Title: Advancing Patient Safety and Improvment Science by using a Knowledge Brokering Framework
Funder: Department of Health and Social Care

Abstract: Background: The University of Leicester (UoL) University Hospitals Leicester (UHL) have developed a collaborative unit the Leicester Innovation and Improvement Patient Safety Unit (LIIPS). The goal of the unit is to support patient safety and quality improvement projects at UHL. This will be achieved by building up collaborative networks, sharing and mobilising knowledge and building research capacity between the University and UHL and other key stakeholders. Research into healthcare routinely produces and refines knowledge that has the potential to improve the quality and safety of patient care, this knowledge does not consistently find its way into organisational or clinical practice (Seddon et al, 2001). Bridging the gap between knowledge and action is known as knowledge transfer or knowledge mobilisation (Lomas, 1997). Knowledge transfer is not a linier one way push of information or a one size fits all approach (Grimshaw, et al, 2004). It is a number of interactions between the producers and users of research (Graham et al., 2006). Knowledge brokers act as catalysts to facilitate the knowledge transfer process and are individuals who are positioned at the interface between the worlds of researchers and decision makers a human force behind the knowledge transfer (CHSRF, 2003). Three models of knowledge brokering have been identified (Ward et al, 2009); knowledge management, linkage exchange model and the capacity building model. The capacity building model aims to foster self-reliance in both the researcher and the decision makers by developing knowledge transfer and communication skills of the researchers and developing the analytical and interpretive skills of decision makers (Dobbins et al, 2007), there is a lack of evidence to support this model (Ward et al, 2009) Self-efficacy is the extent of one's belief in one's own ability to complete tasks and reach a goal (Bandura, 1997). Self-efficacy can help motivate employees to share knowledge with colleagues (Wasko and Faraj, 2005). Knowledge self-efficacy manifests when people believe that their knowledge can help solve work related problems and improves ways of working (Luthans, 2003). The knowledge broker will undertake number activities to build capacity these include: 1. Development of an e-learning training programme, Introduction to Quality Improvement and Science Methodologies 2. Develop Search and Evaluation Strategies training. 3. Develop a Communication Skills training 4. Developing a LIIPS website and active marketing Study Aims: The study aims to address the gaps in the literature on knowledge brokering to build capacity in both the healthcare organisation, UHL and the UoL. Sample: Researchers and clinical teams undertaking safety improvement projects as part of the LIIPS collaboration. Measures: All participants will be administered an adapted knowledge self-efficacy (Lin, 2007) and knowledge sharing questionnaire (Lin, 2007) before taking part in the training interventions and three months after completion. Interviews will be conducted with a sample of the participants that have undertaken the training to understand the process and context of knowledge mobilisation. The knowledge broker will keep a reflective research diary to understand the process of knowledge brokering. Analysis: The quantitative data will be analysed statistically, to identify if the capacity building training significantly affects knowledge self- efficacy and knowledge sharing intentions. The research diary and interviews will be analysed thematically to identify the main themes in relation to knowledge brokering and knowledge transfer and mobilisation.Benefits: The results can serve as a practical template to help researchers, healthcare practitioners and decision makers plan and evaluate improvement projects and research and contributes to the evidence base on knowledge transfer and knowledge mobilisation. The capacity developed will help build self-reliance for both the UHL and UoL to enable more efficient knowledge transfer which should translates to more effective improvement initiatives.

Lay abstract: The University of Leicester University Hospitals Leicester, have developed a collaborative unit Leicester Innovation and Improvement Patient Safety Unit (LIIPS). The goal of the unit is to support patient safety and quality improvement projects at the hospital. This will be achieved by developing networks for sharing knowledge and developing individual's ability to carry out and understand research in both organisations. Research into healthcare often produces knowledge that has the potential to improve the quality and safety of patient care, however this research and knowledge does not always find its way into hospital practices. Knowledge transfer is known as bridging the gap between knowledge and action. Knowledge transfer is the transfer of research, expertise, learning and skills between academia and the non-academic community. Knowledge transfer is not a one way process but a number of interactions between the producers of knowledge such as universities, and users of it such as hospitals. Knowledge brokers act as facilitators to assist in the process of knowledge exchange. Knowledge brokers are individuals who are positioned at the boundary between both universities and hospitals, they are the human driving force of knowledge transfer. Knowledge brokers have a number of roles; these are managing knowledge between the two organisations, building up networks and relationships, and developing the communication skills of the academics and developing the analytical and interpretive skills of decision makers to help both be better at knowledge transfer. The knowledge broker will undertake number activities to build develop the skills of those involved in the LIIPS improvement projects in both organisations, these include: Development of an e-learning training programme on quality improvement Develop library searching skills training Develop a communication skills training Developing a LIIPS website and active marketing The level of confidence individuals have in abilities to do task and achieve a goal can motivate people to share knowledge, therefore to understand if the training activities have been successful a questionnaire of self confidence in knowledge sharing ability will be used. All individuals who take part in the training will be asked to complete a questionnaire before they take start the training and three months after completion. This will allow comparisons to me made to see if the training has positively influenced individuals confidence in sharing knowledge and their desire to do so. A number of those who undertook the training will also be interviewed to try and understand how the training programme has improved their knowledge confidence and how they have used it to transfer knowledge. The main themes of the interviews will be identified. A diary will be kept by the knowledge broker to document the process of knowledge brokering. It is hoped that by building up the skills of both the academics and clinicians involved in patient safety and quality improvement projects, this will help better knowledge to be transfer between the two and more effective improvements implemented leading to ultimately better patient care.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE