• Canadian Critical Care Trials Group
    The Canadian Critical Care Trials Group (CCCTG) is a highly collegial group that is dedicated to the pursuit of excellence and advancement of critical care research in Canada.
  • Canadian Critical Care Trials Group
    The CCCTG has are more than 30 research programs underway and over 100 peer-reviewed publications to its credit, with direct impact on clinical practice in critical care.
  • Canadian Critical Care Trials Group
    The Canadian Critical Care Trials Group (CCCTG) is a national organization of more than 300 individuals with research interests in the management of the critically ill patient.
  • Canadian Critical Care Trials Group
    Endorsement by the CCCTG communicates our full commitment to ensure that the work is undertaken in a rigorous and ethical manner, and communicated in a timely and effective way.
Programs

Principal Investigator(s)

Coordinator(s)

Carrie Anna McGinn

Status

Enrolling

Knowledge transfer and best practices in emergency medicine and in traumatology: impact of wikis

Health professionals’ failure to implement best practices in clinical practice is costing Canadians their health. The problem is far from anecdotal: 50% of patients with major traumatic injuries do not receive recommended care. Systematic reviews indicate that computer-based reminders are effective interventions for fostering best practices in a variety of clinical areas, including acute care, where they improve process of care outcomes. This said, emergency care professionals have rejected many reminder systems on the grounds that they are slow, incompatible with work processes, unable to adapt to local practices, difficult to access and/or costly to implement. Given these barriers and the increasing pace at which new knowledge is being produced, the need has become urgent to develop knowledge translation (KT) strategies that boost health professionals’ use of computer-based reminders in emergency and trauma care.

By involving healthcare professionals in sharing, updating and creating reminders, wikis, a web-site programmed to allows edition by anyone with access, have the potential to empower physicians to use reminders more often in their practice. Furthermore, wikis are very inexpensive and easily adaptable, which makes them especially attractive in the current context of rising healthcare costs. However, little is known about wikis’ effectiveness at increasing the use of reminders at the point of care. Strong empirical evidence of wikis’ mechanisms of action is also lacking.

The overarching goal of this KT research program is to evaluate the impact of an intervention which
aims to raise the use of a wiki-based reminder promoting best practices in trauma care. The specific
objectives are:
  1. To synthesize the state of the knowledge concerning the use of collaborative writing applications in health care and the different effective strategies that exist to increase their use by healthcare professionals (scoping review);
  2. To identify the theory-based determinants of emergency healthcare professionals’ intention to use collaborative writing applications in the context of health care (survey with a validated questionnaire based on the theory of planned behavior) ;
  3. To develop a theory-based intervention to increase emergency healthcare professionals’ use of wiki-based reminders promoting best practices based on the results of objectives 1 and 2;
  4. To conduct a pilot cluster-randomized clinical trial of this intervention.
This research program is associated with the Quebec Trauma Care Continuum Assessment Team to ensure that the results respond to an important need: improvement of quality of trauma care. It is the first program to explore the vast potential of wikis and collaborative writing applications to increase the use of reminders promoting best practices in trauma care.

Co-Investigators

Tom van de Belt, France Légaré, Marie-Pierre Gagnon, Alexis Turgeon, Tasnim Sinuff, François Lauzier, François Lamontagne, John Muscedere, Julien Poitras, Jean Lapointe, Gunther Eysenbach, Francisco Grajales, Craig Kuziemsky, Irving Gold, Marjan J Faber, Jan A.M Kremer, Marcel Heldoorn

Participating Centers

Centre de santé et services sociaux Alphonse-Desjardins (Centre Hospitalier Universitaire affilié de Lévis) - Departments of Emergency Medicine and Anesthesia, Université Laval - Department of Anesthesia (Division of Critical Care Medicine) and Department of Family Medicine and Emergency Medicine