However, owing to methodological limitations, we cannot conclude that the KB interventions performed by Ward et al. [43], Lyons et al. [42], Waqa et al. [32], and Yost et al. [48, 49] were responsible for the reported changes to participants’ knowledge (Additional file 4). A second framework adopted in relation to KBs2,6,14 is the Promoting Action on Research Implementation in Health Services (PARiHS) framework (Figure 2), which describes the determinants or influences of KT. Its authors purport that for successful research implementation to occur, facilitation strategies must be selected on the basis of the nature of the evidence and the characteristics of the context.26 This framework is a logical fit for knowledge brokering as it relies on a human-driven facilitation process.
Burt (1992) was among the first to use the term knowledge brokering to describe what an entrepreneur does to network individuals with complementary resources or information. In this context, this individual built social capital from developing benefit-rich networks and a reliable flow of useful information, thus providing individuals or organizations with a competitive advantage in market transactions. The purpose of this special interest article is to propose a new model of the knowledge brokering role in health care by outlining the role domains of KBs drawn from the literature. The article begins with a discussion about how KT theory can provide insight into knowledge brokering, followed by an introduction to the model. Examples from the real-world experiences of 2 KBs (the authors) are then used to demonstrate its application.
Optimally, this assessment should be conducted face-to-face, although the telephone can be used when resources are limited. Early one-to-one contact was instrumental in facilitating the development of the KB/participant relationship, and in essence, set the stage for all activities to follow. For example, the one-third of participants in the RCT who had very early contact with the KB appeared to become more engaged in the EIDM process, and utilized the KB services to a greater extent than those who did not ‘meet’ the KB until later in the study. There did not appear to be any differences between those who engaged early with the KB and those who didn’t on their level of capacity for EIDM. Not every participant responded to KB communication right away, meaning some did not meet the KB until two to three months following initiation of the intervention. The in-depth assessments also allowed for tailoring of the KB services over the full duration of the study by identifying at baseline the knowledge, skill, resource, support, and organizational change needs among the public health decision makers.
Concerns about the delay between discovery and evaluation of new interventions and their routine incorporation into practice have been particularly pronounced in healthcare, resulting in international efforts to understand and close this ‘translational gap’ (Curran et al, 2008; Swan et al, 2010). The Oxford English Dictionary defines brokers as middlemen, intermediaries or agents who act as negotiators, interpreters, messengers or commissioners between different merchants or individuals (OED online). Brokers traditionally favour neither individual but instead act as go-betweens, serving the needs of both. For our purposes the role of brokers is to make research and practice more accessible to each other.
In New Zealand, Gluckman has promoted the knowledge broker as someone who helpfully translates but does not advocate, and plays a central role in a ‘science advisory ecosystem’ populated by science (not policy) institutions and actors. This particular type of brokerage role is expected to ‘enhanc[e] the uptake of scientifically developed knowledge into public policy’ (Gluckman, 2017c, p. 11). Early examples of brokering include an informal network of ties that connected the German synthetic dye industry to academic partners in the late 1800s (Lomas 2007) and the use of “county agents” to diffuse innovations to farmers in the USA (Rogers 2003).
The SNA provides important insights into the development of this network over time, demonstrating that over the 12-month period the network became more cohesive and dense, suggesting that the knowledge broker was successful at facilitating new relationships between scientists and decision-makers within their network. Indeed, strong social networks such as those facilitated by the knowledge broker have been shown to improve collaborative governance processes by facilitating the generation, acquisition, and diffusion of different types of knowledge and information. Dedicated, professional knowledge brokers have been promoted as a promising means of enabling exchange across fields and breaking down institutional boundaries to foster collaboration. However, our Bourdieusian analysis of professional knowledge-broker roles suggests that without capital endowments that are valued in both fields, their efforts to engender change in either can be futile. For professional knowledge brokers to be able to succeed, the capital-exchange systems of the fields they will act in should be taken into account, and individuals with capitals that give them legitimacy and the power to act in those fields should be sought. Whilst knowledge brokering has been championed as a mechanism for transferring research evidence into policy and practice, it is not without its challenges.
As such, defining our role is important to make sure that our work targets the needs, expectations and goals of both our stakeholders and ourselves. These tasks involve using facilitation techniques — although knowledge brokers themselves may not be involved or be able to provide expertise, their role is in bringing the right people together. Using the findings from these 22 studies, Bornbaum and colleagues provide a list of the knowledge broker tasks described in these studies, and link them to the 3 domains of (1) knowledge management, (2) linkage & exchange, and (3) capacity-building in this table. In the example, the knowledge broker identified resources, processes, outcomes, and impacts with timelines early in the project. It was important to define knowledge utilization outcomes early in the process as well (LaFrance, Nichols, & Kirkhart, 2012).
They provide services that focus on promoting prenatal, newborn, and parent health, as well as health promotion within schools and worksites, nutritional counselling, physical activity promotion, injury prevention, development of community strengths to promote and improve health, and the promotion of healthy environments [49]. All provinces and territories in Canada have recommendations in place requiring public health departments to develop and implement strategies to promote healthy body weight in children. Despite these recommendations there is limited capacity (i.e., time, skill, access) among public health decision makers and limited resources to utilize the best available research evidence with which to plan and implement effective healthy body weight programs and services. From the outset, the broker role was created by ECan to change the way science was used in policy and to set resource limits. While it appeared relatively straightforward to shift from a knowledge arbiter to a knowledge broker, the role involved our participants in the on-going drawing of boundaries to distribute authority, roles and responsibilities in efforts to retain their credibility, having taken on roles so closely involved with policy (Duncan, 2013b, 2017). ZC decisions shaped and were shaped by the technical work and the boundary work of brokers who grappled with the provisions of the CWMS, the values of the people sitting around the ZC table, the wider institutional and political environment within which limit-setting was occurring and the inevitable uncertainties.
To achieve this, knowledge brokers build and sustain productive working relationships with a range of stakeholders, be they individuals or organisations, to understand their existing knowledge base and capacity for evidence-based decision-making and to subsequently help build these. In turn, knowledge brokers must also have the ability to interpret and frame stakeholder needs and then communicate those to the research community. Finally, for knowledge brokers to act efficiently business broker definition it is widely believed that they must possess superior interpersonal, communication, and motivational skills. According to the aims of individual researchers and users, knowledge brokering can fall into one of three types – information management, linkage and exchange and capacity development. However, the boundaries between these are often blurred and many brokering projects combine elements of all three types to meet the needs of researchers and decision makers.
These have been touched on in previous sections and include the time and resources needed for effective brokering, the range of skills that brokering requires and the lack of evidence about the effectiveness of knowledge brokering. Similarly, some have questioned the appropriateness of using empirical designs to evaluate the effectiveness of KT strategies (e.g. knowledge brokering) [46]. Of particular concern is the inability to account for all differences (e.g. personal, organizational) between participant sites. This measurement limitation arises from the real-world context in which KBs operate and poses interpretive challenges as it often remains unclear as to whether an observed outcome represents the true impact of the KB (i.e. treatment effect) or of some other factor. Further, differences in personal and organizational factors may moderate or conceal the effect of a KB intervention.
Team members knew, for instance, that the company would need to learn how to launch low-volume, superpremium brands. The low volumes meant that the company’s senior executives wouldn’t approve large advertising budgets. Ultimately, the team sought lessons from managers in companies—including small consumer goods organizations, such as the UK-based smoothie-maker innocent drinks, and global giants, like P&G—that excel at launching new brands through viral marketing. Over the past decade, open innovation has begun transforming the way global companies develop new products, as executives increasingly recognize the benefits of exposing internal R&D to outside ideas.
The British Columbia (BC) Physical Therapy KB position is structured to bridge research, clinical and policy realms with equal funding and direction from a university department, the research institutes of 2 local health authorities and the discipline’s professional association. This KB is considered external to the groups with whom she liaises, in that her work spans across the multiple clinical and research sites within her portfolio. However, her background as a clinical physical therapist reflects a peer association with clinicians, as well as offers knowledge of the professional context in which she brokers knowledge. Contextual knowledge of the individual health care settings in which she works is acquired through previous clinical experience, experiential learning, and exploratory discussions with key stakeholders in all settings (clinical, research, and education). In contrast, the Sunny Hill Health Centre for Children (SHHC) KB initiative, supported by the onsite Child Development and Rehabilitation Evidence Centre, engages clinicians as KBs within a pediatric health center to support EIP within their interprofessional teams or discipline groups.
The article provides specific examples of how we have applied these roles to our own work as knowledge brokers in British Columbia. Note that some KBs may function mostly in one of these role domains, while others may cross all five categories. As knowledge brokers (KBs), we often get submerged in a sea of detail and pulled in multiple directions by the different groups we work with.
This approach included the identification and critical evaluation of existing knowledge-brokering models that led to the clarification and refinement of an innovative model. While third parties such as business schools, consultancies, and other organizations with extensive networks can play a role in helping companies find knowledge brokers, many good sources are available through a team’s existing professional networks. Most experts, we find, happily share their experiences free of charge, since they too benefit from the interactions. Further, we find that most managers simply enjoy the experience of sharing their stories and helping to develop new approaches. Such companies have resorted to a practice called knowledge brokering, a systematic approach to seeking external ideas from people in a variety of industries, disciplines, and contexts and then of combining the resulting lessons in new ways.
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