||Cammer, A., Morgan, D., Stewart, N., McGilton, K., Rycroft-Malone, J., Dopson, S., & Estabrooks, C. (2013). The hidden complexity of long-term care: How context mediates knowledge translation and use of best practices. The Gerontologist, gnt068.
||The hidden complexity of long-term care: How context mediates knowledge translation and use of best practices
||Medical care is often thought of as an exchange between client and provider, and context is seen as irrelevant to the equation. However, research has shown that context impacts the knowledge translation (KT) of healthcare practices. Little research has focused on the care of older adults. The present study examines the ways in which organizational context impacts knowledge translation in longterm care (LTC) facilities. The study involved a qualitative case study of a facility in Canada, and data included document review, direct observation of daily care practices, and interviews with direct care, allied provider, and administrative staff. The researchers found that eight contextual factors contributed to knowledge translation in the LTC: physical environment, resources, ambiguity, flux, relationships, and philosophies. The effects of these contextual factors were mediated by two other factors: experience and confidence, and leadership and mentorship. Several factors were related to poorer knowledge translation: inappropriate physical environments, inadequate resources, ambiguous situations, continual change, multiple relationships, and contradictory philosophies. Understanding the complexities behind the LTC context can improve knowledge translation and increase the use of best practices in these settings.
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