https://doi.org/10.1186/s13012-015-0242-0 Reardon CM, Damschroder LJ, Ashcraft LE, Kerins C, Bachrach RL, Nevedal AL, Domlyn AM, Dodge J, Chinman M, Rogal S. The Consolidated Framework for Implementation Research (CFIR) User Guide: a five-step guide for conducting implementation research using the framework. Implement Sci. 2025 Aug 16;20(1):39. doi: 10.1186/s13012-025-01450-7. PMID: 40819067; PMCID: PMC12357348. Reszel, J., Daub, O., Dunn, S. I., Cassidy, C. E., Hafizi, K., Lightfoot, M., … Graham, I. D. (2025). Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: A cross-sectional survey. BMC Nursing, 24, 10. https://doi.org/10.1186/s12912-024-02643-z Rogers, E. M. (2003). Diffusion of innovations (5th ed.). Free Press. Rycroft-Malone, J. (2004). The PARIHS framework—A framework for guiding the implementation of evidence-based practice. Journal of Nursing Care Quality, 19(4), 297–304. https://doi.org/10.1097/00001786-200410000-00002 Schein, E. H. (2010). Organizational culture and leadership (4th ed.). Jossey-Bass. Shirey, M. R. (2013). Lewin’s theory of planned change as a strategic resource. Journal of Nursing Administration, 43(2), 69–72. https://doi.org/10.1097/NNA.0b013e31827f20a9 Small, S., & Irvine, F. (2006). The application of Kotter’s change management model in the implementation of evidence‐based practice. Journal of Nursing Management, 14(4), 235–241. https://doi.org/10.1111/j.1365-2934.2006.00601.x Straus, S. E., Tetroe, J., & Graham, I. D. (2013). Knowledge translation in health care: Moving from evidence to practice (2nd ed.). Wiley-Blackwell. Straus, S. E., Tetroe, J., & Graham, I. D. (2019). Knowledge translation in health care: Moving from evidence to practice (3rd ed.). Wiley-Blackwell. Tabak, R. G., Khoong, E. C., Chambers, D. A., & Brownson, R. C. (2012). Bridging research and practice: Models for dissemination and implementation research. American Journal of Preventive Medicine, 43(3), 337–350. https://doi.org/10.1016/j.amepre.2012.05.024 Vamos, C. A., Thompson, E. L., Mason, S., Detman, L., Merrell, L., & Daley, E. M. (2023). MCH Leadership Training Program: An innovative application of an implementation science framework. Maternal and Child Health Journal, 27(4), 597–610. https://doi.org/10.1007/s10995-023-03607-6
MODULE 11 COMPLETED
Remember to review what you've learned!
Educational Outreach
Refreeze
In this final step of refreezing, you are reinforcing and institutionalizing the new practices to ensure stability.
Implementation Science in Maternity Care – Scoping Review
What they found:
APA Reference:Dadich, A., Piper, A., & Coates, D. (2021). Implementation science in maternity care: A scoping review. Implementation Science, 16(1), 16.https://doi.org/10.1186/s13012-021-01083-6
Barriers & Facilitators to KT
(overview here)
Storytelling & Case Studies
Clinical Decision Support Systems (CDSS)
Audit and Feedback
Interdisciplinary Collaboration
Policy Brief & White Papers
Digital Platforms & Mobile Apps
Unfreezing
In this unfreezing step, you are preparing the organization or individuals to accept that change is needed.
MCH Leadership Training Program – Implementation Science Framework
What they did:
What they found:
APA Reference:Vamos, C. A., Thompson, E. L., Mason, S., Detman, L., Merrell, L., & Daley, E. M. (2023). MCH Leadership Training Program: An innovative application of an implementation science framework. Maternal and Child Health Journal, 27(4), 597–610. https://doi.org/10.1007/s10995-023-03607-6
Implementation Processes in Maternal-Newborn Care (Ontario)
What they did:
What they found:
APA Reference:Reszel, J., Daub, O., Dunn, S. I., Cassidy, C. E., Hafizi, K., Lightfoot, M., … Graham, I. D. (2025). Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: A cross-sectional survey. BMC Nursing, 24, 10. https://doi.org/10.1186/s12912-024-02643-z
Train-the-Trainer Programs
Change (move)
During the second change step, you are introducing new behaviors, processes, or ways of thinking.