Building management capacity for evidence use in health care organizations

Health care organizations face challenges using evidence to inform program management decisions. A number of factors influence the use of evidence by program managers, including: individual skills, organizational context, organizational culture and decision-making processes. While it is recognized that health care organizations require strategies to promote the use of evidence in program planning, implementation and evaluation, there is a paucity of research on ways to achieve this. The purpose of this thesis is to critically examine the use of evidence in planning, implementing and evaluating programs within health care organizations. It contains a series of four papers that collectively explore the use of evidence to inform program management decisions.;The first paper is a review synthesizing the literature on barriers and facilitators to evidence-informed decision-making experienced by decision-makers at the program level within health care organizations. The second paper provides an overview of a collaborative initiative between two Canadian health care organizations and a University partner to build organizational capacity for evidence-use in program planning, implementation and evaluation. The third paper explores the use of evidence to inform decisions in two programs in two different health care organizations through a participatory action research project. Research methods include: documentation review, key informant interviews and focus groups. The opportunity to examine the use of evidence in health care organizations through this partnership initiative provide insight into strategies to build organizational capacity to use evidence to inform management decision-making. The fourth paper presents the development of a model to support evidence use in program management within health care organizations. Through a review of theoretical and empirical research on evidence-use by decision-makers at the program level in health care organizations a model illustrating the organizational resources, tools and supports needed to support the use of evidence in program development, implementation and evaluation is developed. The model builds on and enhances the knowledge to action process by overlaying the organizational tools, resources and supports that are required to operationalize the knowledge to action process at the program management level within health care organizations.