Seniors who are no longer able to manage in the community move into one of the 600+ long-term care (LTC) homes in Ontario. Seniors living in the 75,000 LTC beds in Ontario are cared for by approximately 45,000 staff (full time equivalents (FTEs)). These caregivers provide a range of personal care, nursing, program, support and other services to residents.

By the time seniors make the move to a LTC home, many have multiple, and complex health conditions that require knowledgeable and well trained staff. This poses a tremendous challenge for the leadership group in LTC as approximately 80% of their total staff complement is unregulated staff.

Leaders in the LTC and community care sectors agree that existing funding models make staff training a challenge. Leaders in these sectors have had to find innovative and creative ways of dealing with this. One of the solutions that they and the Ministry of Health and Long-Term Care promote in order to help caregivers provide evidence based, or informed care is to encourage staff to participate in knowledge exchange activities.

The Seniors Health Research Transfer Network (SHRTN) was created in 2005 through a grant from the Ministry of Health and Long-Term Care to help facilitate knowledge exchange and transfer in Ontario.

Knowledge exchange is the mutual sharing of research and data knowledge (i.e. explicit knowledge) and/or of practice and experience based knowledge (i.e. tacit knowledge) for the purpose of improving practice. Knowledge exchange can take place face-to-face, over the telephone, or online in real-time, or it can take place by capturing and sharing stories.  The sharing of evidence via knowledge exchange is an important contributor to the success of knowledge transfer.

Knowledge transfer is the process of moving knowledge into practice. This process is successful when research and practice-based evidence is clear and relevant, the context shares the characteristics of a learning organization, and facilitation mechanisms are appropriate to the needs of the community of practice members” ³

What is SHRTN?

SHRTN is a knowledge exchange network that links paid and unpaid caregivers with researchers and policy makers with the goal of providing evidence based health care services to seniors in Ontario.

SHRTN facilitates knowledge exchange through four main pillars:

1.      SUPPORTING SHRTN MEMBERS IN COMMUNITIES OF PRACTICE (CoPs)

A Community of Practice (CoP) is a community or group of people who have made a commitment to be available to each other, offer support to share learning, and to consciously develop new knowledge. A CoP makes the intentional commitment to advance the field of practice and to share those discoveries with anyone engaged in similar work.⁴

In SHRTN, a Community of Practice is a group of people who come together to exchange information and knowledge on a specific topic related to seniors’ health and health care.

SHRTN CoP members include paid and unpaid caregivers, researchers, policy-makers, educators, specialist librarians and others who are interested in the topic.

SHRTN support for CoP members includes the support of a SHRTN a knowledge broker and an information specialist, access to technology that facilitates working together (such as on-line collaboration tools, video conferencing and e-meeting tools, toll-free teleconference lines), as well as seed funding and an Annual Assembly.

In May 2008, the SHRTN Board of Directors approved support for a total of 19 communities of practice.  Table 1 lists the 19 CoP topics for the fiscal year of April 1/08 – March 31/09. Visit www.SHRTN.on.ca Communities of Practice for more details on our CoP activities, membership, resources and other links.

2.      SHRTN LIBRARY SERVICE

In order to provide evidence-based or informed care, caregivers need to have access to the evidence. In Ontario, any caregiver who works with seniors can access evidence through the SHRTN Library Service. This important free service is coordinated by a trained librarian and four seniors’ health information specialists working out of partner library sites situated in Ottawa, Guelph, Toronto and Hamilton.

SHRTN Information Specialists provide free and easy access to evidence and tailor made tools to help paid caregivers deliver evidence-informed care. Services include the traditional library services such as literature searches, document delivery, and reference services, as well as specially tailored services such as outreach, education, current awareness, and information tools developed to meet specific needs of caregivers working with seniors.

3.      COORDINATING LEADERS

The Canadian Health Services Research Foundation (CHSRF) research has shown that in order to successfully change health care practices, strategies have to be developed to work at the system level as well as at the care delivery site.

In order to heed the advice of CHSRF, SHRTN involves key SHRTN stakeholders on both a provincial Board of Directors and in Local Health Integration Network (LHIN) based Local Implementation Teams.

Board of Directors

On June 6, 2008, a new Board of Directors was convened. The main function of the SHRTN Board of Directors is to develop and support the SHRTN vision, mission and guiding principles. The Board provides strategic direction and oversees progress of the budget and action plan, evaluates funding proposals, approves the annual evaluation plan and facilitates relationships with stakeholders.

Catherine Brookman (Ontario Community Support Association) and Dr. Larry W. Chambers (Élisabeth Bruyère Research Institute) were selected as Board Co-chairs. The other 13 voting members of the Board represent geographic regions of the province, caregivers in long-term care and community care, policy-makers, researchers, educators, librarians, seniors and SHRTN Communities of Practice. Visit SHRTN.on.ca for a full list of SHRTN Board members.

Local Implementation Teams

SHRTN Local Implementation Teams bring together leaders in geographic areas to provide advice, guidance and oversight to SHRTN initiatives and help implement SHRTN initiatives locally. These teams are aligned with the Local Health Integration Network (LHIN) boundaries. To date, we have established SHRTN Local Implementation Teams in Waterloo Wellington; Hamilton Niagara Haldimand Brant; Mississauga Halton / Central West; and Champlain.  As we continue to grow and expand, we will create new teams in the remaining nine LHINs.

4.      COLLABORATNG ON SENIORS HEALTH RESEARCH

The Ontario Research Coalition (ORC) brings together research institutes and centres from across Ontario that are involved in conducting research on seniors health. The ORC was created in August 2007 to increase research capacity by supporting early researchers, fund collaborative seed projects, determine priority topics and research gaps, and to hold an annual research symposium.

How do we know if SHRTN helps improve health care for Seniors?

Every year we work with a team of evaluators who help us document lessons learned, make course corrections and to better understand the impact of the work we do. They have developed the SHRTN Knowledge Exchange Network Evaluation Model (based on the PARiHS ⁵ model). To date, two journal articles have been published by the SHRTN Evaluators ⁶ and they have written several evaluation reports to document their findings.

How is SHRTN funded?

The Ministry of Health and Long Term Care funds SHRTN funds SHRTN through a grant, and  SHRTN partners provide significant in-kind contributions. The current MOHLTC grant (2007-2010, valued at approximately $3.6 million, includes funding for the knowledge exchange network, the ORC and the Alzheimer Knowledge Exchange (AKE) and other special projects such as the Quality in LTC Summits.

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