Case studies
Social Movement Action Framework
Increasing visibility to advance the rights of Deaf children
A community coalition in Los Angeles, California took collective action to advocate for the rights of Deaf children in accessing child abuse prevention and treatment services. he coalition took multiple steps to increase visibility, spread awareness and gain support. Read more in this case study.
A community coalition in Los Angeles, California took collective action to advocate for the rights of Deaf children in accessing child abuse prevention and treatment services. The coalition took multiple steps to increase visibility, spread awareness and gain support. Some examples:
- one of the member organizations wrote an article published in a magazine for the Deaf community advocating for the protection of Deaf children.
- A presentation by coalition members was made at a local synagogue that included members of the Deaf community.
- A local social event included a focus on the collective actions of the coalition and how attendees could financially support their efforts.
These activities drew further attention to the collective action being taken and the urgency for change (Embry and Grossman, 2006).
Using communication platforms to mobilize change for persons with diabetic foot ulcers
The collective actions of RNAO, Wound Care Canada and other supporters used public visibility strategies to advocate for diabetes-related foot ulcers care. Read more in this case study.
In 2014, RNAO, Wound Care Canada, and other supporters organized a coalition and advocated for diabetes-related foot ulcers care from the provincial government in Ontario, Canada. The coalition used evidence, political pressure to demand an integrated system of care with universal access to improve health outcomes, including reduced ulcers and amputations and reduced costs for pressure-alleviating devices. Members of the coalition participated in many activities, including:
- attending and participating in stakeholder meetings
- writing a media release and lead article in RNJ
- meeting with members of provincial parliament (MPPs) at RNAO’s annual Queen’s Park Day (Grinspun et al., 2018a)
The result of these advocacy efforts and changes in health outcomes are also described in an RNAO Evidence Booster measuring the impact of offloading devices for people living with diabetes and foot ulcers (https://rnao.ca/bpg/resources/evidence-booster-assessment-and-management-foot-ulcers-people-diabetes).
Using social media to increase public visibility and raise awareness
Social media is used by RNAO regularly to advocate for advancing the rights of Ontarians, including residents of long-term care homes. Read this case study that includes examples of effective social media campaigns advocating for the Nursing home Basic Care Guarantee.
RNAO uses social media campaigns to increase public visibility and raise awareness of issues. One example: RNAO’s call on the Ontario government to mandate recommendations set out in its Nursing Home Basic Care Guarantee. The campaign incorporated the hashtags #LTC #BasicCareGuarantee and #4Hours4Seniors to raise awareness of the staffing crisis in long-term care (LTC) and to encourage the public, health professionals, the government, LTC residents and their families to mobilize change.
As the campaign evolved, so did the visuals and the messaging. The three examples below show the stages of the campaign as it gained attention and momentum – from “good” through “better” to “best.”
RNAO developed an Action Alert (AA) to mobilize collective action to advocate for nursing home residents. The link to the AA, the graphic, the messaging and the hashtag #4Hours4Seniors were all shared on social media to urge others to sign and share the AA. People were also encouraged to use the hashtag to contribute to the dialogue about the LTC crisis.
The social media campaign aimed to support the goal set out in the AA – encourage as many people as possible to add their signatures to urge action from key political leaders.
This is a good example of a social media campaign, incorporating a graphic, supportive messaging, a call-to-action (the link to the AA) and a specific hashtag.
In this example, RNAO staff members are holding signs identifying why #4Hours4Seniors matters to them. The hashtag is used consistently and individual reasons for supporting the cause are illustrated.
This is a better example of a social media campaign – it brings a personal touch to the campaign and allows supporters to share why they want to join the conversation. It also brought life to the hashtag and to the purpose of the campaign.
Image
In this example, RNAO collaborated with F.J. Davey Home in Sudbury, Ontario, Canada to encourage residents to share their “why” for wanting #4Hours4Seniors. Building on the same idea as the “better” example given above, this example truly brought a face to the reason for the campaign in the first place. RNAO shared the photos and quotes from residents on its social media feeds (Instagram, Facebook and Twitter) alongside the hashtag #4Hours4Seniors.
For example, M. Doan, a senior living at the F.J. Davey Home, shared: “I am a very independent person, but my wife on the other hand isn’t and she means the world to me. With four hours of care, it doesn’t need to be rushed. And who wouldn’t want to see her beautiful smile for four hours!" (https://twitter.com/RNAO/status/1336781022780928000).
The photos are powerful as they show a real-life married couple living in a LTC home – two of the many residents RNAO advocated for through its AA and its ongoing call for a Nursing Home Basic Care Guarantee. The posters held by the couple express their personal values of dignity and comfort.
Knowledge-to-Action Framework
Adapting BPG recommendations to a public health context – Insights from Toronto Public Health
Toronto Public Health – a Best Practice Spotlight Organization® (BPSO®) - has adapted several RNAO best practice guidelines (BPGs) to align with a population health approach.
Toronto Public Health – a Best Practice Spotlight Organization® (BPSO®) in Toronto, Canada – has implemented several RNAO best practice guidelines (BPGs), including Woman Abuse: Screening, Identification and Initial Response (2005) and Preventing and Addressing Abuse and Neglect of Older Adults (2014). Because some practice recommendations in these guidelines focus on the individual person or patient level, they didn’t always align with Toronto Public Health’s population health approach.
To adapt recommendations to the public health context, the change team completed a literature review to explore definitions and adapt strategies to align with the model of care delivery and health promotion philosophy.
Another approach that was taken by Toronto Public Health: piloting BPG recommendations within one small program team. The team would then evaluate the implementation until successful, consistent with the Plan-Do-Study-Act approach). Once successful, the intervention was scaled up within the organization to other programs and teams (Timmings et al., 2018).
Adapting BPG recommendations to a Chinese acute care context to reform care delivery– lessons learned from DongZhiMen Hospital
Care practices were revised using adapted evidence-based best practice guidelines in an acute care facility in Beijing, China.
DongZhiMen Hospital – a BPSO in Beijing China – was motivated to reform care delivery through the use of RNAO BPGs. While best practice recommendations provided general guidance, DongZhimen Hospital identified the need to translate these statements into detailed instructions and parameters tailored to their specific hospital context.
To adapt statements to their context, they translated the guideline into Chinese. A multidisciplinary team then worked through the initial steps of the Knowledge-to-Action Framework. This involved:
- reviewing carefully the evidence to thoroughly understand the intent of the recommendations
- conducting a comprehensive gap analysis
- interviewing staff members and others to identify facilitators and barriers to the use of the BPG.
Using this information, the team was able to create specific, clinical nursing practice standards derived from the recommendations and relevant to their context (Hailing and Runxi, 2018).
Facilitating an evidence-based culture at Unity Health Toronto - St. Michael’s Hospital
Unity Health Toronto - St. Michael’s Hospital, a Best Practice Spotlight Organization® (BPSO®) has embedded evidence-based practices into its culture and daily work processes as part of its corporate strategy.
Unity Health Toronto - St. Michael’s Hospital, a Best Practice Spotlight Organization® (BPSO®) in Toronto, Canada, has embedded evidence-based practices into its culture and daily work processes. Evidence-based practice is part of the hospital’s corporate strategy. It has invested resources to build a critical mass (over 30 per cent) of staff members who are best practice champions.
The hospital also provides multiple capacity-building opportunities, including a community of practice, boot camps, booster sessions and mentorship. The annual Nursing Week Gallery Walk, depicted in the image above, is just one way that St. Michael’s Hospital profiles the work of champions and others dedicated to using evidence to inform change initiatives.
SOURCE: Transforming Nursing Through Knowledge, 2018.
Engaging Persons with Lived Experiences
Integrating patient partners in change – Lessons learned from Kidney Health Australia
Kidnney Health Australia case study
In early 2018, Kidney Health Australia (KHA) developed a guideline for managing percutaneous renal biopsies for individuals with chronic kidney disease (Scholes-Robertson et al., 2019). KHA included 40 persons from across Australia with lived experience of chronic kidney disease and their caregivers – “patient partners”. KHA asked patient partners to prioritize which topics were most important to them during a percutaneous renal biopsy.
Patient partners valued: minimizing discomfort and disruption, protecting their kidneys, enabling self-management, and making sure that support for families and caregivers would be available. They indicated that all of this would help alleviate anxiety and avoid undue stress. Their voices were heard, and KHA effectively incorporated these suggestions in guideline development.
Notably, there were marked differences between the priorities identified by the content experts on the guideline development working group, versus what the patient partners perceived to be important to their health and wellbeing, as shown in the table below.
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Topics prioritized by content experts |
Topics prioritized by patient partners |
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