Supporting the use of emerging and just-in-time evidence into practice
Sponsor: Dr. Gail Tomblin Murphy
Leads: Drs. Tara Sampalli and Meaghan Sim
Rapid review team and volunteers’ coordination: Julia Guk
Team: Julia Guk, Daniela Meier and the Research Methods Unit, Dr. Prosper Koto, Andrew Hamilton, multidisciplinary team of learners
Other partners: Relevant members of academic community and Nova Scotia Health Library Services
“Rapid reviews are a form of evidence synthesis that may provide more timely information for decision making compared to standard systematic reviews." (AHRQ) These reviews can be conducted using various methods including qualitative methods to understand to contextualize a topic in a rapid way and are typically done is less than 5 weeks. These reviews are mainly targeted towards meeting priority requests or needs from policy and decision-makers, and require a short deadline. The search topics are driven by very locally relevant needs, on priority topics and with short deadlines. These topics are not easily found in the existing literature. Relevant information is often found in grey literature but often linked to contextually relevant findings for jurisdiction or a local context. These requests for reviews thus require a combination of finding evidence in a rapid way in the literature that is found in academic and grey literature, locally published policy, and other relevant documents, very often internal and unpublished documents, analyzing locally relevant data and finally engaging relevant stakeholders such as policy and decision-makers, frontline staff, patients and others through key informant interviews to address policy or priority issues more comprehensively.
NSHA’s team of embedded scientists under the leadership of Drs. Gail Tomblin Murphy and Tara Sampalli in partnership with DHW, several academic partners and entities and patient partners in the province have created a blueprint for conducting rapid reviews on key issues such as collaborative care models in the province, optimization of nursing roles, pain management strategy and organizational culture in enhancing the quality of care for patients to name a few. These reviews have been conducted in rapid timelines of 1 – 2 months or less and with research rigor to inform best practice evidence, policy direction and practice improvements with the overall goal to improve the health and wellbeing of Nova Scotians.
The COVID-19 pandemic and dealing with a novel virus has presented a unique challenge for pandemic planning and policy-setting with changing policies and practices related to rapidly changing understanding and evidence. This has created a higher need for rapid synthesis of emerging evidence related to public health, infection control practices, long-term care and personal protective equipment and new considerations for virtual care, working with vulnerable populations, the safety of the workforce and patient engagement. The COVID-19 circumstance has generated unprecedented requirements for rapid reviews with researchers, policy and decision-makers, and frontline staff producing evidence daily to enable a rapid learning environment to mitigate the massive impact of the virus. Much of the evidence being produced are early learnings, ideas, innovations with limited few that could demonstrate evidence with scientific rigour. Consequently, the quick turnaround synthesis of evidence has to be generated from diverse sources such as grey literature, relevant websites from government and other organizations or media sites.
The rapid review team is comprised of embedded scientists in NSHA, members of the Research Methods Unit, academic partners from local universities and a team of volunteers comprised of multidisciplinary learners including medical, health administration, occupational therapy, nursing, and computer science. The rapid synthesis of evidence has been conducted daily based on requests from the Emergency Operations Centre, Executive Leadership Team, various working groups established to address priority needs during COVID-19. Reviews have been conducted daily and often times with a 24 hour turnaround timeline. The information and evidence retrieved from diverse sources including systematic reviews, commentaries, rapid reviews, credible and trustworthy websites (JAMA, BMJ, CMAJ, NEJM, WHO, IPAC, Health Canada, CDC), and credible media sites. Information and evidence in the review documents have been reflective of what is known on the day the request is processed with new evidence and updates provided as evidence have further emerged and become available.
1. Rapid reviews generated based on a request from EOC/ELT, key working groups involved in COVID-19 planning / response, or identified as relevant for planning by the rapid review team. These preliminary documents will be made available with restricted access to EOC, ELT and relevant working groups on the COVID-19 Hub to facilitate easy and timely access to elicit further discussion and conversations.
2. Disclaimer for the first round of documents to be noted and acknowledged by all using content from reviews and the intended audience is typically the members requesting the review or as identified by the rapid review team as being relevant.
3. Once identified as relevant for a broader audience, reviews will be finalized with the support of relevant partners as co-authors or endorsers. These reviews will now include a section of key considerations, limitations or impact as relevant to the NS context in COVID-19 planning and response. They will be published for open access on the COVID-19 Hub.