COVID-19: investing in country capacity to bridge science, policy and action

Production and use of rapid responses during the COVID-19 pandemic in Quebec (Canada): perspectives from evidence synthesis producers and decision makers

BACKGROUND

The COVID-19 pandemic has required evidence to be made available more rapidly than usual, in order to meet the needs of decision makers in a timely manner. These exceptional circumstances have caused significant challenges for organizations and teams responsible for evidence synthesis. They had to adapt to provide rapid responses to support decision-making. This study aimed to document (1) the challenges and adaptations made to produce rapid responses during the pandemic, (2) their perceived usefulness, reported use and factors influencing their use and (3) the methodological adaptations made to produce rapid responses.

METHODS

A qualitative study was conducted in 2021 with eight organizations in the health and social services system in Quebec (Canada), including three institutes with a provincial mandate. Data collection included focus groups (n = 9 groups in 8 organizations with 64 participants), interviews with decision makers (n = 12), and a document analysis of COVID-19 rapid responses (n = 128). A thematic analysis of qualitative data (objectives 1 and 2) and a descriptive analysis of documents (objective 3) were conducted.

RESULTS

The results highlight the teams and organizations' agility to deal with the many challenges encountered during the pandemic (e.g., increased their workloads, adoption of new technological tools or work processes, improved collaboration, development of scientific monitoring, adaptation of evidence synthesis methodologies and products). The challenge of balancing rigor and speed was reported by teams and organizations. When available at the right time, rapid responses have been reported as a useful tool for informing or justifying decisions in a context of uncertainty. Several factors that may influence their use were identified (e.g., clearly identify needs, interactions with producers, perceived rigor and credibility, precise and feasible recommendations). Certain trends in the methodological approaches used to speed up the evidence synthesis process were identified.

CONCLUSIONS

This study documented rapid responses producers' experiences during the COVID-19 pandemic in Quebec, and decision makers who requested, consulted, or used these products. Potential areas of improvements are identified such as reinforce coordination, improve communication loops, clarify guidelines or methodological benchmarks, and enhance utility of rapid response products for decision makers.

Routinizing the Use of Evidence in Policy - What Is Needed? Comment on "Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis"

In their study of sustaining knowledge translation (KT) practices, Borst et al found that this process is an interplay of: (i) constructing and extending networks, (ii) creating contexts that support KT practices, and (iii) understanding how actors create, maintain, and disrupt institutions. Their article is an important contribution to the body of research promoting KT. In this commentary we reflect on the convergences and differences between the concepts of 'sustaining' and 'institutionalizing' KT, highlighting domains and processes related to the institutionalization, providing an analysis of KT landscape in Brazil and making a case for the need to increase countries' routine use of evidence.

Enabling evidence to tackle everyday diseases to mitigate another pandemic

The next emergent novel pathogen is likely to occur where the ability to undertake health research and collect life-saving data is lacking. Without embedded and ongoing research activities in place spotting and stopping a new threat is not possible, thereby enabling undetected infection and unchecked transmission within a community. Without local existing capabilities to collect such data delay is catastrophic. Fundamental goals in pandemic preparedness should be to stop an outbreak before it becomes a pandemic. This requires immediate action from teams already in place with the right skills, this could be readily achieved if we shift our thinking and enable research capabilities to be present in every healthcare setting. Addressing fundamental gaps in health research capacity and equity could tackle this and then we would be better prepared, globally.

How COVID-19 affects the use of evidence informed policymaking among iranian health policymakers and managers

BACKGROUND

The COVID-19 pandemic increased the need for new valid scientific evidence to support urgent clinical and policy decision making; as well as improved processes for the rapid synthesis, uptake and application of that evidence. Evidence informed policymaking (EIPM) can be considered as a way to access and use the results of evidence in practice. This study aimed to determine what effects COVID-19 had on the way Iranian health managers and policymakers use evidence in their decisions.

METHODS

This study was conducted in 2021 applying a qualitative research design. Data was collected through semi-structured interviews. Thirty health care managers, policy makers and medical university faculty members were recruited as the study participants, initially via a purposive sample, followed by snowballing. A conventional content analysis presented by Hsieh and Shannon (2005) was applied for data analysis.

RESULTS

Ten main themes emerged from the data including: 1) roles and duties of knowledge brokers (KBs); 2-5) the roles, benefits, barriers and necessities of applying Knowledge Translation Exchange (KTE) tools; 6-8) the facilitators, benefits and barriers to the application of evidence during COVID-19; 9) challenges of rapid evidence production evidence during COVID-19 and 10) consequences of not applying evidence during COVID-19. According to the present conceptual framework, KBs act as an intermediator between the large amounts of knowledge produced and decision makers. KTE tools should be applied to enhance EIPM during COVID-19. Attention should be paid to the facilitators, barriers, benefits and necessities of evidence application during COVID-19 to avoid negative consequences for the health system.

CONCLUSIONS

Results of this study show that developing KTE tools and activating KBs can be among the main strategies to produce applied actionable messages for policymakers to move toward EIPM; and that this applies even when rapid decision making is required, such as during the COVID-19 pandemic. It is strongly recommended to reinforce the local capacities through supporting scientific networks and relationships between research centers and local and national policymakers. At the same time, attention to local barriers to and facilitators of the application of evidence while facing a pandemic can pave the way to better identification of health system`s problems and rapid responses.

A micro credential for interoperability

In the midst of a global pandemic the need for health and social care providers to commit to, and deliver on, integrated patient-centered care services has been accelerated. Globally, health and social care programme administrators are turning to digital devices and applications to provide supporting infrastructure which can offer safe access to health information at the point of care. Digitalisation is increasingly considered a key requirement to support diagnostics and therapeutic care services in health care delivery. The open source community are responding to this need to advance integrated care and digital services by providing targeted resources to address the interoperability challenge. Addressing interoperability in health systems is a core part of achieving sustainable enterprise wide integrated care. Using Open Innovation 2.0 methods for advancing knowledge on interoperability, this paper describes the development of a micro credential for knowledge transfer on interoperability created by the Centre for eIntegrated Care (CeIC). Designed and developed to signpost interested stakeholders to targeted material and build understanding and capacity on the topic. The design approach and initial resource content are explained through the lens of a specific research project funded by an Elite S Fellowship to advance leadership and standardisation for Information and Communications Technology (ICT) in Europe.