Dunja Dreesens

47 Introduction The amount of knowledge in health care is vast and accumulates fast (14). Clinical practice guidelines (CPG) and patient decision aids (PDA) are common tools being developed to support healthcare professionals and patients in knowledge translation and (shared) decision making (95). These tools can help in staying abreast of the available knowledge and contribute to the improvement of quality health care. Beyond CPGs and PDAs, a scoping review yielded an abundance of types of knowledge tools available to professionals and patients in the Netherlands to support quality improvement. It also became clear that contrasting or incomplete definitions were used to describe these tool types (143). Moreover, these tools are not often used in practice for instance due to unfamiliarity, limited usability, or non-acceptance (42, 43, 141, 144-147). It might be argued whether the sheer number of tool types is helpful or complicates the process of knowledge translation (KT) (148), and quality improvement in health care. Organisations such as Agency for Healthcare Research and Quality (AHRQ), Canadian Institutes of Health Research (CIHR), the Cochrane Collaboration and World Health Organization (WHO) have glossaries or A-to-Z’s on their websites, but these mostly explain health terms and do not describe the knowledge tools in detail (122, 123, 129, 130, 132). Existing overviews of tools include similar tool types with different names and without a clear definition or description (70, 88, 149). No attempts seem to have been made to limit the number of tool types and achieve consensus on the definitions on a national level. A comprehensive, commonly accepted set of knowledge tool types and their definitions seems to be lacking in the Netherlands, as we expect is the case elsewhere. Although we focused on the Netherlands in this study, we aimed to link English terms and tool types to the Dutch ones and to contact international research communities active within knowledge translation (120), and connected to the Guideline International Network (G-I-N) and International Shared Decision Making (ISDM) (88). The research and preliminary results were discussed with experts and at two conferences of G-I-N and ISDM (138, 139). We learned that others encountered the same issue in other countries. This led to an invitational meeting with international experts to develop a framework for (patient-directed) knowledge tool types (142). The objectives of this study are: first, to agree at a national level on a core set of knowledge tool types that supports clinicians and patients in knowledge translation, (shared) decision-making and quality improvement; and, second, to agree on the definitions of these tool types. Our ultimate aim is to promote a mutual understanding and use of a limited set of tool types. The Dutch National Health Care Institute, responsible for quality of care against acceptable costs in the Netherlands supported and participated in the study. Chapter 3