Relevant to: Research, Policy
Sector: Health
Summary: The authors propose a series of actions that can be taken to implement evidence successfully in complex health systems.

In this article, Holmes et al propose a series of six actions – aimed at those responsible for moving knowledgeto-action or those who can influence its movement – that can be taken to implement evidence successfully in complex systems, with a focus on health systems. The authors present four case studies – that can all be characterised as complex systems where no individual or organisation has control but where many have influence – and draw on a workshop where invited colleagues (policymakers, researchers and practitioners with an interest in complexity) critiqued their ideas in preparation for this paper. The six actions proposed are:

Co-produce knowledge – researchers and research users need to be supported to co-create solutions to complex challenges based on the best available contextualised evidence.

Establish shared goals and shared measurements – those who will play a significant role in moving knowledge-to-action need to clearly understand and agree on what needs to be accomplished and how they will know if it is on track.

Enable and support leadership – Continuity in leadership is an important enabler of achieving lasting change.

Ensure adequate resourcing – implementing and sustaining change requires resourcing (funding, tools, expertise and skill sets, time, and leadership) over and above that required for ‘business as usual’ service delivery; it requires focused and intentional effort to use what is available in different ways.

Contribute to the science of knowledge-to-action – it is critical to apply lessons learned across knowledge-to-action initiatives; ideally we will not view initiatives as so constrained by context that we do not see any relevance beyond them.

Be strategic with communication – who needs to do, think, feel and believe what, for an initiative to be successful; it is important to engage with people in ways that are meaningful to them.

The insights offered in this article suggest practical ways forward for driving knowledge-to-action in complex systems. Its main limitation is its focus on health systems, with little discussion on the broader applicability of its findings, although others are likely to find this paper a useful start for such considerations. This paper makes an important contribution toward moving discussion on knowledge-to-action beyond theory to a more practical level.

This annotated bibliography was developed from the following paper:
Holmes, B.J., Best, A., Davies, H., Hunter, D., Kelly, M.P., Marshall, M., Rycroft- Malone, J. (2017) Mobilising knowledge in complex health systems: a call to action, Evidence & Policy, vol 13 no 3, 539–60.