Applying the phases of the Knowledge-to-Action Framework

Knowledge- to Action

Using the KTA Framework, let’s look at how it can be applied to the implementation of Home Health Monitoring (HHM) for seniors who have an obstructive pulmonary disease (Lee & Ho, 2019).

Home Health Monitoring (HHM) for senior adults

Scenario

The promise of Home Health Monitoring (HHM) for Chronic Obstructive Pulmonary Disease (COPD) is to: improve self-management by the person; reduce health-care system expenses; and establish potential use of data algorithms to predict episodes of exacerbation. The KTA Framework can be applied to guide HHM uptake so that enough skills and resources are harnessed to transfer knowledge across the various research and decision-making cultures within the organization.

In the table below, all of the KTA Framework Action Cycle phases are listed. The right-hand column illustrates how each action cycle phase can be applied to the implementation of HHM for seniors who have COPD (Lee & Ho, 2019).

KTA Framework Action Cycle Phase Applying the Action Cycle phases of the KTA Framework
Identify the problem
  • The change team, along with relevant stakeholders, identified several problems that could be addressed:
    1. There is an increased demand for health-care resources because the population is aging.
    2. Patients with chronic diseases are vulnerable to frequent hospitalizations and emergency department visits.
  • The change team and stakeholders found emerging evidence that suggests HHM as a promising approach to improving these patients’ quality of life and reducing the need for re-hospitalizations.
Adapt knowledge to local context
  • The change team conducted site visits of emergency departments and hospital wards. They built rapport and trust with site leads in preparation for implementing HHM.
  • They also set up a steering committee that included different stakeholders as members to help with identifying strategies to implement HHM in their local context.
Assess barriers and facilitators
  • The change team, working with the steering committee, identified facilitators for the intervention: for example, a user-friendly and internet-enabled feature of HHM which allows patients to conveniently self-monitor their symptoms and send data to a secure server.
  • They also identified barriers, including: potential resistance among health providers to offer this HHM option to their patients; and possible lack of digital literacy among patients and health-care providers.
Select, tailor, and implement interventions
  • The change team selected and tailored strategies that would help minimize barriers. For example, they: designed processes to make sure that each patient can access help to learn how to use the HHM; trained health providers on the benefits and use of HHM; sought input from health providers and patients; and made sure to incorporate input is incorporated in the implementation stages
Monitor knowledge use
  • When HHM approaches were put into use, the change team monitored how they were implemented and noted any required local adaptations. The change team also reviewed how these adaptations affected intended and unintended consequences.
  • The change team fed these findings back regularly to the steering committee to improve the implementation of HHM.
Evaluate outcomes
  • Data repositories collected from HHM users could be used to provide comparative scorecards. Such scorecards could be used to compare internal and external benchmarks to find effective healthcare improvement strategies.
Sustain knowledge use
  • HHM became part of routine health practice in healthcare organizations. The change team developed protocols for institutional communication and other stakeholder needs to educate staff and patients on the benefits and use of HHM.

Don’t worry if your implementation plans do not include all of the Action Cycle phases of the KTA Framework. To learn more about the framework and its phases, see  Knowledge-to-Action Framework