Knowledge Management in Health Services

1
Knowledge Management in Health Services

• Mallard Valley PCT a Factional Case Study

2
Setting the Scene

• For many of us Knowledge Management is a
  potentially overpowering concept, largely because
  of the scale and complexity of our health care
  organisations.
• We have, therefore, chosen to illustrate general
  principles of knowledge management within the
  context of a single PCT.
• While the organisational backdrop moves on at
  pace the general principles essentially remain
  the same.

3
About Mallard Valley PCT

• Approx 1,500 staff. 20 mile radius of
  Mallard-On-Ooze
• 25 general practices on 35 sites
• 2 community hospitals
• Specialist clinics and centres
• Mallard Manor Hospital site
• PCT management offices

4
The story begins

• Typically knowledge management (KM) initiatives
  are not created in a vacuum
• Usually they are built on a base of existing
  information/library services
• So in Mallard Valley there is a peripatetic
  librarian, Ms. Litiga Damask-May, who expands her
  role to take on the portfolio for KM as
  encapsulated in corporate documents of this time
  period

5
First Steps

• A specialist travelling knowledge manager
  employed to spread evidence of effectiveness and
  encourage use of on-line databases
• The PCT provides multi-professional workshops, a
  knowledge manager, and computer skills training
  
• Creation of Mallard Valley PCT, Public
  consultation document. Summer 2000

6
Planning a strategy

• Litiga Damask-May, the Knowledge Manager, starts
  by contributing to development of a KM strategy.
• This is a valuable way of placing knowledge on
  the corporate agenda. It acts as a focus for
  previously unjoined-up activities.
• The KM strategy embodies both an overarching aim
  and key principles

7
Knowledge Policy

• Principles
• Commitment from senior management
• Developing a learning culture
• Facilitating access to information and helping
  colleagues to share knowledge
• Enabling people to develop greater skills in
  finding and using information
• Delivering information electronically

• Aims
• Enabling staff to access, understand and use
  knowledge derived from research as well as from
  the body of experience of best practice.

8
Understanding User Needs

• Litiga first conducts a literature review of
  primary care information needs.
• She next conducts qualitative research into the
  specific needs of her patch.
• Then, in Spring 2002, her PCT is included in a
  County-wide Knowledge Audit.
• Knowledge Audit (internal sources) and Knowledge
  Mapping (external resources) are important early
  stages in a practical KM approach

9
What do we know?

• Information needs and information-seeking
  behaviour of family doctors
• Family doctors seek information for needs arising
  from professional responsibilities and personal
  characteristics.
• Problem-orientated information, related to the
  care of individual patients, is the predominant
  driving factor.
• Personal collections are preferred information
  resource electronic sources rank second.
• The medical library received low use. Both
  vocational training and the employment of a
  practice librarian impacted on library use.

10
Developing an Intranet presence

• Successful knowledge sharing requires an
  underpinning technical infrastructure.
• A shared intranet is a good mechanism to
  facilitate knowledge sharing, particularly where
  an organisation is spread over several
  buildings/sites.
• In the case of Mallard Valley it was decided to
  survey staff for their preferences regarding
  sources to be shared via the intranet.

11
Knowledge Sharing Networks/Intranet

• Intranet survey of staff preferences
• Mallard Valley PCT, Winter 2001

12
Database of Expertise

• In sixth place on the list of resources suggested
  for the staff intranet is a database of experts
  or staff skills.
• Such databases of expertise are an excellent way
  of emphasising the presence of tacit knowledge
  (non-verbalised implicit knowledge) within an
  organisation
• They do carry several challenges (to be explored
  in more detail elsewhere)
• Level of detail (balancing conciseness with
  usefulness)
• Mechanisms for maintenance (balancing central
  control with individual responsibility)

13
Learning Networks/Communities of Practice

• With a shared IT infrastructure in place and a
  mechanism for knowledge sharing underway it
  becomes possible to look at the development of
  learning networks or communities of practice.
  These are built around shared interests of PCT
  staff either clinical specialties (e.g.
  dermatology) or shared functions.
• The aim of these is to make implicit knowledge
  explicit. Communities of shared interest can be
  fostered through various methods of communication
  such as person-to- person and through
  e-communication.

14
Taking stock

• After her promising start Litiga decides to take
  stock. In 2001 an article appears outlining ten
  building blocks towards knowledge management
  within a clinically-focused organisation.
• Litiga decides to assess the early progress
  within Mallard Valley PCT against this published
  model. She imagines what a hypothetical end of
  first term report might look like for her
  emerging organisation

15
How does Mallard Valley measure up?
16
First Term Report

• A very promising start with the achievement of
  some quick wins (e.g. Knowledge Audit and
  Intranet).
• More work required on raising the profile of KM
  within the Trust
• More sophisticated approaches to KM (e.g.
  Measuring Intellectual Capital) will take time to
  develop
• Issues remain about organisational readiness

17
The Mallard Valley story continues
18
Acknowledgements

• The Mallard Valley PCT Case Study has been
  devised using materials in the public domain.
  However, the FOLIO team would like to acknowledge
  the contribution of Sue Lacey Bryant (Independent
  Information Specialist) to realisation of this
  Case Study.
• Any resemblance between Mallard Valley PCT and an
  existing PCT is entirely in the eye of the
  beholder!

19
Further Reading

• Booth, A. (2001) Managing knowledge for clinical
  excellence ten building blocks. Journal of
  Clinical Excellence 3 (4)187-194.
• Bryant, S. L. (1999) Information services for
  primary care the organizational culture of
  general practice and the information needs of
  partnerships and primary care groups. Health
  Libraries Review, 16 (3), 157-165.
• Bryant, S L (2000) The information needs and
  information-seeking behaviour of family doctors
  a selective literature review. Health Libraries
  Review 17 (2), 8390
• Bryant, S L (2001) Knowledge management enabling
  colleagues to access and share knowledge. Journal
  of the Learning Workplace 3 3-6.
• Bryant, S L (2002) Know-how? Exploring the
  knowledge dimensions of primary care IFMH Inform
  13 (1) 1-3.