Cooke2010
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The document discusses knowledge management strategies and practices in the NHS. It provides examples of how NHS organizations are: 1. Using chief knowledge officers and knowledge management tools to improve quality, patient safety, and productivity by sharing best practices. 2. Conducting after action reviews and knowledge retention activities to learn from past experiences and ensure important insights are not lost when staff leave. 3. Partnering with libraries to capture and disseminate evidence and data that supports clinical effectiveness and decision making.
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Cooke2010
- 1. Working Smarter by Mobilising Knowledge Rachel Cooke Acting Lead for Libraries & Knowledge Management NHS East of England
- 2. • NHS agenda – QIPP • Where does Knowledge fit? • Spectrum of Knowledge • A few examples of good practice • The Challenge
- 3. 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
- 5. 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
- 6. Knowledge Sharing & Learning • Better informed projects • Prevent same mistakes • Reduce the risk of duplication of effort • Generate & sustain innovation
- 8. 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
- 9. 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.
- 10. 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.
- 11. Knowledge Management: Tools & Techniques Capturing & Structure Sharing & Re-use Creation & Acquisition Peer Assist Collaboration Spaces wikis, blogs Knowledge Exchange After Action Review Knowledge Plan Elicitation Interviews Knowledge Assets Retrospec t Learning Reviews Self assessment/river diagramPost Project Appraisal Storytelling Social Network Analysis Rapid Onboarding Knowledge Retention starters, movers, leavers Communities of Practice Learning from Projects
- 12. 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
- 13. 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
- 14. Data & Research • Quality Observatory & Library Service • 50% MRSA community acquired • Statistical model of CA-MRSA • Commissioning to reduce CA-MRSA
- 15. 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?
- 16. 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
- 17. Knowledge Retention & Transfer When someone is leaving: 1. Identify knowledge at risk 2. Prioritise areas of expertise and agree transfer plan 3. 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
- 18. 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
- 19. 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
- 20. 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
- 21. Where can you add value
Editor's Notes
- QIPP
- AAR ask 4 simple questions What did we set out to achieve – this is critical, as frequently people come with different expectations (e.g. because of their genre) e.g how often at the end of a meeting does the real conversation happen in the corridor afterwards “…that wasn’t what I expected to happen…….”) – by building an AAR into meeting can gain understanding and go about things differently next time.
- Procedure said should always check date on sutures before using them, reality one type of suture normally used, - never went out of date – stopped checking. On this occasion used a different suture not used often ….. No one was hurt, however looked at what happened and why, realised needed to make others aware of the danger of this happening. - internal alert which requested all clinical areas check for out of date supplies a number of out of date items were found in departments throughout the Trust (I don’t think I said this bit last time but it is important) Frequently the lessons from the AAR don’t need to go any further than the those involved, however sometimes the lessons need to be shared more widely and methodically.