Building knowledge integration systems for evidence-informed decisions.
OBJECTIVE
This paper aims to describe methods and models designed to build a comprehensive, integrative framework to guide the research to policy and practice cycle in health care.


METHODS
Current models of science are summarised, identifying specific challenges they create for knowledge to action (KTA). Alternative models for KTA are outlined to illustrate how researchers and decision makers can work together to fit the KTA model to specific problems and contexts. The Canadian experience with the evolving paradigm shift is described, along with recent initiatives to develop platforms and tools that support the new thinking. Recent projects to develop and refine methods for embedded research are described. The paper concludes with a summary of lessons learned and recommendations that will move the KTA field towards an integrated science.


RESULTS
Conceptual models for KTA are advancing, benefiting from advances in team science, development of logic models that address the realities of complex adaptive systems, and new methods to more rapidly deliver knowledge syntheses more useful to decision and policy makers.


CONCLUSIONS
KTA is more likely when co-produced by researchers, practitioners, and policy makers. Closer collaboration requires shifts in thinking about the ways we work, capacity development, and greater learning from practice.


CONCLUSIONS
More powerful ways of thinking about the complexities of knowledge to action are provided, along with examples of tools and priorities drawn from systems thinking.
Best
Allan
A
Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada. allan.best@in-source.ca
Terpstra
Jennifer L
JL
Moor
Gregg
G
Riley
Barbara
B
Norman
Cameron D
CD
Glasgow
Russell E
RE
D002170:Canada; D003657:Decision Making; D055317:Evidence-Based Practice; D017146:Models, Organizational; D011050:Policy Making; D020399:Practice Management; D018511:Systems Integration