Knowledge Translation Program at St. Michael's Hospital

Knowledge Translation Program at St. Michael's Hospital
Name	Knowledge Translation Program at St. Michael's Hospital
Formation	2000s
Headquarters	Toronto
Location	St. Michael's Hospital
Parent organization	Unity Health Toronto

Knowledge Translation Program at St. Michael's Hospital The Knowledge Translation Program at St. Michael's Hospital is a clinical and research initiative based at St. Michael's Hospital in Toronto, Ontario, Canada, focused on moving evidence into practice across health systems. It operates at the interface of academic medicine, health services research, and frontline clinical care, engaging with partners ranging from University of Toronto departments to provincial agencies such as Ontario Ministry of Health. The program emphasizes implementation science, evidence synthesis, and stakeholder engagement to improve outcomes in acute care, chronic disease, and population health.

Overview

The program situates itself within Unity Health Toronto and connects to academic units including the Dalla Lana School of Public Health, Leslie Dan Faculty of Pharmacy at University of Toronto, and the Li Ka Shing Knowledge Institute. It draws on methodologies from Implementation science, Evidence-based medicine, and Health services research to design interventions for hospitals such as St. Michael's Hospital and systems like Ontario Health. Staff collaborate with centers including the Institute for Clinical Evaluative Sciences and international bodies such as the World Health Organization. The program translates clinical trials, systematic reviews, and guidelines into practice through clinician education, audit-and-feedback, and pathway design linked to organizations like Canadian Institutes of Health Research.

History and Development

Origins trace to quality improvement initiatives at St. Michael's Hospital in the early 2000s and subsequent alignment with academic programs at University of Toronto. Early collaborations involved researchers from Sunnybrook Health Sciences Centre and Mount Sinai Hospital (Toronto), leveraging methods from Cochrane Collaboration and frameworks such as the Knowledge-to-Action Framework. Growth paralleled national investments by Canadian Institutes of Health Research and provincial policy shifts led by Ontario Ministry of Health, with milestones including adoption of audit-and-feedback programs, toolkit development for frontline teams, and participation in multicenter trials with partners like Hamilton Health Sciences and The Ottawa Hospital.

Structure and Governance

Governance aligns with Unity Health Toronto executive structures and advisory input from academic partners at University of Toronto faculties including Faculty of Medicine. Leadership comprises clinician-scientists, implementation specialists, and project managers drawn from institutions such as St. Michael's Hospital, Sunnybrook Health Sciences Centre, and the Institute for Clinical Evaluative Sciences. Advisory committees include representatives from provincial agencies like Ontario Health, funding bodies such as Canadian Institutes of Health Research, and professional associations including the Canadian Medical Association and Ontario Hospital Association. Operational units mirror models used at Mayo Clinic and Johns Hopkins Hospital for integrated clinical research and quality improvement.

Programs and Activities

Programs include guideline implementation for conditions managed at St. Michael's Hospital such as coronary artery disease, heart failure, and diabetes mellitus care pathways developed with partners like Toronto General Hospital and Women's College Hospital. Activities encompass design of clinical decision support integrated with electronic records similar to systems at Intermountain Healthcare, delivery of workshops modelled after curricula from Harvard T.H. Chan School of Public Health, and production of toolkits informed by Cochrane Collaboration reviews. The program runs knowledge brokering, stakeholder consultations with entities like Ontario Ministry of Health, and capacity-building initiatives for clinicians modeled on programs at Imperial College London and King's College London.

Research and Evaluation

Research strands cover implementation trials, process evaluation, and economic evaluation in collaboration with academic units including the Dalla Lana School of Public Health and research institutes like the Institute for Clinical Evaluative Sciences. Methodologies draw from randomized implementation trials exemplified by work at Stanford University and pragmatic trials used at Vanderbilt University Medical Center. Evaluation metrics track outcomes used by Canadian Institute for Health Information and incorporate frameworks from the Medical Research Council (United Kingdom). The program publishes in journals affiliated with BMJ, The Lancet, and Annals of Internal Medicine and engages in meta-research with groups such as the Campbell Collaboration.

Partnerships and Collaborations

Key partners include University of Toronto, Unity Health Toronto, provincial bodies like Ontario Health, and funders such as Canadian Institutes of Health Research and Canadian Foundation for Healthcare Improvement. International collaborators have included World Health Organization technical units, academic partners at University College London, University of Melbourne, and McMaster University. Clinical partnerships span Toronto General Hospital, Mount Sinai Hospital (Toronto), and regional networks like Hamilton Health Sciences. The program also works with professional societies including the Canadian Medical Association and regulatory bodies such as College of Physicians and Surgeons of Ontario.

Impact and Outcomes

Reported impacts include improved adherence to evidence-based pathways at St. Michael's Hospital, reduced length-of-stay metrics tracked by Canadian Institute for Health Information, and dissemination of toolkits adopted by provincial networks coordinated by Ontario Health. Evaluations demonstrate changes in clinician behavior consistent with implementation outcomes used by National Institutes of Health implementation programs, and cost-effectiveness analyses align with methods from Canadian Agency for Drugs and Technologies in Health. The program's work has informed policy discussions involving Ontario Ministry of Health and has been cited in academic syntheses from Cochrane Collaboration and international health policy reviews.

Category:Organizations based in Toronto Category:Implementation science