Working Smarter by Mobilising Knowledge

Rachel CookeActing Lead for Libraries & Knowledge

Management NHS East of England

• NHS agenda – QIPP

• Where does Knowledge fit?

• Spectrum of Knowledge

• A few examples of good practice

• The Challenge

Q I P P

Quality & Productivity Challenge

Innovation

Productivity and

Prevention

Quality

“To invent and begin to apply new devices

or methods”

•To improve patient experience•To improve patient safety•To improve clinical effectiveness

•To do more with the same•To do the same with less•To do more with less•To reduce downstream costs

Knowledge Sharing & Learning

• The problem:• ‘…inefficiency of vast variation in activity

and outcomes of care’

• The solution:• ‘The adoption of best practice is massively

beneficial to quality and productivity’

• David Nicholson, HSJ; 10 September 2009

Knowledge Sharing & Learning

• Better informed projects

• Prevent same mistakes

• Reduce the risk of duplication of effort

• Generate & sustain innovation

Evidence Based Healthcare

Best Research Evidence

Patient ValuesClinical Expertise

Evidence Based

Healthcare

“integration of best research evidence with clinical expertise and patient values.”Sackett David et al. Evidence Based Medicine: How to Practice and Teach EBM. Churchill Livingstone: Edinburgh, 2000

Chief Knowledge Officer

• March 2008 National Review of Health Libraries in NHS England Published (Hill Review)

• Recommendation 11 - In every NHS organisation someone at Board level should be entrusted with the role of Chief Knowledge Officer (CKO) for that organisation

• Objective - To lead the development, management and sharing of knowledge within NHS and partner organisations to maximise its use in supporting the improvement of Patient Care.

Work with EoE Chief Knowledge Officers to enable them to have a positive impact on

improving quality and patient safety, maximising productivity and sustaining

innovation throughout their organisation.

By the effective use, generation and sharing of knowledge and best practice from within

and outside their organisations.

Knowledge Management:Tools & Techniques

Capturing & Structure

Sharing & Re-use

Creation & Acquisition

Peer Assist

Collaboration Spaceswikis, blogs

Knowledge Exchange

After Action Review

Knowledge Plan

Elicitation Interviews

Knowledge Assets

Retrospect

Learning Reviews

Self assessment/river diagramPost Project Appraisal

Storytelling

Social Network Analysis

Rapid Onboarding

Knowledge Retentionstarters, movers, leavers

Communities of Practice

Learning from Projects

Reducing Risk

Maidstone & Tunbridge Wells

• 90 C Diff deaths - cited in Hill Review

• Poor knowledge can result in patient harm

• Chief Knowledge Officer

• Head of Library Services

Reducing Risk

Maidstone & Tunbridge Wells• Using Knowledge to Reduce Risk

– Number of workshop run – using KM self assessment tool

– Start of new MTW Community of Practice

• File management, good practice, template approach, help guides

• Knowledge Audits• Joint work with Quality Observatory

Data & Research

• Quality Observatory & Library Service

• 50% MRSA community acquired

• Statistical model of CA-MRSA

• Commissioning to reduce CA-MRSA

After Action Reviews

• What did we set out to do?

• What actually happened?

• Why was there a difference?

• What can we learn for next time?

After Action Reviews

Brighton & Sussex University Hospital

• Expected:– Sutures used in surgery should be within

use-by date

• Actual:– Out of date sutures were used during

surgery

Knowledge Retention & Transfer

When someone is leaving:1. Identify knowledge at risk2. Prioritise areas of expertise and agree transfer plan3. Deliver agreed activities e.g. Organise personal information, emails, contacts Hold a Q&A session Ensure documents are transferred to accessible place 4. Capture outputs and disseminate – facilitated session

Knowledge Retention & Transfer

Case Study - Lessons Learned

• Overall benefit for leaver feels:– more organised leaving– leaving the team with less stress

• Overall benefit for successor feels:– less stressed than she would have without having done this exercise

• The future – make it part of a more joined-up leavers process, with HR and ICT– Start early

© NHS Institute for Innovation and Improvement Knowledge Management Team

Workshop Approach

• Introduction to KM• Social network analysis• Organisation Development

– Taking Stock – exercise– Culture of sharing – 3 case studies

• Lunch• Connecting People to People

– Communities of practice & other techniques

• Data, Information & Technology– Technology – an overview– Data & Information – SEC case study

• Where do we go from here

The purpose of knowledge management is to provide support for improved decision making

and innovation throughout the organization. This is achieved through the effective management of human intuition and experience augmented by

the provision of information, processes and technology together with training and mentoring

programmes.

David Snowden www.cognitive-edge.com

Where can you add value