Making knowledge work:Factors, strategies and leadership to improve sharing and application of knowledge in the care and support for people with intellectual disabilities

Background:In the context of caring for people with intellectual disabilities, knowledge (scientific, professional, and experiential) is of profound importance for care professionals to be able to provide sufficiently good care. Through their knowledge policies, care organisations for people with intellectual disabilities seek to stimulate their care professionals to share and apply the knowledge they have acquired. However, it often takes a long time for the most up-to-date scientific knowledge is acquired by care professionals and properly applied within the care and support for people with intellectual disabilities. In addition to this, professional knowledge and experiential knowledge are also insufficiently shared and utilised. If care professionals do not have the requisite knowledge, then this can negatively impact upon their ability to provide professional support, and, in turn, lead to poorer quality of care and quality of life for service users. This thesis focuses on how care professionals in care organisations for people with intellectual disabilities can be stimulated to effectively share and apply knowledge within their practice. Research question and method:Five sub-studies investigated what factors and strategies influence both the sharing and application of knowledge within the context of care and support for people with intellectual disabilities. The first sub-study identified organisational factors that had been identified in extant scientific literature in this field. This revealed the important contingent role of management. Based on this, the second and third sub-studies focused on the key role of CEOs. Through interviews with CEOs, we found out which strategies they deploy in their knowledge policies, what motivated this, and which factors influence the subsequent execution of these strategies. These studies showed, amongst other things, that establishing a good fit between their strategies and incoming professionals is vitally important. Building on this, the fourth sub-study investigated how, according to incoming support staff, psychologists and ID physicians, the use of new knowledge can be encouraged. The fourth sub-study coincided with the COVID-19 pandemic in early 2020. This ‘living experiment’ provided an opportunity in the fifth sub-study to understand the factors that influenced knowledge sharing and application during the pandemic. Conclusion:Knowledge sharing and application appear to be influenced by a combination of personal factors and environmental factors. Improving these processes requires the effective interplay between these factors, in which care professionals have a key role to play. First and foremost, knowledge sharing and application require professionalism, leadership and the complementary role to be played by CEOs and managers comprises facilitating, encouraging and providing appropriate learning strategies, resources, such as time, space and budget, as well as a stimulating learning environment that utilises knowledge from research, practice and from people with intellectual disabilities themselves and their relatives. When the combined efforts of care professionals, CEOs, and managers generate working knowledge, then this will in turn enhance both the quality of care and quality of life of service users._Aanleiding:In de zorg voor mensen met een verstandelijke beperking is kennis (wetenschappelijke-, professionele- en ervaringskennis) van groot belang om als zorgprofessional goede zorg te kunnen bieden. Met hun kennisbeleid stimuleren zorgorganisaties voor mensen met een verstandelijke beperking dat zorgprofessionals kennis delen en toepassen. Het kost echter veel tijd voordat onderzoekskennis de professionals bereikt en goed ingezet kan worden bij de zorg en ondersteuning van mensen met verstandelijke beperkingen. Daarnaast worden praktijkkennis en ervaringskennis onvoldoende gedeeld en gebruikt. Als zorgprofessionals niet beschikken over de juiste kennis kan dit leiden tot handelingsverlegenheid. En tot minder goede kwaliteit van zorg en kwaliteit van leven.Dit proefschrift richt zich op de vraag hoe zorgprofessionals in zorgorganisaties voor mensen met een verstandelijke beperking gestimuleerd kunnen worden tot effectieve kennisdeling en -toepassing in hun praktijk.Onderzoeksvraag en -methode:In vijf deelstudies is onderzocht welke factoren en strategieën het delen en toepassen van kennis in de zorg en ondersteuning van mensen met verstandelijke beperkingenbeïnvloeden. In de eerste deelstudie is in kaart gebracht welke organisatiefactoren er op dit gebied uit reeds bestaande wetenschappelijke literatuur bekend zijn. Hieruit kwam de belangrijke voorwaardelijke rol van het management naar voren. Daarom richtten de tweede en derde deelstudie zich op de sleutelrol van de bestuurders. Via interviews met bestuurders is achterhaald welke strategieën ze inzetten in hun kennisbeleid, wat de aanleidingen hiervoor zijn en welke factoren de uitvoer van deze strategieën beïnvloeden.Uit deze studies bleek onder andere dat een goede aansluiting van hun strategieën bij de startende professionals cruciaal is. Daarom is in de vierde deelstudie onderzocht hoe volgens startende begeleiders, gedragsdeskundigen en artsen VG het gebruik van nieuwe kennis aangemoedigd kan worden. Ten tijde van de vierde deelstudie vond begin 2020 de uitbraak van de coronapandemie plaats. Dit ‘levend experiment’ bood gelegenheid om inde vijfde deelstudie inzicht te krijgen in de factoren die kennisdeling en -toepassing beïnvloedden tijdens deze pandemie.Conclusie:Kennisdeling en -toepassing blijken te worden beïnvloed door een combinatie van persoonlijke factoren en omgevingsfactoren. Voor het verbeteren van deze processen iseen goed samenspel nodig tussen deze factoren, waarbij de zorgprofessionals een sleutelrol hebben. Kennisdeling en -toepassing vraagt van hen vakmanschap, leiderschap en motivatie. Daarnaast zijn leiderschap van bestuurders en management nodig. Deaanvullende rol van bestuurders en managers is faciliterend en stimulerend en bestaat uit het bieden van passende leerstrategieën, hulpbronnen zoals tijd, ruimte en budget en een stimulerende leeromgeving waarin gebruik wordt gemaakt van kennis uit onderzoek, praktijk en van mensen met een verstandelijke beperking zelf en hun naasten. Wanneer de gezamenlijke inzet van zorgprofessionals, bestuurders en managers leidt tot werkende kennis zal dit op zijn beurt de kwaliteit van zorg en de kwaliteit van leven van zorgvragers bevorderen

Contextual factors influencing knowledge sharing and application in the care and support for people with intellectual disabilities during the COVID-19 pandemic.

During the COVID-19 pandemic, support workers and health professionals caring for and supporting people with intellectual disabilities (ID) required new knowledge on, for example, treatment and infection prevention. ID care organizations had to quickly share up-to-date knowledge and encourage its application. This study explored the contextual factors influencing knowledge sharing and application in the care and support for people with ID, contrasted their relevance prior to and during the pandemic, and compared the relevance of these factors according to support workers and health professionals. In 2021, 160 Dutch professionals working with people with ID completed an online survey, with 69 being support workers and 91 being health professionals. For most of the participants, the contextual factors known to be relevant for knowledge sharing and application prior to the pandemic (e.g., the leadership of professionals, user-friendliness of interventions) also helped them to process knowledge during the pandemic. These factors were rated equally or as being even more important (e.g., “Practice leadership of management” and “Office arrangements and Information and Communication Technology (ICT) systems”). Moreover, support workers and health professionals rated factors such as the available capacity of employees and office arrangements and ICT systems differently. The findings provide initial evidence that during a health crisis like the COVID-19 pandemic, both the role and importance of contextual factors influencing knowledge sharing and application in the care and support for people with ID partially differ from prior to the pandemic

Incoming professionals’ perspectives on the application of new knowledge in care organisations for people with intellectual disabilities:A concept mapping study

ObjectivesWithin care organisations for people with intellectual disabilities, numerous strategies are employed to stimulate the application of new knowledge, and professionals play a key role in this process. Consequently, gaining insight into professionals’ perspectives on how to encourage the application of new knowledge is vital, especially in the case of incoming professionals. They have a stronger need for new knowledge due to having acquired only a limited knowledge base about intellectual disabilities in their education. Therefore, this study focused on the incoming professionals’ perspectives on factors stimulating application of new knowledge within the care and support for people with intellectual disabilities.MethodsA concept mapping study was conducted with incoming support staff, psychologists, and intellectual disabilities physicians. Data collection included brainstorming, pile sorting and rating to create three concept maps, which were interpreted by experts.ResultsOverall, the participants generated 234 statements. Incoming support staff primarily expressed their preference for experiential and work-based learning and described their role as being knowledge receivers. Incoming psychologists and physicians expressed their ownership of knowledge in requesting opportunities to develop themselves.ConclusionTo enhance incoming professionals’ application of new knowledge, care organisations for people with intellectual disabilities can encourage professionals in manifold ways, ranging from providing (in)formal learning opportunities and accessible sites to creating a learning culture

How to improve sharing and application of knowledge in care and support for people with intellectual disabilities?:A systematic review

Background: To optimise care and support for people with intellectual disabilities (ID), sharing and application of knowledge is a precondition. In healthcare in general, there is a body of knowledge on bridging the 'know-do-gap'. However, it is not known to what extent the identified barriers and facilitators to knowledge sharing and application also hold for the care and support of people with ID, due to its specific characteristics including long-term care. Therefore, we conducted a systematic review to identify which organisational factors are enabling and/or disabling in stimulating the sharing and application of knowledge in the care and support of people with ID. Method: A systematic review was conducted using five electronic databases of relevant articles published in English between January 2000 and December 2015. During each phase of selection and analysis a minimum of two independent reviewers assessed all articles according to PRISMA guidelines. Results: In total 2,256 articles were retrieved, of which 19 articles met our inclusion criteria. All organisational factors retrieved from these articles were categorised into three main clusters: (1) characteristics of the intervention (factors related to the tools and processes by which the method was implemented); (2) factors related to people (both at an individual and group level); and, (3) factors related to the organisational context (both material factors (office arrangements and ICT system, resources, time and organisation) and immaterial factors (training, staff, size of team). Conclusion: Overall analyses of the retrieved factors suggest that they are related to each other through the preconditional role of management (i.e., practice leadership) and the key role of professionals (i.e. (in)ability to fulfill new roles)

Making knowledge work:Factors, strategies and leadership to improve sharing and application of knowledge in the care and support for people with intellectual disabilities

Background:In the context of caring for people with intellectual disabilities, knowledge (scientific, professional, and experiential) is of profound importance for care professionals to be able to provide sufficiently good care. Through their knowledge policies, care organisations for people with intellectual disabilities seek to stimulate their care professionals to share and apply the knowledge they have acquired. However, it often takes a long time for the most up-to-date scientific knowledge is acquired by care professionals and properly applied within the care and support for people with intellectual disabilities. In addition to this, professional knowledge and experiential knowledge are also insufficiently shared and utilised. If care professionals do not have the requisite knowledge, then this can negatively impact upon their ability to provide professional support, and, in turn, lead to poorer quality of care and quality of life for service users. This thesis focuses on how care professionals in care organisations for people with intellectual disabilities can be stimulated to effectively share and apply knowledge within their practice. Research question and method:Five sub-studies investigated what factors and strategies influence both the sharing and application of knowledge within the context of care and support for people with intellectual disabilities. The first sub-study identified organisational factors that had been identified in extant scientific literature in this field. This revealed the important contingent role of management. Based on this, the second and third sub-studies focused on the key role of CEOs. Through interviews with CEOs, we found out which strategies they deploy in their knowledge policies, what motivated this, and which factors influence the subsequent execution of these strategies. These studies showed, amongst other things, that establishing a good fit between their strategies and incoming professionals is vitally important. Building on this, the fourth sub-study investigated how, according to incoming support staff, psychologists and ID physicians, the use of new knowledge can be encouraged. The fourth sub-study coincided with the COVID-19 pandemic in early 2020. This ‘living experiment’ provided an opportunity in the fifth sub-study to understand the factors that influenced knowledge sharing and application during the pandemic. Conclusion:Knowledge sharing and application appear to be influenced by a combination of personal factors and environmental factors. Improving these processes requires the effective interplay between these factors, in which care professionals have a key role to play. First and foremost, knowledge sharing and application require professionalism, leadership and the complementary role to be played by CEOs and managers comprises facilitating, encouraging and providing appropriate learning strategies, resources, such as time, space and budget, as well as a stimulating learning environment that utilises knowledge from research, practice and from people with intellectual disabilities themselves and their relatives. When the combined efforts of care professionals, CEOs, and managers generate working knowledge, then this will in turn enhance both the quality of care and quality of life of service users._Aanleiding:In de zorg voor mensen met een verstandelijke beperking is kennis (wetenschappelijke-, professionele- en ervaringskennis) van groot belang om als zorgprofessional goede zorg te kunnen bieden. Met hun kennisbeleid stimuleren zorgorganisaties voor mensen met een verstandelijke beperking dat zorgprofessionals kennis delen en toepassen. Het kost echter veel tijd voordat onderzoekskennis de professionals bereikt en goed ingezet kan worden bij de zorg en ondersteuning van mensen met verstandelijke beperkingen. Daarnaast worden praktijkkennis en ervaringskennis onvoldoende gedeeld en gebruikt. Als zorgprofessionals niet beschikken over de juiste kennis kan dit leiden tot handelingsverlegenheid. En tot minder goede kwaliteit van zorg en kwaliteit van leven.Dit proefschrift richt zich op de vraag hoe zorgprofessionals in zorgorganisaties voor mensen met een verstandelijke beperking gestimuleerd kunnen worden tot effectieve kennisdeling en -toepassing in hun praktijk.Onderzoeksvraag en -methode:In vijf deelstudies is onderzocht welke factoren en strategieën het delen en toepassen van kennis in de zorg en ondersteuning van mensen met verstandelijke beperkingenbeïnvloeden. In de eerste deelstudie is in kaart gebracht welke organisatiefactoren er op dit gebied uit reeds bestaande wetenschappelijke literatuur bekend zijn. Hieruit kwam de belangrijke voorwaardelijke rol van het management naar voren. Daarom richtten de tweede en derde deelstudie zich op de sleutelrol van de bestuurders. Via interviews met bestuurders is achterhaald welke strategieën ze inzetten in hun kennisbeleid, wat de aanleidingen hiervoor zijn en welke factoren de uitvoer van deze strategieën beïnvloeden.Uit deze studies bleek onder andere dat een goede aansluiting van hun strategieën bij de startende professionals cruciaal is. Daarom is in de vierde deelstudie onderzocht hoe volgens startende begeleiders, gedragsdeskundigen en artsen VG het gebruik van nieuwe kennis aangemoedigd kan worden. Ten tijde van de vierde deelstudie vond begin 2020 de uitbraak van de coronapandemie plaats. Dit ‘levend experiment’ bood gelegenheid om inde vijfde deelstudie inzicht te krijgen in de factoren die kennisdeling en -toepassing beïnvloedden tijdens deze pandemie.Conclusie:Kennisdeling en -toepassing blijken te worden beïnvloed door een combinatie van persoonlijke factoren en omgevingsfactoren. Voor het verbeteren van deze processen iseen goed samenspel nodig tussen deze factoren, waarbij de zorgprofessionals een sleutelrol hebben. Kennisdeling en -toepassing vraagt van hen vakmanschap, leiderschap en motivatie. Daarnaast zijn leiderschap van bestuurders en management nodig. Deaanvullende rol van bestuurders en managers is faciliterend en stimulerend en bestaat uit het bieden van passende leerstrategieën, hulpbronnen zoals tijd, ruimte en budget en een stimulerende leeromgeving waarin gebruik wordt gemaakt van kennis uit onderzoek, praktijk en van mensen met een verstandelijke beperking zelf en hun naasten. Wanneer de gezamenlijke inzet van zorgprofessionals, bestuurders en managers leidt tot werkende kennis zal dit op zijn beurt de kwaliteit van zorg en de kwaliteit van leven van zorgvragers bevorderen