Appendix 5:
Knowledge Transfer

Three related papers by Rushmer et al explore the ways in which the principles of Learning Organizations could be applied in Primary Care settings at the point of service delivery. The first article draws upon both theoretical concepts and empirical research into Learning Organizations in healthcare settings. It introduces the notion of the Learning Practice (LP). Characteristics of LPs include flatter team-based structures that prioritize learning and empowered change, involve staff, and are open to suggestions and innovation. Potential benefits include: timely changes in service provision that are realistic, acceptable, sustainable, and owned at practitioner level; smoother interprofessional working; and fast flowing informal communication backed up by records of key decisions to facilitate permanent learning. Critical comment on potential pitfalls and practical difficulties highlights features of the present system that hinder development: tightly defined roles; political behaviours and individual-oriented support systems; plus the difficulties involved in tolerating errors while people learn (Rushmer, Kelly et al. 2004). The second paper explores the ways in which the principles of Learning Organizations could be applied at the point of service delivery. A distinction is made between individual, collective and organizational learning. Attention is given to the routines that can be established within the practice to make learning systematically an integral part of what the practice does (Rushmer, Kelly et al. 2004). The third paper reviews contextual factors that either play a key role in facilitating or acting as barriers to a learning culture. Core contextual conditions are identified as, first, the requirement for strong and visionary leadership. The second core condition is the involvement and empowerment of staff where changes grow from willing participation. The third prerequisite is the setting-aside of times and places for learning and reflection (Rushmer, Kelly et al. 2004).

Knowledge transfer is complex in and of itself, and in the case of continuity-of-care innovations this complexity is compounded by the need to simultaneously target multiple sectors, settings, agencies, and providers. Although there are a number of knowledge transfer theories/models, their uses in guiding implementation activities is not yet commonplace. The authors briefly review some of the theories/models that could have relevance for implementing continuity-of-care innovations in both research and practice. They highlight in greater detail the Ottawa Model of Research Use, which they have found to be a useful conceptual framework for guiding the implementation of continuity-of-care innovations that require major practice or organizational changes (Graham and Logan 2004).

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• The Patient as Central in Healthcare
• Family Physicians & Primary Care
• The Toolkit
• The Canadian Medical Home
• Other Resources
• Appendix 1: Provincial Chapters / Colleges of Family Physicians
• Appendix 2: Provincial Medical Associations
• Appendix 3: Primary Care within Provincial Ministries of Health
• Appendix 4: Privacy Legislation
• Appendix 5: Knowledge Transfer
• Appendix 6: Change Management
• Appendix 7: Presentations Related to Primary Care Meetings
• Appendix 8: Presentations Related to Promotion and Dissemination of Primary Care Toolkit
• Appendix 9: Key Principles and Values for Family Physicians in Primary Care Model Development