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Bringing research and researchers into the policy-making process resolves conflict more readily; it also increases the likelihood of consensus in the areas where research is available. 8 Conflict and disagreement feed on uncertainty and the multiple interpretations of reality that this uncertainty makes possible. Apparently, the synergy of combining research and researchers' analytic abilities with decision-makers' input reduces this uncertainty, thereby starving conflict of its nutrient. Finally, the one-on-one encounter consistently emerges as the most efficient way to transfer research. 9 Exchanges between decision makers and researchers allow for nuance and interrogation. The success of academic detailing in altering drug prescribing patterns is largely attributable to this face-to-face interaction. 10 For a decisionmaker, being linked to a researcher provides a conduit to more than one individual's expertise, as the link becomes a gateway to the more extensive knowledge of that researcher's whole community. Working with this evidence base, the foundation has built in the principle of linkage and exchange to nearly all of its activities, including its governance.
Every three years the foundation conducts a national consultation exercise that brings health-sector researchers, managers, and policymakers together to forecast the pressing issues for the next five years. These consultations are conducted as workshops across the country. Not only do these give the potential end users a say over research priorities, but they also afford both the researchers and the decisionmakers an opportunity to get to know each other and each other's cultures. The foundation uses this exercise to establish the theme areas in which it provides support for research, personnel, and training. The current areas are centralization and aggregation of health services, continuity of care, informed public participation in decision making, and nursing policy and management. The foundation funds only half the cost of most of the research and personnel it supports. The remainder is contributed by partners in the provinces, known as cosponsors. Given the constitutional division of powers in Canada, provincial governments are responsible for health services and, therefore, are the main decisionmakers for the design and day-to-day operation of health systems. Involving provincial governments and their agencies in cosponsoring research in their jurisdiction is one way of generating ownership in the results.
In a recent survey, 55 percent of decisionmakers and 75 percent of researchers with a view on this topic felt that this cosponsorship promoted partnership between the two. Cosponsorship also gives the foundation an opportunity, and the cosponsors a motivation, to collaborate in the foundation's periodic priority-setting and program design activities. The peer-review process, or “study section” in U.S. “peer.” Our reviewers convene as a merit review panel, with equal representation from researchers and decisionmakers. Panel members are selected from a pool identified by cosponsors, the foundation, and others. The assessment of applications therefore becomes another venue for linkage and exchange. The panel uses explicit criteria to concurrently assess both the scientific merit and the potential impact of the proposed research. This recognizes, and gives an imprimatur to, the relative expertise of each type of panelist. A proposal must pass threshold values for both dimensions before the panel will recommend it for funding.