Category Archives: Mobilising Evidence and Knowledge

K is for Knowledge and M is for Mobilisation. Why bother with Knowledge Mobilisation in healthcare?

At a recent workshop the statement was made that no-one understands the term knowledge mobilisation explaining that it needs to be translated to have meaning within the specific cultural context of a particular organisation.  So what words do you use to describe knowledge mobilisation for your own organisation? 

Sharing ideas; reflecting; connecting; experiential learning; networking; using organisational knowledge; sharing information; learning lessons; using evidence; managing knowledge; translating knowledge; organisational learning; using know-how; learning before, during and after; transferring knowledge; sharing good practice and ideas; connecting people. 

The good thing about the term “knowledge mobilisation” is that it encompasses all of the above but this also makes it tricky to define.  Breaking the term down may help. 

KNOWLEDGE:  That which is explicit or documented – research, data-sets, guidelines and that which is tacit – the know-how and values held by individuals and within organisations based upon wisdom and experience  

MOBILISATION:   Organising and preparing for action – considering how knowledge is to be used to achieve a particular purpose.   

Knowledge Mobilisation is about connecting and encouraging people to share explicit and tacit knowledge  AND  to  USE  this knowledge to inform their decision making.  

This definition was reflected on a discussion board by participants at the recent UK Knowledge Mobilisation Forum: 

  • “Getting the right knowledge to the right people at the right time so they can use it in a way to aid in their decisions and sometimes this right knowledge is also about getting the right people to the right people at the right time” 
  • “Knowledge Mobilisation is about bringing together different communities to share knowledge to catalyse change” 
  • “Joining up /connecting different forms of knowledge (from research, from practice, from experience, etc) helping people make sense of it all and how it joins up to build a clearer picture” 

 An easy-read description 

Within Knowledge for Healthcare (HEE, 2021) one of the key strands of work relates to mobilising evidence and knowledge.  In the easy-read version of the strategy (HEE, 2021) this is simply described as “Getting the right information from different places and sharing it” and this “right information” can be from reports, research , the  internet and from the things people know but haven’t written down.  People can then use this knowledge to help inform their decisions and actions.   

What about knowledge management? 

Some prefer the term knowledge management but this too lacks an agreed definition (BSI, 2018) and often gets confused with information management (Payne, 2020).  Knowledge management has been described by Nancy Dixon as evolving through three eras over the last 20 years.  The first era relates to leveraging documented knowledge, creating a collection and connecting people to it.  The second is concerned with leveraging experiential knowledge which is primarily concerned with connecting people to people and the third era is about leveraging collective knowledge and is primarily about creating new knowledge and innovation often from conversations (Dixon, 2018).   More recently there has been discussion about  the evolution of a fourth era, some consider that this will reflect technological changes with increased use of artificial intelligence whereas others feel there is a further stage of collaboration emerging (Henley Forum, 2020; CILIP, 2020)   

Knowledge Mobilisation incorporates all of these phases as described by Dixon and many of the processes, tools and techniques commonly associated with knowledge management are part of the knowledge specialists’ toolkit to mobilise knowledge.  The decision to substitute the word mobilisation for management is however very deliberate.  Rather than control and organise knowledge our role as knowledge specialists is about enabling others to actively use knowledge to inform their decisions and actions. 

 Where does evidence fit into all of this? 

Knowledge Mobilisation is also concerned with enabling the use of evidence.  Evidence comes in many forms and varying degrees of quality and volume depending on the topic. It is often research published in peer-reviewed journals, or as reports. Evidence based practice emphasises the importance of understanding and applying the evidence taking into consideration other factors including expert knowledge and values.  Decisions must take account of the best available evidence and individual and organisational knowledge.  Enabling evidence-based practice must consider the capture and mobilisation of knowledge as well as evidence. Knowledge specialists enable decision makers to take account of this full continuum.   

The valuable role of the knowledge specialist 

The Knowledge Specialists’ role is crucial, not only providing access to evidence, perhaps as books or research databases, but also gathering examples of good practice and connecting people to actively encourage knowledge and insights to be shared.  To mobilise knowledge the knowledge specialist translates and transforms all of this knowledge so it can be easily used and applied in practice by the people working within healthcare organisations, services and systems.  Sometimes described as a “knowledge broker” the knowledge specialist uses their expertise to ensure healthcare organisations, services and systems are effective in mobilising evidence and internally generated knowledge. They also ensure  that healthcare staff can: 

  • Apply and use evidence 
  • Build know-how 
  • Continue to learn 
  • Drive innovation 

They do this by: 

  • Connecting people to people  
  • Connecting people to knowledge and the evidence base  
  • Connecting people to good practice
  • Ensuring  people  keep up to date 
  • Facilitating shared learning 
  • Connecting people to corporate knowledge
  • Enabling collegiate working 

Aligned to multidisciplinary teams, embedded knowledge specialists release the time of health professionals by seeking out evidence and good practice. They are often asked to synthesise and summarise information, working with clinical or management teams to deliver decision-ready evidence and knowledge.  They promote tools and techniques so teams can capture, share and re-use staff know-how and organisational knowledge; enabling teams to learn continuously and work collegiately.  Mobilised in this way knowledge is used to underpin strategy, operations and innovation and helps to foster a learning culture. 

But, another team does this in my organisation. 

Some of the aspects of knowledge mobilisation may be carried out by other teams within the organisation.  Chris Collison describes it as one country bordered by many, including organisational development, research, project management, quality improvement, informatics, education and training, transformation to name but a few (Collison, 2014).  One role for the knowledge specialist is therefore to build bridges with these other disciplines and to work in partnership with these teams to align knowledge mobilisation activities.  Recently an example of how knowledge mobilisation activities mapped to a quality improvement cycle was shared on Twitter (Gibbons, 2021):

Tweet with image of circles Weaving evidence, horizon scanning and knowledge mobilisation through the QI journey

A picture says more than a thousand words 

If we use “knowledge mobilisation” with conviction to describe the valuable work knowledge and library specialists do then there will be less of a necessity to reach for an alternative for each separate NHS organisation or system.  You may find that a single image encapsulates all of this much more effectively. 

Drawing of a road with signposts adn icons indicating different types of evidence and knowledge 

The bottom-line is that knowledge mobilisation, when done well, encourages NHS bodies, their staff, learners, patients and the public to use the right knowledge and evidence, at the right time, in the right place, enabling high quality decision-making, learning, research and innovation to achieve excellent healthcare and health improvement.  

For further information about knowledge mobilisation please refer to  the  NHS Knowledge Mobilisation Framework.   To get ideas for knowledge mobilisation activities take a look at the KM ToolkitKNOWvember resources or start a conversation of your own on the KM Community of Practice. 

References:

UK Knowledge Mobilisation Forum 2021 – discussion board at forum 

Health Education England (2021) Knowledge for Healthcare: Mobilising evidence; sharing knowledge; improving outcomes

Health Education England (2021) A plan to make NHS Library Services in
England better.  Knowledge for Healthcare Easy Read
Version.

BSI (2018) BS ISO 30401: Knowledge management systems – Requirements.  London: BSI 

Payne, J. and Fryer, J. (2020) Knowledge management and information management: A tale of two siblings. Business Information review 37(2): 69 -77 

Dixon, N.M.  (2018) The three eras of knowledge management.  In: J.P. Girard and J.I. Girard (Eds.) Knowledge management matters:  Words of wisdom from leading practitioners (19-47). Macon, GA: Sagology

Henley Forum 20th Annual Conference 2020, Collaboration for Innovation.

CILIP (2020) Conversation Café Webinar with David Gurteen

Collison, C (2014) Mapping the KM Landscape.  Knowledgeable Blog Post 

Gibbons, A. (2021) E4QI Meeting Tweet re presentation by @PhoneixAutumn Weaving evidence, horizon scanning and knowledge mobilisation through the QI journey

Alison Day
Knowledge for Healthcare Project Manager
Health Education England

Mobilising Evidence and Knowledge: A Retrospect

As 2020 draws to a close it is a traditional time for reflection, and we could not reflect on the Mobilising Evidence and Knowledge workstream without at the same time using some of the techniques from the NHS Knowledge Mobilisation FrameworkThe Retrospect

What was the objective? What did or didn’t we achieve and why?

Emphasising the critical role played by NHS knowledge specialists and librarians to mobilise evidence and knowledge across the NHS was a main objective. Much has been achieved in the first five years, mainly due to how well NHS library and knowledge staff across England have embraced this work, building their confidence and developing their skills to mobilise evidence and knowledge.

What were the successes?

#AMillionDecisions

#AMillionDecisions raised our profile. It calls on government and health service providers to meet their statutory obligations to ensure the million decisions made every day in healthcare are informed by evidence. It encourages healthcare staff to work with and use the expertise of librarians and knowledge specialists to get evidence into practice.  From this work evolved a bank of impact case study vignettes and endorsements from a range of senior leaders across healthcare.

Extending Reach

Using a range of evidence and tacit knowledge to inform and respond to system level healthcare has been delivered by the “bottom-up” partnership approach of the STEMClub (Sustainability and Evidence Mobilisation) in the North East of England. Adopting models similar to STEMClub are likely to increase in 2021 with the announcement from NHS England that Integrated Care Systems (ICS) are to have more statutory functions, potentially taking on a commissioning role in 2021. https://kfh.libraryservices.nhs.uk/the-stem-club-in-the-north-east-of-england/

 Skills development – workshops and study days

In February 2020 thirty library and knowledge service staff attended a two-day knowledge mobilisation course facilitated by knowledge management consultant Chris Collison. This core group of individuals work as a reference group for future mobilising evidence and knowledge work.

Tools and Techniques

  • The Knowledge Management Task and Finish Group developed the Knowledge Management Toolkit to share techniques and stories about how knowledge management has been used in practice.
  • Publication of the enhanced NHS Knowledge Mobilisation Framework E-learning introduced the concepts of learning before, during and after and demonstrated the benefits of using 11 simple knowledge mobilisation techniques. The accompanying postcard sets were expanded in 2019 to include additional techniques of Appreciative Inquiry and Fishbowl Conversations. Feedback has been positive with Dr Farzana Hussain, GP of the Year 2019 commenting on the After Action Review technique that
    • It has changed my staff meetings and significant-event analyses, the non-judgemental approach supporting a no blame culture”.
  • The self-assessment tool for organisations to consider opportunities to develop how they are using external evidence and organisational knowledge. A series of modifications were made to the tool and the current version has been used by several organisations to help plan and prioritise activities. We are currently working on developing a digitised format for this tool with the help of our knowledge champions.
  • A space to share ideas, resources and ask questions has been developed with the Knowledge Management Community of Practice. It is a great way to encourage learning, develop a knowledge base and build confidence to practice some techniques.
  • The Policies Procedures and Guidelines Toolkit was developed to capture and share good practice around supporting the production and management of these vital knowledge assets.  
  • Connecting people to people, people to research and raising the profile of an organisation by exploring different ways to promote locally produced research are explored in the Institutional Repository Toolkit which presents an ideas bank and hints and tips for implementing a local repository.  

Learning lessons from Covid-19

Rapid learning, spread of knowledge and use of evidence was essential for the response to the Covid-19 pandemic. CILIP held a virtual conference in May 2020 exploring the role of knowledge management in a time of crisis. Perspectives were shared from knowledge specialists working in various sectors including the NHS. A series of thought-provoking questions were raised, including how we take learning from a crisis and apply to our everyday practice. https://kfh.libraryservices.nhs.uk/what-is-the-use-of-knowledge-management-in-a-time-of-crisis/ This topic was explored further by Holly Case Wyatt who shared tools to rapidly share learning from Covid-19 including a framework from Collaborate for Care https://kfh.libraryservices.nhs.uk/lesson-learnt-supporting-your-organisation-to-capture-the-learning-during-covid-19/ We also produced a short recorded presentation about the Before Action Review, After Action Review and Retrospect as a suite of tools to encourage the sharing and re-use of lessons learnt.

KNOWvember

KNOWvember is an annual celebration and showcase of the work by NHS library and knowledge staff to mobilise evidence and knowledge. The aim of KNOWvember events is to share practical examples of how library and knowledge service staff have used techniques to encourage more widespread use of evidence and sharing of know-how across the NHS. This in turn generates ideas for more knowledge mobilisation to take place.

Four virtual events were held in KNOWvember20 featuring work by various library and knowledge specialists coupled with opportunities to experience a variety of knowledge mobilisation techniques. We were also joined by external speakers including CILIP Trustee Karen McFarlane, who provided an overview of the BSI/ISO 30401 Knowledge Management Systems Standard and CILIP’s Knowledge Management Chartership and Dr Nicola Millard, Principal Innovation Partner at BT who shared insights into the digital workplace. Presentations from these events, plus summaries of discussions and recorded conversations between knowledge specialists, can be found on the Knowledge for Healthcare KNOWvember20 YouTube Playlist.

What could have been even better?

We know that terminology has at times proved challenging.

As the ISO 30401:2018 Knowledge Management Systems Standard says there is no single accepted definition of knowledge management and our preferred term is knowledge mobilisation emphasising that knowledge needs to be used and not just managed. David Stewart’s reflection considers this change in terminology and presents a long view concluding that knowledge management is no longer a “nice to have” trend but that KM will become the every-day core of what we do” – delivering Knowledge and Library Services to ensure that organisational knowledge and best evidence are mobilised to achieve excellent healthcare and health improvement.

Marks out of 10 for the work as a whole? What would have made it a 10?

The work to date deserves at least an eight as demonstrated by the range of mobilising evidence and knowledge work showcased at the recent KNOWvember20 events. It will become a 10 when even more NHS staff routinely use evidence and share knowledge to inform their decisions.

A big thank you to all who have contributed to this work, and in particular to our knowledge champions. We wish you time for your own reflection over the festive break and look forward to working with you on the next chapter of this story in the new year.

To read more about the mobilising evidence and knowledge work see Day A and Goswami L (2020) Driving change with evidence and knowledge: Transforming knowledge services for the NHS across England. Business Information Review Volume 37,
Issue 1 https://doi.org/10.1177/0266382120909240

2020 and Covid-19: library and knowledge services getting evidence into practice

2020 has been an extraordinary year. Covid-19 has presented many challenges, particularly in phase one, including redeployment of library staff and space, IT connectivity to allow working from home and the development of virtual and digital services. However, library and knowledge staff have risen to meet and overcome these challenges, demonstrating resilience and adaptability. Messaging throughout the pandemic has been that library and knowledge staff are accessible and services have remained open for business, even if the doors to some physical spaces have been closed.

The role that library and knowledge specialists play in mobilising knowledge and evidence into practice has supported individual and organisational learning and Covid-19 decision making. This has raised the profile of library and knowledge services in many organisations.

  • Library and knowledge service managers working for the Trusts leading the Nightingales, developed tailored service offers into the new hospitals. The national HEE library and knowledge services LKS team has worked with this group of service managers to facilitate a community of practice to support learning and sharing.
  • Services have provided evidence support for Boards and supported the management of incidents by gold and silver command groups by delivering rapid evidence reviews.
  • Library and knowledge staff have used knowledge management tools to facilitate discussions and share learning for example, using After-Action Reviews to capture lessons learned and running Randomised Coffee Trials to share learning and keep staff connected.

Across the networks, we have seen greater collaborative working between services, for example through the sharing of expertise and supporting colleagues where capacity has been reduced. Collaborative working has also resulted sharing examples of Covid current awareness sharing bulletins and in the development of the Covid-19 Search Bank. Since the launch of the Search Bank in May, over 200 search strings and strategies have been published. Feedback from participants and users has been very positive and we are looking at what this experience can tell us about supporting expert searchers.

There has been a move to making greater use of technology, strengthening delivery of virtual services, including training, demonstrating a capability for rapid and agile development. Most services are now offering some type of virtual training session, and there are examples of development of online and e-learning modules to support induction and critical appraisal. The national CPD offers to develop skills in facilitating virtual meetings have been well received by library and knowledge staff.

The HEE Resource Discovery team has supported remote working by ensuring off-site access to OpenAthens administration tools. They also optimised access to the evidence-base by collating trusted evidence resources, with sources on the vaccine currently being pulled together, and signposting developments with BMJ Best Practice and access to e-books through the Kortext platform.

Library and knowledge staff have continued to provide knowledge services remotely throughout the pandemic. In May, 45% of our physical library services were either closed or open but not staffed. By October 20 this had reduced to just 11%. All services have worked with their organisations to adapt both the working and learning space within the library to ensure it is safe. Many of you have shared your approach, together with pictures of the changes including:

  • changes in layout for PC and study space
  • self-issuing systems
  • screens around library counters
  • booking systems for workstations.

Some services have added to the ways in which the library is valued by NHS staff as a wellbeing resource, creating and expanding the health and wellbeing space and collections for staff.

We are aware that there is pressure on library space in some organisations. Accordingly, we have prepared policy recommendations that emphasise the importance of library learning space, which will go to the HEE Executive for approval in January 2021.

Over the last few weeks HEE’s library and knowledge service regional teams have been ringing everyone. It has been good to catch up with you and find out what is currently happening in your services and organisations during the second wave. We will be considering all the feedback to identify any themes where areas for further support or training have been raised. In talking to you all it has been amazing to hear that, despite the challenges faced, many of you are still seeking out the opportunities in your organisations and continuing to develop the service through innovation and adopting good practice.

During the pandemic, services have captured some amazing impact stories which we are delighted to share some with you here. Working with the HEE Communications team, we have been using these to raise the profile of NHS library and knowledge services on social media. Please do continue to collect your impact case studies and share them with us.

We would like to finish this blogpost with thanks to you. Your work in mobilising evidence and knowledge to support Covid-19 decision making, supporting the health and wellbeing of NHS staff, and ensuring that accessible, evidence-based health information is made available for patients and the public, has made all for the difference to many lives during the pandemic.