How to partner with consumers in research

Okay. Good morning, everyone. Um, thank you very much for joining us today for our session regarding impact and translation. I hope that everyone can hear me. Yes, excellent. Um, my name is Erica Wright and I'm the manager of research development for Metro South Research. Firstly, I'd like to acknowledge the Yugara and Turrbal peoples as the traditional and cultural custodians of the land upon which we meet today.

Me and Gin Brisbane and pay respect to elders past, present and emerging. We have two presentations today and time allocated at the end for both presenters. The session will be recorded and available on our website, and we also have a feedback survey, which we will attach in the chat. Amber has been able to join us this morning.

She was a little delayed with another meeting, so I'd like to introduce Amber Williamson, Senior Engagement Advisor from Metro South Consumer Partnering. Amber is a motivated and enthusiastic consumer and community engagement specialist with 23 years of diverse marketing, engagement, communications, project management and event management experience.

Amber's professional career boasts significant national and international corporate experience. And after receiving a life changing kidney transplant, Amber transitioned her career to the not for profit health sector, where she learnt the importance of building trust with consumers and community, and the value of consumer and community partnerships.

Working in the Metro South Health clinical governance risk and legal team, Amber now influences, supports and encourages consumer partnering best practice. Amber also passionately promotes the values of embedding consumer partnering practice in the planning, delivery and evaluation of health services. I will now hand over to Amber to start her presentation regarding partnering with consumers in Metro South Health.

Thank you, Amber. Thank you so much, Erica. I really appreciate it. Um, can I just make sure that that's being shared on the screen? It is being shared. We can see it. Um, if you put it into presentation mode, we'll be able to see the whole thing as well. Fantastic. There we go. Excellent. Thank you so much for the invitation.

Um, I am very excited to be here representing the consumer partnering team today. Um, and, um, thank you to all of our research community for coming, um, and joining this presentation. I'd like to pay, um, acknowledge, um, and recognize and pay my respects to the Elders past, present and emerging. Um, and, or I will be presenting today on Jagera and Turrbaland, um, and acknowledge any, um, individuals in the audience today that may identify as Aboriginal or Torres Strait Islander.

So today, what I'd love to share with you, um, it's a really quick snapshot of why we, um, do consumer partnering, um, at Metro South Health. Who our Metro South community and consumer partners are, what is the current state of consumer partnering and Metro South health and how and what the processes are to support researchers, um, and consumer partnering throughout Metro South health and really, it's all about working together, um, which will generate us to be more successful in the work that we do.

So firstly, Often this part of a presentation is missed. The real reason why we engage, um, the firstly, it's the right thing to do. Um, if you look at the human rights approach to, um, engagement, um, it says that everyone has a right to participate in decisions that affect their human rights. And in healthcare, if we talk about the rights based approach, it's about meaningful participation in decisions.

In rights, um, and, and being involved in decisions that affect them, um, who are our patients. Um, secondly, it's expected of us, um, as a research community, um, and clinicians, we know that the national, um, standards, um, We are expected to ensure that we're partnering with patients in their own care at the bedside, um, and we're also expected to ensure that we've got systems set up, um, and we're partnering with consumers in the organisation of design and governance, and that really crosses over with the research world, particularly when you're talking about the projects and et cetera and research projects that you're doing and also obviously we've updated the national clinical trials governance framework with a stronger emphasis on governance, stronger emphasis on patient safety and quality improvement systems, which I know Michelle is going to talk to you about today.

Um, and obviously the, um, the strength and the addition of partnering with consumers within that framework. Finally our founding bodies wanna see it. Um, you know, the h um, the H-N-H-M-R-C, um, is always, um, encouraging and, um, stipulates that consumer and community engagement is imperative. So in engagement, obviously you've got so many different engagement models that you may use in research.

I've just pulled out the NHMRC's Keeping Research on Track 2018, which identified the eight steps in the research journey. Um, and it's really talking about, Building looking at the steps of a project, um, that you're working on in the research world and working out where consumer and community engagement can be effective.

Um, so what we, as a team in our Metro South health clinical governance team, we advocate for consumer partnerships to be in bed across multiple stages of projects. within research and quality improvement. Um, and that also might mean using multiple engagement techniques in order to do that. It might not just be one committee that's working on a project.

It might involve multiple different types of engagement, um, techniques throughout different stages. So we talk about, um, you know, Having consumers involved in the planning and the research design, um, you might consider having consumers involved in the implementation, um, and the implementation of results, um, and information, um, you also, you know, Um, might have consumer partners involved in your oversight and your guidance, which is probably somewhere where we heavily sit, where we have consumers on our steering committees, um, then we might have consumers involved in the evaluation process, um, and in particular, the resource development, the publications, the presentations, the co presentations and using social media to translate your research into action on the floor.

Firstly, I suppose when we're considering doing a research project or a project, a quality improvement project, in fact, you really need to understand who our audience is. So if we're talking about Metro South Health, obviously we know we've got the five hospitals and then we've got our directorates with community and oral health and addiction and mental health.

And we're talking about a community that is actually the biggest in Queensland. Recently, our team was responsible for generating the Metro South demographic profile report, and many of you may not have seen this before. I've put in the link so you can actually access data report. It gives an overarching snapshot of who you should be looking at targeting.

When you're talking about to consumers and getting consumers involved in your research work throughout Metro South Health, overarchingly, we've got equal males to females. 1 in 3 people are aged under the age of 24. We have 2. 6 percent identify as Aboriginal Torres Strait Islander and that, although that's a 2.

6 percent representation is actually the biggest Aboriginal Torres Strait Islander community group in Queensland because of our volume. And that's just something to keep in mind of. 4 percent identify as Pacifica or Maori. And then if you look at, if you're doing a research project, say, in the Logan community, that would be much higher.

One in five people have a disability, and one in five people speak another language other than English. So in order to ensure that the voices that are being heard in your research project are person centered and value the communities that we serve, it's really great for you to have a look at the data, have a look at your demographic profile, and make sure your consumer representatives are linked in some way to some of those identified groups.

So what does consumer partnerships actually look like at Metro South Health? I've tried to put this slide together, um, to sort of demonstrate how we're setting up a structured approach to consumer partnering. Um, our team is responsible for making sure that, um, we set up systems, um, for, um, our national safety, quality and healthcare standards to meet standard two.

Thank you. Um, and we, as we're tasked, um, as a Metro South, um, standard two committee to actually be responsible for the delivery of the consumer and community engagement strategy and also some of the patient safety and quality, um, strategy items as well. So how our systems work, um, largely we set up committees, um, That represent all the different standards to ensure that the organization a whole was moving together rather than having pockets of excellence working in here, we've been working together to have common goals.

So, in the consumer partnering space, so we stood up the Metro South standard to committee with our executive sponsor of and who's now the ED of QE2. And the chair of that committee is Dr. Jody Nixon, who many of you may know in the research world, who is also my manager, who I'm stepping in here today for.

In that committee, we have four consumer partners, um, that sit and are representative of diverse community groups, and also have strong links to other community networks. And then we have staff representatives for each of the directorates across Metro South Health. We then have a two way system where information is shared.

Both at the standard to committee and also into the directorate committees of standard to, uh, to ensure that all of the actions that we're doing across Metro South health look and feel the same and we're not going off on silo tangents and we're trying to bring the governance together to ensure that we, um.

actually can achieve the goals that we set out. We're actually proud to say that at the moment our consumer and community engagement strategy is six percent complete with 71 percent commenced of projects that we've identified and our target This year was 60%. So we're well on track to meeting the organizational needs in the consumer partnering space.

And that document, the consumer and community engagement strategy is definitely one of our guiding documents in this space. At the directorate level, we have the directorate standard two leads, um, across each of the hospital and directorates, and also most directorates have a person called a person centered care coordinator role, and that role is, um, responsible for consumer partnering, um, initiatives, um, At the directorate level, we also have consumer directorate, consumer partners and director of staff.

We work very closely with our health equity and access team who do a lot of work in the consumer partner space and we have committees set up such as the Metro South multicultural advisory committee and we have the Metro South committee. Disability Action Committee, and soon we'll be having a Disability Inclusion Committee as well, that will be a higher level tier in response to some of the, um, the changes that have just occurred in the disability space.

We also have our Aboriginal and Torres Strait Islander team that we work with, and last year, in September, we set up the Metro South First Nations Elders Consumer Advisory Group. And these committees. are available for members of Metro South Health to come and present projects to and gain consumer feedback.

Across the whole network, we have over 130 consumer partners that sit on across 63 committees. Um, And they all have ongoing consumer partnering roles within Metro South Health. They've all completed orientation. Um, they receive a consumer connections newsletter that we've just updated this year with a new book.

It's sent out quarterly with consumer snapshot stories. And we also run a consumer partnering network meeting quarterly, um, which is an opportunity for, um, executives. Boards and our consumer partners to meet, um, and develop relationships and have that peer connection with one another. At the same time, our team is responsible for supporting the Metro South and statewide, um, consumer partnering initiatives and providing advice to some of those teams across Metro South Health, providing team and support to the research community, and also providing advice to those staff that are running quality improvements and want to include consumers.

Thanks. How to, um, what we're trying to do is be really systematic in how we support staff across Metro South Health. Our standard two website is our go to, um, for everything consumer partnering. Um, this design was co designed by our consumer partners and the little icons actually represent the values of why our consumer partners actually want to improve health care.

Um, and partner with us on a regular basis, I've put in the links here to the links to the website so you can have a look at your own leisure and also the link to the consumer partnering and research site, um, which and link which we update on a regular basis as the research community develops new resources and tools.

In terms of our Metro South consumer onboarding process, we've recently updated this this year. We've developed a new website, which allows people in the community to become consumer partners. They can jump online, find out about consumer partners, and this could be a tool that researchers use. Um, when they're recruiting consumer partners, because you could actually ask your consumers that are interested to jump online, fill out the form.

It comes immediately to our team, and then we can start the onboarding process with that consumer. We've also updated the Metro South consumer orientation onboarding exit procedure, developed a new consumer database, which gives us demographic profiling of all of our 130 Consumer partners, um, and helps feed into the demographic profile report that gets generated annually, and they join our consumer partner network.

We also have developed a, um, on an adaptable virtual and face to face consumer partnering orientation program, which was. Co lead with consumers. Um, and we delivered this five times a year face to face. Actually, I've delivered six and I'll be delivering another one in November. So that would be seven. Um, and basically, we've hosted this on Metro South learn.

Um, and we've been so lucky to have. videoed and profiled in here. So it's peer to peer learning. We've made sure it's inclusive. Um, and we have, um, all of our closed captioning for, um, consumers that are hard of hearing. Um, and also we have had, um, learning opportunities throughout. So the orientation is a great opportunity for you guys when you're doing a research project and partnering with consumers in a long term basis, you send it through to us, we'll do the mandatory training, cultural awareness training, criminal history check, and set your consumers up as vendors, um, and then you basically then just do the partnering.

So this slide's really busy, but I wanted to ensure that we had all the links to our. Um, resources to support consumer partnering. So, obviously, we're led by our policy, but we've got the partnering with consumers in research guideline, which I believe is going to be updated. Um, I know that Jody is going to be working with Erica and the team to update in the next 6 months.

So that's a fantastic guide for researchers to use, um, utilizing the consumer orientation and onboarding procedure, utilizing the online, um, Um, website, um, and asking consumer partners to join up that way and, um, get connected with your projects that way. Um, and then we book, um, the consumers into the orientation program and support them that way.

Obviously, in. Back in 20, um, 22, we introduced renumeration and reimbursement of consumer partners, and this is just really a way to value the contributions that consumers make, and a way to say thank you for the, appreciate the time and the effort, um, and the personal stories that consumer partners share to improve health care.

Metro South holds a central budget, um, which endures, uh, it has supports, um, Um, national standard committees and some of the Metro South advisory committees and the Directorate of National Standards. Currently, there's 4 research committees that are supported in this endorsed list. So, I think I mentioned before, there's 63 committees that are on the endorsed list.

The remuneration procedure recommends that all other research projects are actually funded within the research budget. And generally when you're partnering in that type of situation, you'd be looking at the rate of health consumers rate of 40 per hour to support consumer partnering and valuing their assistance.

Um, all consumers need to be set up. Um, and have a vendor to receive payment. Um, and that's all part of the remuneration process. And I've put in the claim form here, um, because if your research teams are supporting consumer partners, you'd be offering them remuneration. And there's a, we've developed a work instruction for your business manager or your DSO to use to be able to, um, submit the, the claims into S4HANA for payment.

And the other part, which is really important in the research world, is all about health literacy. So, many of you would have known that it is actually Health Literacy Month this month. Um, and we've actually had a guest speaker speak, um, on our website. We've got, um, some of those videos, which are really great.

Practical resources that clinicians and researchers could really benefit from. We encourage you to share that with your teams. And Metro South Health has just recently, our board and executives have endorsed a statement of commitment towards health literacy. And this is all about ensuring that a patient that comes into our care and a consumer that comes into our care actually, you know, Um, understands the health care needs.

They walk away understanding what they need to do next, and they can act on the information that they're actually receiving. One of the biggest tool changes is actually rewriting and writing at a grade level of six to seven. Um, Which is really trying to ensure that we're meeting the low health literacy grade that we need for our community to understand and act upon the health information in this link here for the I've actually put in some tools there that can really help you with your writing.

We've got a shell editor tool. Link in there and also Fleshcade Smith, which are some guiding principles and tools that you might be able to use to help for your research summary sheets, which helps to translate the great research work that your community does and share it with the community in which the patients are receiving care.

You know that language and terminology is really important. So when you're doing a research project, um, we encourage, um, you know, research and technical language can make people feel excluded. So, um, as a researcher, if you can always consider the ways that you're, um, ensuring that you're clear and inclusive and using concise language, um, in your meetings with consumers, spell out any acronyms as much as possible.

And even maybe preferred. Um, discuss preferred terms with your consumers. They might have come up with great ideas that make sense to the population that we're trying to, um, to to actually, um, help. Um, I suppose we know that we don't assume that everyone can read and write. So, when we're talking about those, translating that research into interaction in the summary sheets, it's having a look at the language we use to explain it, maybe using pictures, infographics, to explain.

the impact of the research and how it might help a patient that is living with that, um, that condition that you're researching. The how. So I touched on this before really briefly. Um, obviously when you're engaging throughout a research project, um, we encourage Early participation and involvement of consumers, but also looking at different engagement activities that you might be able to use throughout the cycle of your research project.

I've had a look at the Metro South engagement framework that we've got, and then we've tried to put some research examples in there for the research community to think about, well, if in my project, what type of activities might I be able to use? Do to ensure that I'm engaging with the community that I'm sort of working with.

So it might be about informing your stakeholders about research opportunities, developing fact sheets, newsletters, social media. You might be talking about. developing surveys, doing a community pop up or doing a notice board pop up, the waiting room of the research area to get your patients to give feedback on the topic that you're studying.

And that might be the starting point of how you're actually gathering the insight to what's important to the community that you're serving as well. So, um, There's a range of engagement activities, and I suppose the buzzword at the moment is co design. And when we have a look at the engagement framework, co design sits right at the empower stage of the engagement framework.

And to co design, it really means that you're putting the end decision in the hands of a consumer. And so you might have an element of co design in your research project, but the whole project might not be co designed. And just spelling that out in the research project goes a long way to making it true and authentic.

Um, I, I suppose it's, it's just having a look at different ways that we can, rather than just having a research project committee, it's having a think about what other interesting and creative engagement techniques can we use to engage the community in the work that I'm doing for research. I suppose one of the things that I get most asked often is how do we do this?

Um, so I suppose the key tips that I'd, I'd say for those that are. that researchers that are partnering with consumers involve consumers early and often throughout your research project. Um, I always start out with a map, a stakeholder map of the community organizations, the staff and the departments that actually already have relationships and connections with consumers.

Because what this does is make sure that you are getting the right people at the table. Um, Which who has the right voice and a representative of the community that you serve and that you're researching. I've put in a link here of an engagement stakeholder diagram that you can map out and use as a tool in your research work.

Recruiting is always the big question that we get asked as a team and really coming back to that mapping of relationships and connections. The best way that to find a consumer is. When it's relationship based, so based on clinicians and staff relationships with patients will get you the best consumer that that is, it is really wanting to be investing in your research project as researchers, you can use the Metro South tools that we have on offer, such as.

The consumer partnering recruitment plan, but you might be handing them to your colleagues and fellow clinicians to actually have a conversation with those patients that, um, they know, would make a great consumer partner for a research project for a condition in which that that patient is living. So, That definitely is the best tool for recruitment.

Um, the other thing is offering support to consumers. So it can be quite daunting in coming to a research meeting for the 1st time. So maybe having an informal meet and greet or a call with consumers. tumors before the research commenced. Um, that way you find out their needs, their preferences. And also, I challenge you as researchers to find out what those consumer, what makes those consumer partners tick.

Why are they interested in the research topic that you're proposing? Because that will help you understand how you can get the best insight out of your consumer as well. Um, I think the other thing comes back to communication, be clear, set scope, um, because we know scope creep can be great in a research project.

So, um, if we can try and develop the objectives, um, and set the scope together, then that helps, um, reduce that scope creep, um, when you're working on a project and keeps, keeps the research project on track as well. Reduce using medical jargon and acronyms in meetings in the research meetings, because sometimes research can be really complicated.

Um, the, the language that's used, um, so keeping the meetings to a bare minimum helps, um, and just communicating openly and frequently with your consumers. If you're cancelling a meeting, give them a call, jump on the phone, don't send them an email, um, things like that just make a difference to that personal relationship and connection.

We've got a closing the loop tool here, so if you're doing an engagement activity such as a focus group, um, there's a tool already there which is universally used in engagement. Um, practice around Australia and internationally. We ask you said we did. Um, and it's a great tool to be able to put together all of the insight consumers provided to you and tell them how that you're going to use that insight in your project and recognize, um, and celebrate the successes together and always remember you're not alone.

You've got your Directorate, Person Centred Care Coordinators, or our Metro South Consumer Partnering team to provide advice and I've put the link of all your key staff contacts for your Directorates down the bottom there as well. So, in summary, the one thing that I say often people will come to our team and say, look, I've never done a research project before and I've never partnered with a consumer and I don't know where to start.

And if you, I think, think about connections. Don't think so much about the process and the anxiety around the process and think about developing those relationships and connections know that you're appreciated and you consume. You make sure that your consumers are appreciated. Their efforts and their voices are heard.

You're supported with the teams that you have around you, but also your consumer partners supported by you and your team. Everyone is welcome in the committee, um, to ensure that their identities and their stories can be, um, revealed, um, without, um, feeling anxious, um, and that everyone comes as they are, and everyone brings a different perspective.

So consumers are there to provide a different lens, um, and researchers are there to help them. To provide a different perspective as well. So it's working together with all those different lenses to come up with a solution because we know that alone, we cannot do it. Um, and we can do so little and together we can do so much just as Helen Keller said as a health advocate many years ago.

That quote still remains. These are our amazing consumer partners throughout Metro South Health that we partner with on a daily basis to ensure that we improve health care. And we look forward to hearing more about all the amazing research work that this community does with our consumers and for the community.

Over to you guys for questions. Thank you so much, Amber. There was so much information in there and we will share a copy of the slides to the attendees today so that they can access all of those wonderful links and resources. So thank you very much. Um, I will now like to introduce Michelle Padgett, Assistant Director of Nursing, MSH Clinical Improvement Michelle has 28 years experience in both public and private healthcare in Australia and internationally.

Michelle is a Clinical Excellence Queensland Healthcare Improvement Fellow with a Master's in Healthcare Management. She's a member of the International Society for Quality in Healthcare and a CEQ Healthcare Improvement Community of Practice. Michelle also has undertaken professional training as an Institute of Healthcare Improvement Advisor Prince to project manager and the art of facilitation.

Michelle is passionate about influencing contemporary healthcare improvement and building capability at the direct care and executive level of our health service. As part of the Clinical Improvement Unit, Michelle provides contemporary improvement and implementation science methodologies, operational and professional leadership, and management of health service clinical projects and innovation initiatives across Metro South Health.

I'll now hand over to Michelle to start her presentation regarding implementation science. Thank you, Michelle. Thanks very much, and Amber, thanks for your presentation. There's lots of, um, what you're talking about resonates and there'll be some nice links in my presentation as well. So yeah, I've had a, um, interesting, I'm going to talk to you today, probably more, so there's, there's a theory of implementation science and what is it, and I've got some top tips for you.

But I really want to talk to you today about some of those things and about some of my experience, I guess, at a practical level in the real world, because, um, you know, it, we're not suggesting this is easy at all. It can be hard. And when you get down into the grind of trying to get, you know, your evidence, your research, uh, or just improvement into practice, uh, Sometimes it can be a hard slog, so hopefully I can shed some light on that and share some of my experience about things that have worked, um, uh, things that haven't worked and some of the complexities that we're dealing with, um, in our, in the, in the real world.

Um, so, Like I was just mentioned, I did, uh, I started on this journey, um, when I started my Healthcare Improvement Fellowship, and it was really at a tipping point in my career where, um, I could stay in this, this ever, this world and keep, you know, taking that blue pill and just go, keep going on my merry nice little way, or I could take the red pill and start going down a rabbit hole and really exploring of, you know, how do we really, um, make things better for our community and what does that mean?

What does it look like? So, um, you know, I started really on this journey back in 2008 where I did take the red pill. and glad I did because it has led me to, um, you know, really understanding of, of how things could be different, how we can do things differently to really make a difference for our community, uh, in the future.

Um, just some things that I am going to touch on today is just to talk around, uh, what is implementation science and why is it important? I'm trying to give some tips on setting you up for success and we'll talk around, um, everyone likes a good framework theory model. So we'll talk around some of the implementation science frameworks, um, that you could explore in your own time that will help you on this journey.

So why focus on, why is it so important? And I know I'm probably, I'm preaching to the converted and you all know this and this sort of number has changed over time that it does like when we're, from when we get out, study does. uh, take quite a number of years to get, you know, those studies, research, evidence based practice into, onto the floor and influencing practice as well.

So implementation science, um, as it's developed over the years, trying to bridge that cap of how can we get this amazing research evidence, uh, improvement into practice faster and let it stick and make it sustainable and scalable, uh, again, to really benefit our consumers. So that's why it's so important.

There is a difference. People do talk and this is a, can be a tension between people of what is improvement science, implementation, what's good, what's not good. I'm bad about both of them. They really do work where I sit. And as I've gone along on my journey, they really do work hand in hand. And they've both got advantages from all of it.

And really improvement is around, you know, that rigorous measurement of outcomes associated with that, uh, you know, the efforts of, um, improving care. Um, so it's that continual, you know, measuring, changing, tweaking as well. The implementation science is really around, um, promoting that evidence in the real world and how do we get that evidence into and make it stick in the real world.

So they, but they do have overlapping, both of them have really overlapping aims, is that trans, getting that translational research into practice. Um, it's that systematically implements, implementing that, Evidence on a systematic way, uh, and really to improve the quality of our community. So, that's, there's always been a bit of a tension here, but they do, can complement each other.

When we think about healthcare, so why, why is it seems so hard sometimes? So, when we think about healthcare, and I know, um, some of you have heard some of this language. I might pitch new to some of you. The healthcare is, is a really complex environment and some of it you might have heard the phrase it's a complex adaptive system.

And so what that all means is it's such, it's, health is never linear. So there's so many complexes and systems and behaviours that change over time, um, and it can't completely be understood just as what, on individual components, you've got to consider the whole system of what you're dealing with to really make sense of it and to really, um, get change of practice embedded, uh, and make change happen.

And when you think about it, there's no other system that's more complex than healthcare. You know, Banking, education, manufacturing and the military, you know, healthcare is one of the most complex systems that you can think around. Which I think, uh, is exciting, but when you think about it, it does lend us to, that's why it can be so hard as well.

Not impossible, but you know, it, it, that's, that can lend it to, cause, cause of the complexities, it's never linear, uh, at all. So that's, that's, can, can, can, can, can, can, can, can, can, can, can, can, can, can, If you, some of you want to delve more into the complexities, I recommend reading about complex adaptive systems as well.

It's very interesting and That really resonates when clinicians start delving into the complex adaptive system because you start reading that and you go ah, that's, that's why it's so hard. That makes sense as well. So I'd encourage you to go away and have a look at, um, uh, that area. Um, first of all, so sort of getting into my practical, what we've learned and what I want to always talk to people and people come to us around, um, problems that, or, uh, areas that they want solved.

I say to them, well, what is the problem you want to solve? And really, you really need to understand what the problem is you're going to find. Often I find that people are trying to solve too many problems at once, uh, and that becomes, Yeah. Uh, because of the complexity and that just becomes overwhelming and sometimes is a bit of a blocker for people to start.

So just really breaking it down and understanding what is the problem I'm really trying to solve. We always say to people, take time in this area. Uh, often as clinicians, especially, we jump straight into solutions. We're very solutions and we just want to, you know, with, you know, with the right intentions make things better for our patients, but we don't, we don't really understand what problem we're trying to understand, you know, and that goes into understanding what your data, you guys as researchers know that, um, yeah, but understanding the variability in the system is really important before you get started on this journey because there's so much variability and really delving into that is a really, important before you get going as well.

Um, the other thing I say to people always before you delve in and start implementing things is really just stop and ask yourself, is, is the real problem worth fixing as well? Think about that. Uh, is now the right time. Sometimes it's not always the right time. And when you start engaging and talking to people, you do start to get a sense of the, you know, the people I'm trying to help with the problem or, um, make things better for, they're not ready for this change right now.

And that is really important. You won't get in, you won't get engagement with the team if they're not engaged and distracted as well. And sometimes you just need to pause your idea for a while, um, and then keep it in your top. Draw, and then when you think, ah, now might be the time, bring it out as, uh, and then, yeah, sometimes it's just about timing, um, Will the resources required, uh, provide effort, benefit to justify it as well?

I think that's important. You need to sort of, um, For example, we've pulled out of projects, um, Yeah, in our team, because we just, don't have the resources or, um, it just won't be worth, if it won't be worth, we can't justify it right now. It doesn't mean it won't be in the future, but we just can't justify it right now.

Um, this next point, point number four is really important. Have analysts tried trying to fix a similar problem in recent, um, problem recently? And how did they go? So just exploring that is, have people been down this track? There's a lot you can learn. Um, I think as a health service, um, we probably need to get better at sharing, um, our journeys as well, and our teams.

trying to, uh, work on that as a system of how do we share the problems we've solved with other people and how do we go, our lessons learned, what went well. Um, so, you know, watch your space, always do a bit digging, uh, talking to people, I think, before you get going. Um, what are the anticipated consequences of the change, good or bad?

Uh, That's really something you need to consider because change will always have unintended consequences and really nutting those out at the start and having some mitigation around that is something vital that you need to do before you start on your journey.

So there's a few tips around Um, setting, setting up for success as well. So there's a, there's a, about, there's five elements here, um, that I just want to highlight of those really key things that, I bet this, that is in implementation science, but these are some things that, Um, our team have learnt along the way and I've just touched on that of clarifying what the aim is, um, so what are you trying to achieve, um, what changes do you want to make that will lead to improvement, um, what's the evidence, so you guys will understand that, um, and I think I love this quote by Albert Einstein, if you can't explain it simply, then you don't understand it well enough.

And I always, this always resonates with me because if I can't articulate it, um, what my aim is and what I'm trying to do, then I haven't understood it well enough as well. So I go back to the drawing board. The next point, understanding the context. This is really, and we do see this a lot, that people think that, you know, just because one research evidence based practice or improvement in one area, you can pick it up and put it into another area.

They're definitely not the case. So you really need to understand the environment you're going into. and the interactions at multiple levels in that area to know whether your intervention, uh, is going to be successful. So really understand the context of where you're trying to implement your research change, uh, before you get going is vital as well.

I see a lot of things, um, where they think it was successful in one area, they just plonk it into another area and it fails. And it's, and it's often because they haven't really understood the context of that area. This is, I know this will, um, resonate with, uh, what Amber's talking about. This is, and this is one of the most important steps, is including people in the plan, or the planning, and the journey as well.

This obviously, uh, includes consumers in this, uh, extremely important. Uh, find out. you know, who's interested in the project. Um, also to people, have they got, have people got something to gain and lose and really understanding it from their perspective of what, what's that about? Um, you know, uh, what, and if they're affected by the project, um, I think you're often hearing people talk about, you know, Uh, and I mean this with people sometimes will have a lot of the squeaky wheels and I always say to those guys, you need to listen to those people because it's sometimes or often there's something in there that is a little pot of gold that can be a warning sign for you about what you're about to implant as well.

So listen to those people because they often, um, can be your greatest allies too along your journey. Uh, so that's another one of my key tips and things that I guess I've learned along the way. Um, in your, uh, planning, Uh, as well, um, make sure you've got, you know, you're well prepared a good design. It is preferable that you do a pilot test.

Uh, we always recommend that, um, your pilot test will always give you some redesign opportunities, um, uh, to tweak and iterate. Um, it's never, implementing is never a linear thing. You always need to, uh, test, tweak, test again. Um, and that's iterative over, uh, ongoing as well. The other thing is we always, um, Building support for sustainability and scale up and that can be, um, I think evaluation important is important, is important in this step, but also who you bring on the, uh, journey to make sure it's sustainable.

You need to have a really good evaluation process of the outcomes as well. Evaluation starts at the start of your project. Um, addressing those contextual barriers, like I said before, is really important. Keeping people in, in engaged and informed of the progress along the way, um, uh, is completely, uh, is vital to this, keep it in that will lead to sustainability.

Get them on board and keep them on board. They'll keep your project, uh, on track. ongoing when you step away. So I think those are probably the top, the top tips. I've put a few in terms of frameworks and implementation science. There are a couple of, um, which I know some people listening would have heard of.

So our frameworks that you can go to, um, and I've put them up here so you can explore them in your own time. Probably one of the most famous one is the IPARIS framework that's used in implementation setting. Uh, there's a, the, um, TDP framework, um, and there's also the behaviour change wheels as well. So they're probably the most, typically some of the frameworks that are used in the implementation science world.

Um, so I guess some of my key messages is, from what I've learnt along the way, is that, um, we often see in healthcare a lot of, uh, it's a top down, it can be top, um, down changes. So we say you need to get in with the people on the floor, um, to really get them on board to embed and sustain your change and to help you and to help you, um, be change agents on the floor as well.

Get those guys and they, and that will help it stick. They'll help you along the journey as well. And they will feel invested in, um, you know, the project or, you know, getting your research into practice. Um, I think remembering what I said before around that it isn't easy, it is, it's really, it can get messy in this world and that's because of the complexity in it.

But remember there's always people, particularly in Metro South around that can help you with the complexity and that can help you on your journey and you're never alone. Just, um, you know, reach out and there's, uh, always people to help you on the journey. Doing this, this implementation, um, is never, we talk about it's never in a straight line.

It's twists and turns and there's curve balls that come your way as well. And that's part of it. Um, And, and sometimes that's a lot of the time that's appropriate because like I said before, this is never linear. This is a never linear process. It's complex. It's messy. Um, but at the end of it, I think it's fun.

And when you do, um, your research evidence practice practice into, into embedded and improvements embedded, um, and we see if not system change, then it's, making it better for our community and our consumers, uh, it is very rewarding at the end of that. So that's really my high level tips on implementation science.

Um, the, our clinic, our team's always available to help guide people around improvement, implementation and innovation. So, uh, feel free to contact me if you need any advice, guidance, we're, um, always here, that's part of our job to help people. Uh, and help guide them and mentor on the journey. So thank you very much.

Thank you so much. That was really wonderful information. And I've enabled everyone's mics and cameras to be turned on now if you have any questions. Um, just to get the ball rolling, I just had a quick question for Michelle. Um, we've noticed that there are more and more implementation science or practitioner positions being implemented in universities and in other HHSs.

Do you see there being a role for implementation science positions to support research projects in Metro South Health in the future? Or is it something that we need to build into our current skill set? Um, I think it both. I think you've got to have, um, I've got to, you've got to have the people and there are people with the expertise around Metro South that is growing, but like our team, we're, um, we almost have a philosophy that, um, We have the expertise, but we want to build the capability of the teams out there as well.

So when we're doing, um, there'll be a couple of points. So we'll be given a project, our team reports to the COO. So Paula might give us a project and she say, she'll say, this is a CRU project, but what we try and we work with the teams to Facilitate and build their capability of how to do this as well.

So I think it's too, because you almost, we almost want to do ourselves out of a job, if that makes sense. Build the capability so much that we're not needed anymore. I mean, that would be amazing, wouldn't it? Um, so yeah, we can't do, we're only small, we're a small team of 10, we can't do it all, um, but we really want, we really walk with people and help them understand, um, how, how they can, and get them to own it, because they'll have other, uh, you know, research improvement or whatever they want to do, that we want to build that capability, so then we can step away and then they've got this as well.

So, I think it's both. Yeah, definitely needs to be both. Excellent. Um, did anyone else have any questions in the, that they can put in the chat or, um, you can unmute yourself and ask a question of our presenters?

No?

Okay, well, um, Anne has included the, um, feedback form within our chat. So, if you would like to add any feedback, we are planning for our 2024 research education session. So, Really interested to hear what your thoughts are and what you value out of these sessions so that we can continue to target them into the new year.

Just saw that Noni said it was a great presentation and thank you very much to Michelle and Amber for coming along today. We will share the presentations for those links. Um, if that's okay, so you'll be able to find all those resources after the session and, um, yes, this session was recorded. So it will be available for anyone who wasn't able to attend as well.

And we just wanted to say, thank you so much for taking the time to talk to us today. Great, thank you very much. It's our pleasure. Bye.