Development of an Australian practice-based research network as a community of practice

Outcomes of co-designed communities of practice that support members to address public health issues

Communities of practice are commonly used to support members in responding to public health issues. This study evaluated the outcomes of five co-designed communities of practice to determine if members' expectations were met, if knowledge sharing between members extended to knowledge translation, and if that supported members in addressing public health issues. Data were collected through an initial needs assessment, observations were made during community of practice sessions over 1 year, and qualitative interviews were conducted at the end of that year. The findings provided evidence that members' expectations were met, knowledge sharing took place within the communities of practice, and personal benefits gained supported members in advancing knowledge sharing with other members to knowledge translation outside their community of practice. Results demonstrate three outcomes of knowledge translation for members: disseminating knowledge to others, applying knowledge to make small-scale changes in practice and leveraging the knowledge to expand its reach beyond members' organizations. While the scale and speed of expanding outcomes were below initial expectations as indicated in the initial needs assessments, members remained optimistic about achieving larger-scale impacts in the future. This study showed that communities of practice achieve gradual progress rather than quick wins. Co-design supports the facilitators in meeting members' needs, which can positively contribute to members sharing knowledge and translating that knowledge to support their practice to address public health issues.

A community pharmacy practice-based research network: A protocol for a realist evaluation

BACKGROUND

Community pharmacists' active participation in research is essential to build a robust, translatable evidence base. Practice-based research networks (PBRNs) have been established to support collaborative research and knowledge translation in community pharmacies. However, PBRNs' effectiveness in supporting research engagement and knowledge translation remains unexplored. A new PBRN will be implemented in southeast Queensland, Australia. This realist evaluation seeks to explain whether, how, why, for whom, in what context and over what duration the PBRN supports community pharmacists to engage in research.

OBJECTIVES

1. to generate transferable knowledge about the different circumstances in which-and the mechanisms by which-a PBRN influences research engagement outcomes for different community pharmacists, in the form of a program theory. 2. To use the program theory to develop evidence-informed recommendations for use by PBRN stakeholders.

METHODS

A realist evaluation will be conducted in four iterative phases: (1) theory development, (2) hypothesis generation, (3) observations, and (4) theory refinement. A two-year multi-method study will be conducted, including interviews with pharmacists, surveys, participatory and observational data collection. The evidence will be used to confirm, refute, and/or refine the program theory. The evaluation will adhere to the Realist And Meta-Narrative Evidence Synthesis (RAMESES) publication and quality standards.

CONCLUSIONS

The evaluation will contribute to the body of knowledge by generating a realist program theory to explain how, why, for whom, in what contexts, to what extent, in what respects, and over what duration the PBRN supports community pharmacists to engage in research. The findings will support the broader implementation of PBRNs and future network activities.

A valuable approach to the use of electronic medical data in primary care research: Panning for gold

Background:

Electronic medical data (EMD) from electronic health records of general practice computer systems have enormous research potential, yet many variables are unreliable.

Objective:

The aim of this study was to compare selected data variables from general practice EMD with a reliable, representative national dataset (Bettering the Evaluation and Care of Health (BEACH)) in order to validate their use for primary care research.

Method:

EMD variables were compared with encounter data from the nationally representative BEACH program using χ2 tests and robust 95% confidence intervals to test their validity (measure what they reportedly measure). The variables focused on for this study were patient age, sex, smoking status and medications prescribed at the visit.

Results:

The EMD sample from six general practices in the Illawarra region of New South Wales, Australia, yielded data on 196,515 patient encounters. Details of 90,553 encounters were recorded in the 2013 BEACH dataset from 924 general practitioners. No significant differences in patient age ( p = 0.36) or sex ( p = 0.39) were found. EMD had a lower rate of current smokers and higher average scripts per visit, but similar prescribing distribution patterns.

Conclusion:

Validating EMD variables offers avenues for improving primary care delivery and measuring outcomes of care to inform clinical practice and health policy.