Alberta Innovates- Health Solutions

In our discussions to date with individuals around the province, some potential directions have been suggested by individuals for a more effective use of research to improve health related outcomes in the province. These suggestions are presented below, not because they have been vetted or assessed against any particular criteria, but simply to give the reader a sense of what some stakeholders are saying. These suggestions were not necessarily offered within the context of a comprehensive approach, and proponents may feel differently when considering the whole field, but the suggestions are presented here as 'food for thought'.

Human Resource Strategies

1. Introduce role of 'Research Brokers' into health system. Well respected practitioners would take on role of trying to influence peers to make decisions based on research knowledge.
2. Create personnel programs which provide the opportunity for researchers or practitioners to spend extended periods (1-3 years?) in another sector. Perhaps include joint appointments between university and government.
3. Increase capacity of senior decision makers in the health system to implement an evidence based, outcomes oriented system approach.
4. Increased training for primary care givers in research and clinical epidemiology.
5. Release time provided for health professionals to enable them to participate in research projects.

Infrastructure

1. Provision of computers to ensure all decision makers have access to a critical tool. The Health Knowledge Network has provided much easier access to bibliographic databases for Albertans. Many applied researchers lack ready access to computers and internet at their place of work or the skills needed to use them.
2. Improve access to provincial administrative databases for approved research centres/projects.
3. Promote the development of an electronic health record which can link patient data with research-generated knowledge.

Research Grants Approaches

1. Special Initiative for Participatory Research Projects that by definition includes practitioners and intended targets (populations? groups? communities?) as part of the process of research.
2. Research Grants Program to support Research Synthesis. (The need for systematic reviews of various topics has been mentioned often by practitioners).
3. Create a research focus on increasing our understanding of how decisions are made in the health system and what the impacts of these decisions are. Also, increase our understanding of the issue of opportunity costs and resource allocation in a world of finite resources.
4. Create a research focus on understanding incentives in the system.
5. Include Dissemination Strategy in grant proposal forms.

Structural / Organizational Approaches

1. Create an applied health research centre sponsored by partners (Government, AHFMR, Regions) to support research needs of delivery system. Perhaps initially fund 100% by Alberta Health and AHFMR, with gradual (10 year?) transfer of ownership to regions.
2. Create multidisciplinary projects and/or units with leadership by researchers and decision makers.

Programmatic/Service Approaches

1. Support program of dissemination grants. Build on dissemination model developed by AHFMR and community partners 1996-1998 in areas of key importance within the Alberta system (e.g. continuing care).
2. Link payment/rewards with desired behavior and evidence based decision making.
3. Maintain a database of annotated critical reviews of effective interventions and dissemination approaches.

System Orientation

1. Work to identify and remove barriers to the utilization of research knowledge.
2. Market the salience/relevance of research approach or evidence based decision making in the system (Contribute to changing culture).
3. Develop a performance measurement system that will tell us how we are doing at using the knowledge we have to produce better health and health system outcomes in Alberta. Introduce feedback as a primary motivator.
4. Hold regular policy forums to bring research knowledge to bear on important policy questions.
5. Allocate an explicit 'research and development' line item on budgets of regional health authorities.