How did the study work?


How did the study work?
  • The Knowledge Integration study was a three-year project that examined the strategies for the introduction of a best practice guideline. The guideline introduced was the empirically supported, Transitional Discharge Model into the psychiatric setting.


  • It was hoped that this project would test and further outline the Knowledge Translation framework and strategies needed for implementation.


  • Strategies that were tested included:
    • Enhancing staff participation
      • Staff group on implementation wards partnered with researchers and consumer groups.
    • Creating/maintaining a supportive ward environment
      • Training and support of intervention 'champions' who were available as support on the ward.
    • Meeting specific education needs
      • 9 on-ward training sessions were conduction on the best practice guideline.
    • Supporting managers throughout the change process
      • Consultation, documentation and planning aids.
      • Met with other managers.

What was the study design?
  • The Knowledge Integration study used a delayed implementation control group design.


  • There were three groups of wards, Groups A, B, and C. The wards were randomly selected in the order to which they received implementation.
    • Group A consisted of the previous pilot and the randomized control treatments (RCTs). These wards had already implemented the Transitional Discharge Model.
    • Group B implemented the intervention in year one.
    • Group C implemented the intervention in year two.
  • While the wards are waiting to receive strategies, they served as control. Therefore, the numbers in the control and implementation group varied throughout the study.

Group Minimum wards (n) Baseline Pre-test Intervention Status Year 1 Ongoing monthly ward measures: implementation, length of stay & readmissions Intervention Status Year 2 Ongoing monthly ward measures: implementation, lenfth of stay & readmissions
A 14 X TDM X TDM X
B 14 X TDM + new implementation strategies X TDM + new implementation strategies X
C 14 X Control: no intervention X TDM + new implementation strategies X


What was the ward's role?
  • The staff participate in the training sessions, implemented the model, and became a 'champion' on the ward.


  • Throughout the study, the wards were asked to send in monthly reports with specific demographic information, including the number of patients, the number of RN's working, the number of discharges, etc. This quantitative data was used to analyze whether the demographic information was related to the degree of implementation.
Why did we have focus groups?
  • In previous studies, focus groups were conducted on the intervention wards from the Canadian (Forchuk et al., 2002) and Scottish (Reynolds et al., 2002) sites. These assisted in identifying gaps in the strategies for Knowledge Translation.


  • In the Knowledge Integration study, focus groups were conducted on the wards following education and implementation. The purpose of these focus groups was to:
    • Describe the usefulness of each strategy.
    • Make practical changes to the learning modules for the next wards.
    • Identify barriers to knowledge integration.
    • Partner in finding solutions to these barriers.

Why did we interview clients at discharge?
  • Interviews with the clients determined whether or not the Transitional Discharge Model was actually being implemented.


  • Clients were approached at the point of discharge by an in-patient staff. If the client was willing to do the interview, an RA was contacted to come to the ward. Client was also contacted one-month post discharge for a follow-up telephone interview.


  • The interview collected both quantitative and qualitative data.
    • The qualitative data included a description of the client's discharge plan.
    • The quantitative data measured the degree of implementation of the Transitional Discharge Model.
    • Other information included client functioning, length of stay, and re-admissions.