WHAT’S THE PROBLEM?: The overarching problem is that there is a lack of attention given to ‘what to do next’ to advance knowledge brokering in many European countries’ health systems. This problem can be understood by considering four sets of interrelated issues within any given country’s health system: – untapped potential for health systems information to inform policy-making; – missed opportunities to take stock of the current state of knowledge brokering and to prioritize enhancements to information-packaging mechanisms, enrichments to interactive knowledge-sharing mechanisms, and adaptations to organizational models that support knowledge brokering; – lack of alignment of support for knowledge brokering, including incentives and requirements for using promising knowledge-brokering mechanisms and models; and – limited reach of existing efforts to advance knowledge brokering.

WHAT DO WE KNOW (FROM SYSTEMATIC REVIEWS) ABOUT THREE VIABLE OPTIONS TO ADDRESS THE PROBLEM?: Option 1: Establish a portal for knowledge-brokering mechanisms: – This option involves taking stock of the current state of knowledge-brokering mechanisms and resources and establishing a country-specific portal through which available knowledge-brokering mechanisms and resources can be identified, accessed and used. – A portal for knowledge-brokering mechanisms, if optimally designed, should increase the chance that policy-makers can find the best available health systems information in the time that they have available, which is one of three factors shown to improve the use of health systems information. We found a systematic review about the benefits and potential harms of establishing financial incentives, which is one type of potential reward for contributing to such a portal. Option 2: Convene a dialogue to coordinate advancements in knowledge brokering: – This option involves taking stock of the current state of knowledge brokering and convening one or more national policy dialogues to: prioritize advancements in knowledge brokering, allocate responsibilities for these advancements among existing and new knowledge-brokering organizations, and establish a coordination process and rewards for these organizations. – In addition to the review about financial incentives, we found one systematic review about key considerations related to convening policy dialogues and seven reviews about key considerations related to undertaking a priority-setting process. We also found several systematic reviews about key considerations related to supporting the adoption of innovations. Option 3: Centralize knowledge-brokering mechanisms in a well-designed organization: – This option involves taking stock of the current state of knowledge brokering, convening national policy dialogues to prioritize advancements in knowledge brokering and begin to identify whether an existing or new organization can best take responsibility for knowledge brokering, and then designing, building consensus on, launching and monitoring and evaluating a single, well-designed knowledge-brokering organization to support the country’s health system. – The reviews about convening policy dialogues, undertaking a priority-setting process and supporting the adoption of innovations are equally relevant to this option. Deliberations about this option would also need to consider explicitly that there are advantages to both having a single organization within a given country (e.g., reduced duplication and confusion) and to having a diversity of organizations in the country (e.g., potential complementarities and dynamism).

WHAT IMPLEMENTATION CONSIDERATIONS NEED TO BE KEPT IN MIND?: Potential barriers to implementing these options include: – researchers and research organizations resist efforts to give attention to knowledge brokering; – knowledge brokers and knowledge-brokering organizations resist efforts to share insights and undertake advancements in knowledge brokering that might erode their comparative advantage or lead to an end in their role or organization; and – policy-makers do not engage in efforts to design advancements in knowledge brokering to meet their needs. However, these and other potential barriers (and strategies to address them) warrant further study in their own right.