Accelerating Spread of Quality Care

Connecting the Dots

Advice seeking networks in long-term care

How do you spread innovation in the long-term care sector? One way is to engage the people who are asked for advice by others.

Social network analysis is a technique used to map networks of people and the ties that connect them. The TREC study of advice-seeking networks in long-term care used this approach to identify informal advice-seeking networks. The study mapped networks among Canada’s nursing home leaders and networks among nursing homes themselves. 

This study identified a nation-wide network structure in long-term care, tied together through informal advice-seeking relationships—a single advice-seeking network that spans the country, plus highly developed regional networks.

It also identified people and nursing homes that bridge networks—boundary spanners. Both network opinion leaders and boundary spanners can be targeted as early adopters to successfully spread initiatives, to innovate and to implement new health knowledge in resident care.

This study was a Partnership for Health System Improvement project study funded by CIHR and our provincial health funders. Decision makers and knowledge users from across the country, including government department officials, health system administrators and nursing home directors, were heavily involved from conception right through extensive dissemination activities.


TREC identified a nation-wide advice-seeking network among Canada's nursing homes. This pan-Canadian network is a potential tool to spread innovatino more efficiently and cost-effectively throughout the sector.

Sharing research results

TREC shared the results of the network study with a variety of stakeholders, through a variety of strategies:
  • Creating information packages with survey feedback for the 482 survey participants
  • Hosting six webinars for survey participants
  • Hosting eight regional webinars for knowledge users and decision makers in the nursing home sector and in government agencies
  • Completing 39 interviews with advice seekers, opinion leaders and boundary spanners
  • Presenting results to Alberta’s Seniors Health Strategic Clinical Network
  • Presenting results at the Nova Scotia Centre on Aging conference
  • Hosting three knowledge translation summits (Edmonton, Winnipeg, Halifax) attended by 77 knowledge users in total
  • Presenting a nationally broadcast webinar for the Alzheimer’s Society of Canada


The advice-seeking networks in long-term care study is the first of its kind to identify professional advice networks in Canadian long-term care and to analyze how provincial differences in geography, public policy, and market dynamics influence these networks and in turn, the diffusion of innovations.

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