Managerial leadership for research use in nursing and allied health care professions: a systematic review.

BACKGROUND: Leadership by point-of-care and senior managers is increasingly recognized as critical to the acceptance and use of research evidence in practice. The purpose of this systematic review was to identify the leadership behaviours of managers that are associated with research use by clinical staff in nursing and allied health professionals. METHODS: A mixed methods systematic review was performed. Eight electronic bibliographic databases were searched. Studies examining the association between leadership behaviours and nurses and allied health professionals' use of research were eligible for inclusion. Studies were excluded if leadership could not be clearly attributed to someone in a management position. Two reviewers independently screened abstracts, reviewed full-text articles, extracted data and performed quality assessments. Narrative synthesis was conducted. RESULTS: The search yielded 7019 unique titles and abstracts after duplicates were removed. Three hundred five full-text articles were reviewed, and 31 studies reported in 34 articles were included. Methods used were qualitative (n = 19), cross-sectional survey (n = 9), and mixed methods (n = 3). All studies included nurses, and six also included allied health professionals. Twelve leadership behaviours were extracted from the data for point-of-care managers and ten for senior managers. Findings indicated that managers performed a diverse range of leadership behaviours that encompassed change-oriented, relation-oriented and task-oriented behaviours. The most commonly described behavior was support for the change, which involved demonstrating conceptual and operational commitment to research-based practices. CONCLUSIONS: This systematic review adds to the growing body of evidence that indicates that manager-staff dyads are influential in translating research evidence into action. Findings also reveal that leadership for research use involves change and task-oriented behaviours that influence the environmental milieu and the organisational infrastructure that supports clinical care. While findings explain how managers enact leadership for research use, we now require robust methodological studies to determine which behaviours are effective in enabling research use with nurses and allied health professionals for high-quality evidence-based care. TRIAL REGISTRATION: PROSPERO CRD42014007660.

Introducing the Leadership in Enabling Occupation (LEO) model.

BACKGROUND: Occupational therapy is a broad profession yet access to services remains restricted and uneven across Canada. Access to the potential breadth of occupational therapy is severely restrained by complex supply, retention, and funding challenges. To improve access to occupational therapy, widespread leadership is needed by all practitioners. PURPOSE: This brief report introduces the Leadership in Enabling Occupation (LEO) Model, which displays the inter-relationship of four elements of everyday leadership as described in "Positioning Occupational Therapy for Leadership," Section IV, of Enabling Occupation II: Advancing a Vision of Health, Well-being and Justice through Occupation (Townsend & Polatajko, 2007). KEY ISSUES: All occupational therapists have the power to develop leadership capacity within and beyond designated leadership positions. IMPLICATIONS: LEO is a leadership tool to extend all occupational therapists' strategic use of scholarship, new accountability approaches, existing and new funding, and workforce planning to improve access to occupational therapy.

Occupational therapists lead a national injury prevention strategy to help older drivers.

BACKGROUND: As older adults are the fastest growing segment of the driving population, the Canadian Association of Occupational Therapists (CAOT) has taken older driver safety as a key priority. PURPOSE: The purpose of this paper is to present the National Blueprint for Injury Prevention in Older Drivers (Blueprint) and its related activities. KEY ISSUES: Since 2006, CAOT has been working on initiatives relating to the National Blueprint for Injury Prevention in Older Drivers. The most recent activities include the launch of informational brochures and a website. IMPLICATIONS: The Blueprint and its related activities were developed with the intent to prolong safe driving among older adults in Canada, and to propose future actions to be addressed by all stakeholders interested in older driver safety.

Enhancing research utilization capacity through multifaceted professional development.

Some occupational therapists report that they do not feel adequately prepared to perform the arduous tasks involved in integrating research into their practice. To explore how research utilization can be conducted by practicing clinicians, self-reported research utilization behaviors of a sample of 11 occupational therapists practicing in adult stroke rehabilitation were analyzed. The constant comparison of the interview data revealed that participants' clinical experiences, engagement in continuing education, involvement in research activities, and their mentoring of students contributed to their capacity to translate research evidence into practice. The results of the study suggest a model for enhancing research utilization capacity through professional development. Implications for practitioners, provider organizations, educators, and regulators of occupational therapy are discussed.

Enhancing research use through online action research.

BACKGROUND: Many health professionals, including occupational therapists, have difficulty utilizing research findings in daily practice. PURPOSE: To determine if an online action research project could enhance research use among occupational therapists working in similar practice areas. METHODS: Four groups of 12-14 occupational therapists met online for approximately one year. They discussed barriers and facilitators to research utilization, defined practice questions, and attempted to search for, synthesize and apply relevant research findings. Online communications and post-group interviews were thematically analyzed. RESULTS: Only half of the participants who began the project were still online with the research project at completion. These participants believed that their involvement in the group led to increased personal awareness, motivation and confidence regarding the use of research evidence in practice and knowledge to be used in practice. Time to review, critique and synthesize research evidence continued to be a major barrier to enhanced research utilization. PRACTICE IMPLICATIONS: Online meetings designed to enhance research use among occupational therapists appear to hold some promise, but refinements are needed to ensure their ultimate success.

Theory of research utilization enhancement: a model for occupational therapy.

BACKGROUND: There is a pressing need for occupational therapists to provide research-based practice, yet there is little understanding of the specific strategies and processes individual practitioners use to integrate research evidence into their clinical practice. METHOD: Using grounded theory method, the self-reported research utilization strategies of a sample of 11 elite occupational therapists practicing in adult stroke rehabilitation were examined. The triangulation of the interview data, the organizational policies of their workplaces, and existing theoretical concepts and processes of research utilization resulted in the development of a theory and a practice model to guide research utilization in occupational therapy. RESULTS: The Theory of Research Utilization Enhancement for Occupational Therapists, and the Model of Research Utilization in Occupational Therapy are presented, and their implications for practice, policy, education and future research are discussed. PRACTICE IMPLICATIONS: Built upon the Occupational Performance Process Model, the theory and model are proposed as guides to enhance therapists' ability to maintain a client-centred approach while informing clinical practices with research evidence. The application of structured reflection, case application and peer consultation facilitate the integration of research evidence into clinical practices.