Enhancing Advance Care Planning implementation through evidence: Interview with Knowledge Translation Lead, Associate Professor James Low

GERI has convened the Advance Care Planning (ACP) Quality Implementation (AQI) Knowledge Exchange Platform, in collaboration with the Agency of Integrated Care (AIC), to explore ways of adopting research evidence to enhance the implementation of ACP in Singapore. 

Together with practitioners from three regional healthcare clusters, the community care and long-term care sector, and the Ministry of Health (MOH), the team is developing a framework and set of quality indicators aimed at raising standards and enabling quality implementation of ACP in real-world settings. 

In this two-part feature series, Associate Professor James Alvin Low (Knowledge Translation Lead and Joint Faculty, GERI) and Penny Lun (Research Associate, GERI) share their insider insights on working on the national-level AQI project, as well as closing the research-to-practice gap through implementation research and knowledge translation strategies. Read part one of this story below.​

GERI: As GERI’s Knowledge Translation lead, could you share with us why closing the research-to-practice gap is more important than ever today, and especially so for matters relating to the older person in Singapore?

Associate Professor James Low: There is an explosion of new scientific findings and discoveries taking place every day, in many disciplines and areas of human endeavour the world over. Healthcare is no exception. Unfortunately, much of this new information, knowledge or evidence will forever remain in the conceptual realm of the human mind, in the research labs, or remain entombed in medical journals. Lately, there has been a renewed interest in trying to make good use of some of the information and knowledge that has been synthesised, “mined” or “created”, and applying this in real-life settings.

The ultimate goal, truly, is to improve the lives of humans—and in GERI’s case, the older population. The key idea is to turn concepts, theories, research findings into real-life, real-time solutions for the betterment of the older human. GERI stands at the forefront of using implementation research and knowledge translation principles to achieve these ideals and quest.​

You previously observed ​​that two critical success factors to bridge the research-to-practice gap are to “obtain buy-in and cooperation from major stakeholders" and the need for “continual efforts to showcase, share the methods, and impart understanding of knowledge translation with these stakeholders."

What is one useful take-away that you can share on how you and the team built up such buy-in and cooperation this past year?

For this platform, our major stakeholders were decision-makers and policymakers from organisations including the Agency for Integrated Care, the Ministry of Health and the three regional healthcare clusters. It was important to allow these major stakeholders to “take ownership" of the platform and be the main party that crafts the strategic direction, goals and processes involved in the platform. This is because they are the movers and the shakers—we need buy-in from them in order to implement, maintain and sustain any knowledge translation efforts. GERI would act as the co-driver, enabler and catalyst for the platform.

The AQI Knowledge Exchange Platform is the first such platform that GERI's Knowledge Translation team has convened at a national level. From your perspective as a Core Group member, what are some key resources and knowledge that GERI, as a national institute, brought to this project?

We applied our knowledge translation and implementation research expertise and skills in guiding the major stakeholders. It was an interactive process that evolved as the project progressed and was adapted to the needs of the stakeholders. We also possessed some core knowledge of the whole ACP ecosystem and framework that helped us customise the platform accordingly.

The whole exercise was a new experience for the GERI team and much of methods devised were new and novel. We did not have many references or pre-existing models to follow or guide us. We went back to the science and evidence already in existence in the healthcare and medical literature, using that to guide and inform us on the barriers and enablers for good and quality ACP implementation.

Looking ahead, what are your hopes for how the fruits of the AQI platform will “live on" and sustain in different forms, following the conclusion of the platform's two-year run at end 2024?

We really hope that the National ACP Steering Committee and Office would be able to grow and sustain the seeds that have been planted with the help of GERI, on this journey of quality, value and excellence in this ACP ecosystem.

Read the second part of this story here​, where our Research Associate, Penny Lun, dives into her work and process in supporting the AQI project and beyond, such as evidence synthesis to address health policy challenges.