[How can we improve effectiveness (quality) by reducing the gap between research and action? 2008 SESPAS Report]

In our environment, research on health technologies and health care effectiveness is a prominent issue in current knowledge policies. Nevertheless, there is wide consensus on the need for additional efforts to develop the translational component of this kind of research under the hypothesis that taking research into practice is a necessary condition for improving healthcare. The characteristics that facilitate or hinder knowledge transfer in healthcare organizations are analyzed throughout the present text. At the same time, we discuss some successful experiences that illustrate how the chasm can be reduced and healthcare effectiveness (i.e. quality) improved. Among the mechanisms that might either reduce or maintain the chasm are the following: 1) the type of organization (healthcare provider model, teaching status, mix of professionals, the organization's capacity to learn and innovate, etc.); 2) the organization's government (leadership in evidence implementation, capacity to manage professional roles, ability to use economic incentives, availability of an information-rich context, the use of knowledge management, etc.), and 3) the effectiveness of the strategies themselves in translating evidence into practice. Finally, we describe some successful experiences focusing on implementation, on researching the evidence that is needed, and on reinventing the organization to convert information into knowledge.