1Making Stone Soup: Building Organizational Capacity for Health Research & Knowledge Exchange in the BC Ministry of Health Services Victoria Schuckel Presentation at the Nexus Spring Institute April 17, 2009 2Presentation Overview ƒ 1. Health policy context ƒ 2. Case study of a policy research initiative regarding women with mental illness ƒ 3. Current activities to build knowledge transfer & exchange capacity in the Ministry ƒ 4. Suggestions for effective research exchange with the ministries of health 3 41. Health Policy Context „ Government Direction ƒ Throne and Budget Speeches ƒ Government and Ministry Service Plans „ Ministry Scope and Complexity „ Policy Research Challenges 5MoHS Service Plan Excerpt „ Goal 1: High quality patient care „ Goal 2:A Sustainable, Affordable, Publicly Funded Health System „ Objective1.1: Timely access to appropriate health services by the appropriate provider in the appropriate setting 6Ministry Scope „ Governance „ Policy „ Legislation and Professional Regulation „ Funding „ Negotiations „ Direct management of some programs: physician payments, PharmaCare, BC Vital Statistics, BC HealthGuide, etc. 7Ministry Complexity ƒ Importance of health to the public ƒ Keen media interest in health stories ƒ Sheer volume and scope of activity underway ƒ Multiple stakeholders and interests affected by any proposed changes 8… The evidence base for a decision is the multiple forms of evidence combined to balance rigour with expedience—while privileging the former over the latter. Jonathan Lomas, CHSRF, 2005 92. Case Study: Policy Initiative for Women with Mental Illness „ Windows of policy opportunity sometimes open „ Stakeholders don’t always agree with each other „ Sometimes it’s the questions that bring people together „ Evidence is often variable and contested „ People who can span disciplines or sectors are invaluable „ The world is constantly changing 10 Diverse Stakeholders „ Women who use have used mental health services „ Consumer organizations „ Service Providers across various sectors „ Researchers „ Family Members „ Women-serving agencies „ Mental health and women’s health advocacy organizations „ Government organizations 11 Questions to Bring People Together „ What do women who have used the public mental health system regard as its strengths and weaknesses? „ Women use mental health services differently than men Why? Is this a good or a bad thing? „ What support exists for families where the mother has mental illness? „ How do drugs impact parenting and attachment? 12 Questions to Bring People Together „ How accessible are mainstream women serving agencies to women with mental illness? Can they access sexual assault services? Can they access transition houses for domestic violence? Could/should hospitals provide any support to patients who have histories of trauma? „ How does biology impact the aetiology, timing or prognosis of different kinds of mental illness? How does gender impact the experience of mental illness? 13 Funded Activities „ “Hearing Women’s Voices: Mental Health Care For Women”, BCCEWH (Provincial participatory action research project) „ “Demonstrating Progress: Innovations in Women’s Mental Health”, BCCEWH „ “Violence and Trauma in the Lives of Women with Serious Mental Illness”, BCCEWH „ Supporting Families with Parental Mental Illness (two day symposia) 14 Funded Activities „ Trauma Education and Evaluation - Riverview Hospital „ Trauma and Women with Serious Mental Illness: (two-day workshop for at least one staff member from every transition house, sexual assault centre and women centre in the province) „ Clinical practice guidelines for treatment of post- partum depression 15 3. Current Activities to Build Knowledge Transfer & Exchange Capacity in the Ministry „ Ministry Assets „ Ministry Research Advisory Committee „ Research Framework 16 Ministry Assets ƒ Staff & program capacity/expertise ƒ Relationships with research community ƒ Health and Human Services Library ƒ Policy rounds, continuing education program, policy analyst CoP ƒ Connections to social policy Ministry research units, MSFHR, CIHR & CHSRF ƒ Ministry Research Advisory Committee 17 Ministry Research Advisory Committee „ Includes representation from all Divisions „ Broad range of expertise & high degree of commitment „ Provides advice to Corporate Policy and Research and other divisions „ Participates in annual research priority setting process and discussion of research projects and proposals 18 Research Framework - Strategic Directions „ An annual, formalized process for MoH research priority setting and funding „ A work environment where research evidence informs policy, planning and decision-making „ An overarching plan to guide and coordinate inter- agency, cross-program initiatives that have research impacts (e.g., oversee the development of MoH’s position on issues such as infrastructure, research requirements to support medical school expansion, and health authority research activities) 19 4. Suggestions for effective research exchange with ministries „ If you want to impact government policy, familiarize yourself with relevant government documents „ Ask questions about stakeholders and policy minefields „ Seek to understand before you identify or dismiss a policy window „ Work with and across disciplines 20 Suggestions cont. „ Cultivate more than one policy contact if possible „ Avoid drive-by collaborations „ Be open to the wide applications of research (it doesn’t always get converted into or transform policy: it can puncture myths, enrich/enlarge understandings, shift power) 21 Suggestions cont. „ Set realistic expectations – ‰ you can do everything by the book and the world changes ‰ researchers and policy makers can effectively sustain a finite number of relationships ‰ collaboration with government will probably be complex and time consuming (but also interesting) „ Seek feedback on how or whether the research supported the policy maker – expect to change what you do next time, or when you revisit the same issues 22 Conclusion „ The metaphor of Stone Soup, like many diagrams describing the process of KTSE, is relatively silent on the human dynamics underpinning the process; however, they’re always at play. Remember, in your dealings with ministry staff, you’re working with people who are also trying to make a difference. 23 Want to make soup? Contact us! Corporate Policy & Research, MoHS Victoria.Schuckel@gov.bc.ca