Bringing knowledge to bear in a primary care organisaiton Feb 2011


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A description of knowledge management in action in Milton Keynes PCT

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  • If Only We Knew What We Know: The Transfer of Internal Knowledge and Best Practice O'Dell & Grayson 1997
  • Healthcare is knowledge-intensive Multiple teams provide information and evidence to bringing knowledge to bear on commissioning – needs assessment, planning, service specification, contract monitoring, health improvements – and I manage these teams directly
  • Business Intelligence team Performance monitoring of PCT and providers Making best use of analytical tools available Informing planning, programmes and projects Defining measures of success – clinical outcomes, quality improvements
  • And training from CRD on cost effectiveness And where can Where can knowledge have the most impact? Commissioning Librarian role; Library SLA inc. primary-care e-learning librarian
  • How can CKOs build the Know-How to improve business performance, reduce costs and improve quality?
  • Commissioning, Disinvestment and contracting manual describes how we manage the journey we experience when commissioning and contracting. It sets out the phases of work (‘Pipeline’ Fig 1.0) through which requests for changes in the services currently being commissioned are steered. Clearly defined processes and standardised documentation support a shared understanding so that we can effectively navigate / steer a proposed commissioning change through to delivery / implementation.
  • Techniques to support while-system approach to service redesign
  • Sharing Know–How, making learning explicit, signposting evidence
  • Skilled and innovative team
  • NICE – collection of health and social care publications Healthcare bibliographic databases Links to online resources eg journals “ upgrade” due in April 2011 Currently paid for though central agreements, SHA and local libraries
  • Good information and intelligence lies at the heart of health improvement.  GP consortia will want to be intelligent organisations GP commissioners need to be intelligent users of information Many of the practical challenges we need to address as the Trust is dis-established, and new organisations form, will require the conscious management and transfer of knowledge. As new organisational structure are developed, and we disestablish & hand over responsibilities, we will be taking our corporate memory and relevant aspects of our knowledge base off in different directions, (ie consortia, MKC, NPHS, Commissioning Board). We will also wish to enable successor organisations to accelerate their development, and invite them to build on our learning, if they wish. The aim of this workshop is to look ahead - identify key challenges, prioritise, and consider options and approaches we might take in each key area. Rather than finding that individual managers feel left to work out what is best for one responsibility / resource or another, this is an opportunity to come together as a small group to think ahead, sound out ideas and put in some planning. Outputs Prioritised list that informs our capability and capacity plan Gap analysis of where we lack knowledge to meet our organisational priorities 2010-13 Protecting knowledge; identifying key assets; mitigating knowledge drain 2010-13
  • NLH Licences cut for journals Nat PH service - ? LA service cuts NHS Library services? Internal / local knowledge
  • Bringing knowledge to bear in a primary care organisaiton Feb 2011

    1. 1. Bringing knowledge to bear on commissioning Sue Lacey Bryant, Chief Knowledge Officer 11th February 2011
    2. 2. “If Only we knew what we know” “Knowledge is the enemy of disease, the application of what we know will have a bigger impact than any drug or technology likely to be introduced in the next decade”
    3. 3. Who are we? Your virtual knowledge team: • Anne Gray – Knowledge Officer, NHS MK Public Health • Linda Potter – Primary Care Librarian Library services via a joint SLA • Sue Lacey Bryant, Chief Knowledge Officer plus Steve Hance, Project manager
    4. 4. The programme 1. What is Knowledge Management? Sue 2. KM - an ABC; starting at A Sue 3. KM in practice: informing referrals management Steve 4. KM from B-C Sue 5. Evidence into practice: Making an IMPACTE Linda 6. Informing commissioning decisions Anne 7. Keeping up to date Anne 8. Transferring knowledge Sue
    5. 5. 1. What is knowledge management?
    6. 6. • Using knowledge to improve business performance, reduce costs and improve quality • Consciously moving the right knowledge to the right people at the right time to be translated into action to improve organizational performance Knowledge management is about:
    7. 7. Practical and pragmatic • Applying knowledge • Building ‘know-how’ • Continuing to learn
    8. 8. As Chief Knowledge Officer ... • Ensure strategic and operational activity is informed by sound evidence • Ensure information requirements of projects, and of consortia, are defined • Ensure the business intelligence team is proactive, streamlined, focused on users • Stimulate approaches to capturing knowledge so that ‘know-how’ is made explicit and transferred • Manage the Library SLA to deliver proactive services • Spread and embed good practice • Support future configurations & current imperatives
    9. 9. Director of GP Commissioning Consortia Development
    10. 10. Business intelligence team Refining, analysing and combining, and interpreting D A T A I F O R M A T I O N Meaningful Timely Relevant Quality assured Information customersData providers Data Transformation Support and education for data suppliers/customers, to improve data quality and information requests Quality assessed
    11. 11. Implementing primary care systems
    12. 12. Knowledge is everyone's business Across the organisation including - Communications and Engagement Corporate Affairs Human relations & organisational development Information Technology Public Health Intelligence Quality and Standards System Reform
    13. 13. 2. Knowledge management – an ABC Starting at A
    14. 14. A = Applying knowledge • Data on activity, cost, outcomes • Research evidence on clinical outcomes and cost effectiveness • “Best practice” including models of service • Patient experience
    15. 15. KM in practice: opportunities for innovation
    16. 16. Adjusted Clinical Groups system: ACGs • 1 of several predictive models to target case management • Identifies patients with a high disease burden— who may benefit from review, improved coordination of care • Focuses on developing & commonly occurring patterns of morbidity - looking for convergence of risks defined by diagnoses, use of health services and prescribing eg. seeing multiple providers, taking multiple prescriptions • Supports quality improvement; helps control varying levels of co-morbidity amongst patients • From John Hopkins University
    17. 17. 3. KM in practice Informing referrals management Steve Hance Project manager, Referrals project
    18. 18. • The challenge: Reducing un-warranted variation in activity and outcomes of care to increase value and improve quality • The solution: “The application of best practice is massively beneficial to quality and productivity “ David Nicholson . HSJ 10/09/2009
    19. 19. Communication • So much data: how come I never see it? • Data : Referral Data, Referral data from Choose & book, Monthly data report, Practice data, Low priorities data, Audit data • Evidence • Kings Fund report, Understanding patients’ choices at the point of referral, setting out evidence base and options report • Communication • , Newsletter – GP Consortia weekly briefings, Consortia email bulletin, Ad hoc e-mails
    20. 20. Education: Learning opportunities • Referrals wheel • Top tips • GP Referral LES • Practice visits • Sharing best practice • Consortia meetings • CPD events
    21. 21. Commissioning: What next? How can we use these data? • Identify areas which are performing well/badly • Formulate action plan to identify why • Identify ‘spend to save’ opportunities eg Lesion clinic?
    22. 22. Referrals support service
    23. 23. What works best for you in consortia? • Reviewing the sample of documents on referrals – • How would you prefer to receive this data/information? – What format? Media? – Presentation? Level of detail? – From whom? Frequency? • How should it be delivered to give you maximum benefit? • What else do you want to see/have available?
    24. 24. 4. Knowledge management from B- C
    25. 25. B = Building Know-How to improve performance
    26. 26. Establish commissioning methodology Commissioning, Disinvestment and Contracting Manual, July 2010
    27. 27. NHS MK Model of improvement
    28. 28. C= Continuing to learn • Master-classes • 1:1 sessions • Group presentations • Shadowing • Learning sets • • After Action Reviews • Education steering group
    29. 29.
    30. 30. 5. Evidence into practice
    31. 31. Information specialists: skills • Information retrieval: sources, searching and sourcing • Information management • Information skills training • Research • Synthesis • Communications • Web-editing skills
    32. 32. Making an IMPACTE Improving Medical Practice by Assessing CurrenT Evidence
    33. 33. 6. Informing commissioning
    34. 34. What information do you need? • Best practice – guidelines, service specifications, case studies • How to run a clinical service – location, processes, workforce, competencies • Monitoring – performance, outcomes, audit • How much does it cost? – health economics, cost benefit, prioritisation • Tools – NICE, DoH, public health
    35. 35. Helping you find the evidence • NHS Evidence
    36. 36. Helping you find the evidence • NHS Evidence – “upgrade” due in April 2011 – Currently paid for though central agreements, SHA and local libraries • But there are lots of other resources too..
    37. 37. Commissioning resources • Commissioning websites • Expert Bodies eg RCGP, BMA, Pickering, CQC • Other NHS trusts • Social Care and Local Authority sites • Statistical websites eg PHOs, Information Centre Why not ask a librarian? Ask the librarian to find the information • searches based on individual requirements • for individuals or teams eg Programme Boards • appraise and summarise the results
    38. 38. Knowledge Officer • Searching for information – Retrieval, selection, appraisal, synopses • Provide evidence to support pathway review and service redesign • Information skills training • Links to MK Hospital and other NHS libraries • Knowledge Zone: • Keeping up to date
    39. 39. information and resources brought together by NHS Milton Keynes to support the development of GP Consortia
    40. 40. GP Consortia
    41. 41. Knowledge Zone
    42. 42. Local and national statistics
    43. 43. 7. Keeping up to date
    44. 44. How do you keep up to date? • Question 1 - How do you keep up to date with new evidence around clinical practice? • Question 2 -How will you keep up to date with new evidence/policies around commissioning? • Answer - Collection of alerting resources on Quality MK website
    45. 45. Keeping up to date
    46. 46. 8. Your Invitation Transferring knowledge to successor organisations Workshop objectives – Protecting knowledge assets – Mitigate the risk of knowledge drain 2010-13 – Support GP consortia development – Support system transition Workshop outputs – Identifying key assets – Prioritised list that informs our planning – Gap analysis of where we lack knowledge to meet our organisational priorities 2010-13
    47. 47. The future? • How can we better support current imperatives? • Who will manage knowledge in the future?