NHS Education for Scotland and Healthcare Improvement Scotland are working with NHS Boards to define new approaches to implementing and sharing knowledge which support practitioners to get knowledge into action at the frontline. This shift in focus from accessing to applying knowledge will integrate knowledge management more closely with quality improvement. This interactive workshop will use creative knowledge management techniques to challenge the way we apply knowledge in practice.

1. Knowledge into Action – to improve quality of care

3. “ The NHS is….. not good at capturing, using and sharing information. Lots of data, a lot less information and even less knowledge, and that's bad for patients and their families, it's bad for clinicians, bad for managers, bad for regulators and bad for policy-makers.” Ann Abraham, Parliamentary and Health Service Ombudsman, reporting on Mid-Staffordshire Inquiry.

4. “ Yes, it’s quite a noise – - but are we having any impact?” The challenge for getting knowledge into action…..

5. The Knowledge-Practice Gap Only 55% in US healthcare system receive recommended care McGlynn et al (2003) Estimated 30-40% of care in UK not based on available scientific evidence Grol, R. and Grimshaw, J. (2003) 5 year gap between publication of guidelines and changes in routine practice in Western healthcare systems. Lomas et al (1993)

9. What works in getting knowledge into action?

10. A Strong Knowledge Infrastructure

11. Evidence that knowledge works

12. 1)Knowledge Uptake Interventions - Use well defined structured items e.g. SIGN, care pathways, evidence bundles, 1-1 knowledge outreach. 2) Relational use of knowledge - Sharing knowledge to facilitate 3 C’s 3) Organisational / Systems approaches - Barriers and Levers Adapted librarian roles to support all above 3 Key Approaches

13. Examples of Knowledge into Action Approaches

14. Content creation Standards: metadata, taxonomy, content structure Actionable knowledge at point of care ONLINE Actionable Knowledge Relevant Evidence All Literature Clinical Content Management

19. “ The application of what we know will have a bigger impact than any drug or technology likely to be introduced in the next decade.” Sir Muir Gray Director NHS National Knowledge Service & NHS Chief Knowledge Officer

20. Knowledge into Action Stories What can we learn from them and how can we improve?

21. “ In April, a 70 year old, independent lady with no previous comorbidities. became a grandmother for the first time and was looking forward to watching her family grow up. She developed a cough & became breathless and presented to her local hospital. She was admitted, and developed severe sepsis & septic shock secondary to her community acquired pneumonia and died within 7 hours. Her sepsis was not recognised, and antibiotics & fluids were not given in a timely manner. The patient’s family and the well-meaning and competent medical and nursing team are devastated.” Patient and staff story…. From patientstories.org.uk

22. The clinical team meet to review the case and discuss what changes they could make to prevent this happening again. They invite their clinical knowledge manager to join the discussion. What knowledge into action approaches could help?

23. A new set of National Standard Infection Control Policies is being issued. Despite many standards, policies and educational efforts over the years, there is a continuing need to improve practice in infection control in both acute and community care. The Infection Control Nurse in your Board is tasked with managing implementation of the new SIPS and decides to discuss approach with the local knowledge management team. What knowledge into approaches could they consider ? Creating a new story…

24. Define uptake interventions! Build relationships! Analyse the context! Knowledge into Action: interventions & strategies

28. Knowledge into Action – to improve quality of care [email_address] [email_address]