There is a lack of evidence to guide clinical practice in pediatric rehabilitation that is optimally packaged, easily accessible, and relevant to childhood disability. Front–line clinicians also express a lack of confidence and time in finding, reviewing and synthesizing potentially relevant research. KT experts and clinicians need to partner to create evidence-informed products to inform standards of care that address complex clinical questions and support decision making.
A rapid response program was developed to create evidence-informed KT products to facilitate standard of care development and decision-making. The program is based on the ‘knowledge funnel’ component of the knowledge to action cycle, rapid review principles, and an integrated KT approach. This funnel starts with identifying a problem, moving to knowledge inquiry, knowledge synthesis and finally KT product creation to present evidence in a concise and understandable format that is tailored to meet the needs of knowledge users (Graham et al., 2006). Rapid reviews are a type of knowledge synthesis in which the systematic review process is simplified to enhance timeliness of evidence production (Tricco et al., 2015). The program uses an integrated KT approach to bring together the diverse and complimentary expertise within our hospital. This includes Collaborative Practice (clinical decision makers) Evidence to Care (knowledge translation team) and the Clinical Working Group (front-line clinicians).
This process-oriented program includes the following steps: (i) prioritize a clinical topic based on selection criteria, (ii) establish an interprofessional working group, (iii) develop a preliminary review question, (iv) identify relevant clinical practice guidelines and reviews, (v) specify the review question using the PICO or PCC method, (vi) create the review protocol, (vii) synthesize the evidence. Partnering with Collaborative Practice and the Clinical Working Group was crucial as their perspectives reflect high priority and need-based topics as well as practice-informed knowledge. Their perspectives were captured through their participation in selecting and refining the review topic, outlining inclusion and exclusion criteria, and consulting on the interpretation of review findings. This program has supported the development of four standards of care: Managing stoma complications, serial casting, bowel management, and infant care.
A rapid response program informed by knowledge translation activities and principles offers a practical solution for tackling complex practice-based questions. The program enables the development of robust, timely and evidence-informed KT products for clinicians. In sharing these processes, the hope is that other organizations can adopt/adapt them to inform policy development.