How Does TREKK Translate Latest Evidence Into Useful Bedside Tools?

By Leah Crockett

General emergency departments (EDs) treat the majority of acutely ill and injured children in Canada. These EDs are not affiliated with a children’s hospital, and often lack access to the resources and training necessary to provide best possible and consistent levels of emergency care for children.

TREKK, or Translating Emergency Knowledge for Kids, is a knowledge mobilization initiative aimed at transforming the speed that the latest evidence in pediatric emergency care is used in general EDs, whether they be urban, rural, or remote. Through our work, we’ve found the following seven steps essential to effectively translate latest evidence into practical tools for health care professionals working in EDs across Canada and beyond:

Step 1. Establish a baseline need to translate latest evidence

As Patrick explained in his post a few weeks ago, an essential part of developing useful resources is understanding the needs of end users. To that end, TREKK co-director Shannon Scott conducted the first national needs assessment in Canadian EDs to understand the knowledge needs and preferences of both health care professionals (HCPs) and health consumers (HCs). The results informed both the Knowledge Synthesis and Knowledge Mobilization phases of TREKK. Data collection methods included:

• On-site visits to 32 general EDs (TREKK sites) across Canada to collect data via iPad surveys.
• Focus groups with health care professionals at 7 TREKK sites to gather more detailed information on the trends seen in the initial needs assessment.

Step 2. Build relationships

The task of building relationships and engaging network members is intertwined with all the other steps — but it’s critical that this process begin at the start of a project. These relationships and networks help us not only to increase the acceptability and uptake of tools developed at the end stage, but also to identify leading experts (called content advisors) to help develop the tools.

Step 3. Create resources

TREKK’s research librarian and knowledge broker work with the content advisor(s) to develop the evidence repository for a clinical topic area. These reviews are done in a ‘knowledge pyramid’ format, with the most condensed information at the top in the form of a bottom line recommendation (a practical bedside tool to help healthcare professionals diagnose and manage conditions that present to the ED). All topics addressed are based on the initial needs assessment, but can also stem from identified gaps or knowledge needs over time.

Step 4. Feed the feedback loop

All resources are then vetted through the steering committee for approval with rounds of feedback and revision. This is done to ensure the development of quality tools that reflect the knowledge needs of ED physicians in general emergency departments.

Step 5. Disseminate

Once a Bottom Line Recommendation is approved by the Steering Committee, it is ready for dissemination. This occurs via: E-update to TREKK subscribers, tweets, blogs, website promotion, and by email and mail to site reps and other stakeholders.

Step 6. Ensure ongoing feedback & review

The work doesn’t stop there. Content advisors review and update both the evidence repository and Bottom Line Recommendation every two years, or when substantially new evidence emerges. We also welcome feedback from our colleagues across the country who use these resources in their practice.

Step 7. Provide additional supports

Work is further supported within the implementation phase of TREKK. This means not only developing resources, but also enhancing skills through professional development activities, site-based education sessions, simulation training, and the use of latest technology (including telehealth, podcasts and webinars).

Visit the TREKK evidence repository or trekk.ca to learn more.

About the author

Leah Crockett is a Knowledge Translation Coordinator with the George and Fay Yee Centre for Healthcare Innovation (CHI) and the Knowledge Broker for Translating Emergency Knowledge for Kids (TREKK), a national knowledge mobilization network for pediatric emergency medicine.