Communicating clearly: enhancing information-packaging mechanisms to support knowledge brokering in European health systems

Policy-makers are faced daily with making decisions and need access to good-quality health systems information. Stakeholders may seek to influence health policy as well as make decisions in their own spheres of responsibility. Both groups want information products that they can easily understand and that are clearly based on systematically conducted and transparently reported research. And researchers want to know how to communicate their findings effectively so that health systems policy-making can make use of the best available health systems information.The purpose of this BRIDGE summary is to encourage debate and innovation about the ways in which information is prepared and packaged for policy-makers and stakeholders as one component of a broader knowledge-brokeringapproach. Current thinking about knowledge brokering is largely driven by anecdotal information; this document presents real-world insights from research on knowledge brokering, primarily from Europe but drawing on globalexperience as well. This summary is intended not only for knowledge brokers whose work is dedicated to this role, but also for funders, researchers, policy-makers and stakeholders, all of whom can help to steer knowledge brokering by helping to set expectations for this work.

Learning from one another: enriching interactive knowledge-sharing mechanisms to support knowledge brokering in European health systems

Policy-makers, stakeholders and knowledge brokers (including researchers) all have a great deal they can learn from one another. Policy-makers need access to good-quality health systems information that they can apply to a local issue. Stakeholders may seek to influence health policy as well as make decisions in their own spheres of responsibilities. Knowledge brokers need information about policy priorities and the policy context in order to produce, package and share health systems information that will be genuinely useful to decision-makers. The purpose of this BRIDGE summary is to encourage debate and innovation about the ways in which policy-makers, stakeholders and knowledge brokerscan, by working together, engage with health systems information so as to increase the likelihood that it will be understood and used. Current thinking about knowledge brokering is largely driven by anecdotal information; thisdocument presents real-world insights from research on knowledge brokering, primarily from Europe but drawing on global experience as well.This summary is intended not only for knowledge brokers whose work is dedicated to this role, but also for funders, researchers, policy-makers and stakeholders, all of whom can help to steer knowledge brokering by setting expectations for this work.

Matching form to function: designing organizational models to support knowledge brokering in European health systems

Knowledge-brokering organizations need to match form to function when designing organizational models that will best support well informed health systems decision-making. Their functions can include a range of information-packaging mechanisms (such as policy briefs) and interactive knowledge-sharing mechanisms (such as policy dialogues), as well as activities that are not knowledge brokering per se (such as the collection and analysis of healthsystems information). Maintaining a good grasp of the relevant policy-making context and matching knowledge-brokering mechanisms to this context should be considered a key function for any knowledge-brokering organization. Context can mean a range of elements in the national, regional (e.g. European) or sub-national policy-making environment, including policy-making institutions and processes, stakeholder capacities and opportunitiesfor engagement, and research institutions and their activities and outputs. An organizational model that works well for one organization using a particular set of knowledge-brokering mechanisms in a particular policy-making context may not be appropriate for another organization using different mechanisms ina different context. What is likely to be common across all contexts is that: policy-makers need timely access to good-quality health systems information; stakeholders may seek to influence health policy as well as make decisions in their sphere of responsibility, so they too need timely access to good-quality health systems information; and knowledge brokers (including researchers) need information about policypriorities and the policy context in order to produce, package and share health systems information that will be useful. An organizational model should ensure that all of these needs are met.The purpose of this BRIDGE summary is to encourage debate and innovation about the ways in which knowledge-brokering organizations organize themselves in order to increase the likelihood that health systems information will be understood and used by policy-makers and stakeholders. Current thinking about organizational models for knowledge brokering is largely driven by anecdotal information; this document presents real-world insights from research on organizational models, primarily from Europe but drawing on global experience as well. This summary is intended not only for knowledge brokers whose work is dedicated to this role, but also for funders, researchers, policy-makers and stakeholders, all of whom can help to steer knowledge brokering by setting expectationsfor this work.

Getting what we pay for? The value-for-money challenge.

In 2008, Canada spent $172 billion on healthcare, more than $5,000 for every man, woman and child in the country. Canada has one of the longer life expectancies in the Organisation for Economic Co-operation and Development and relatively low (and declining) amenable mortality rates. This suggests that the healthcare system is having some positive effect; but how well do we know what is "right" and what needs improvement? What do we get for the money we spend on healthcare? This paper proposes that there are some basic issues to address before these value-for-money questions can be answered. What do we value, or what do we want to achieve with our healthcare spending? Are we using inputs such as human resources well to provide services? Are we using services well to promote health? How would we know? The paper ends with a series of challenges to healthcare managers and decision-makers: to re-establish a broad information strategy, to include research as an integral part of healthcare delivery, to develop new data that can tell us something about outcomes of care and to articulate more formally objectives for the healthcare system.

Unsentimental education: learning from the workers' compensation boards experience.

Hurley et al. document the rise of care provided by workers' compensation boards (WCBs) in Canada and suggest that they potentially represent the "proverbial canaries in the coal mine) for the publicly funded healthcare system. Given WCBs' potential draw on similar resources and their ability to purchase services through incentive-based funding, some may argue that these systems do indeed challenge our current understanding of equitable access under the public system. Here we suggest, however, that while in some circumstances WCB behaviours and policies can create problems for the universal system, they can also serve as role models in their emphasis on prevention, evidence-based practice and timely service.