Evidence Informed Decision Making in Public Health: Lessons from a Journey to Build Organizational Capacity

Article type
Authors
Mill C1, Harding J1, Figliano Scott J1, Dhawan A1, Wenger A1, Hummel J1, Gardham B1, Sharma M1
1Toronto Public Health
Abstract
Background:Rapid learning, at an organizational level, includes the timely production of research syntheses for improving internal program planning or decision making. Across Ontario, various public health units, including Toronto Public Health (TPH), contracted The National Collaborating Centre for Methods and Tools (NCMMT) from McMaster University to provide in-depth Evidence Informed Decision Making (EIDM) training. This training focused on using the seven steps for conducting a rapid review with the aim of making decisions on adopting, adapting, or eliminating services or programs.

Objectives:This presentation shares our model for training public health staff and management in EIDM, highlights processes to support training and ongoing skill sustainment, and outlines evaluation findings and lessons learned for others interested in building organizational capacity.

Methods:A multi-faceted approach was used to expose staff to EIDM principles and practices. Staff and management received an online self-assessment activity, 5 days of in-person interactive critical appraisal training, and consolidated their learning by completing a rapid review in teams. To support the training various resources, such as a centralized website, standardized tools and report templates were designed. In addition, regular meetings were held to support the research teams along their journey of completing rapid reviews and a knowledge translation event allowed for the sharing of final results and learnings. An evaluation of the training model revealed areas for improvement.

Results:Between 2017 and 2019, expert consultants from NCCMT trained 33 staff and 12 management, including senior managers. As a result of the training, 13 rapid reviews have been completed. A system has been created to support the rapid and critical appraisal of evidence. The evaluation identified key areas to support organizational capacity building, including: 1) investment in library resources, staffing, and technology; 2) ensure dedicated staff time to complete the training and the reviews; 3) train management to support staff in the process and understand resources required for rapid reviews; 4) Utilize EIDM champions to shift culture; 5) Develop centralized supports (e.g. knowledge broker).

Conclusions:The EIDM journey continues; sustainment efforts are underway to ensure that the EIDM culture is cultivated in the organization. This include integrating EIDM skill sustainment into the annual professional development planners for staff; hosting journal clubs to provide opportunity to practice and maintain critical appraisal skills; creating mentoring opportunities for staff; providing opportunities to complete additional rapid reviews. Continued support from NCCMT staff has been the key to ensuring that staff have support when interpreting or appraising published literature.
Patient or healthcare consumer involvement:Ongoing support of EIDM internally ensures that evidence is leveraged when making programmatic or policy decisions that will impact population health.