Tag Archives: knowledge management

Happy KNOWvember19

Don’t forget to use the month of November as your opportunity to showcase all that you do to mobilise evidence and knowledge. Have you held a Randomised Coffee Trial, contributed to keeping guidelines updated, organised a Peer Assist or held a Retrospect? Share what you have been doing, or plan to do, with your organisation and colleagues via social media using the hashtag KNOWvember2019.

Share your story

Jason, winner of a copy of the KM Cookbook, replied to the earlier post explaining how his team have run After Action Reviews to review eLearning sessions for F1 doctors.

Lola and Lisa are busy preparing their third and fourth rounds of Randomised Coffee Trials for their organisations. Feedback to date has been positive:

Susan has been busy planing several knowledge mobilisation activities including launching a systems leadership community of practice and supporting “live event” video capture and dissemination, including sharing the CEO Team Briefs.

Sarah has been holding knowledge cafes for her organisation – see what her Deputy Director of Strategy, Daniel Leveson has to say about taking part in a knowledge cafe

Find out what other teams have done by checking out the KM Stories and consider submitting your own.

6 ways to refresh your own knowledge in November

  1. Find out how the knowledge mobilisation framework can support workforce development by watching this HEE STAR TV episode featuring Louise Goswami.

2. Take a look at the new techniques added to the NHS Knowledge Mobilisation Framework postcard set

3. Take a lunch and learn session by watching one of our four new bite-sized introductions to knowledge mobilisation techniques and consider how you can use your existing enquiries to introduce some knowledge mobilisation techniques in your organisation

4. Get inspired by what someone else has done – read a knowledge management story

5. Join the KM community of practice or if you are already a member post a question or share something you have been doing

6. Take part in the #ukmedlibs Twitter Chat Tuesday 19th November, 12:30 – 13:30 with special guest Denise Carter, Chair of the CILIP Knowledge & Information Management Specialist Interest Group. This will be a great opportunity to find out more about working in a different sector, ask questions about CILIP’s Knowledge Management Chartership process and discuss the ISO Knowledge Management Standard.

So, please enjoy KNOWvember19 and don’t forget to share what you are doing.

The Mobilising Evidence and Knowledge Group

Supporting health care systems to reduce variation and nurture a learning culture

As health care organisations transition to health care systems delivering services across a geographical footprint, there is a wealth of opportunities for library and knowledge services to support and enhance evidence-based care.

A 2017 study, despite being published a while back, demonstrates the enormity of the challenge facing the NHS of ensuring that all patients receive high quality, evidence based care. It’s a useful study for us as library and knowledge professionals to be aware of, highlighting as it does the level of variation and reasons why our expertise in mobilising knowledge is such an important contribution to the delivery of high quality health care.

Willis et al (2017) explored the variations in achievement of evidence-based, high-impact quality indicators in general practice. Seven high impact quality indicators were developed for primary care and the variation in achieving these indicators was measured across GP practices in West Yorkshire. Four indicators focused on processes of care (e.g. prescribing or testing) and three on clinical outcomes (blood pressure, cholesterol and glycaemic control).

Two key findings in the study are of particular interest.

1) The performance of GP practices in achieving quality indicators.

Achievement of the seven evidence based quality indicators across participating GP practices was as follows:

  1. Diabetes processes of care: 59.1%
  2. Risky prescribing: 8.7% (a low percentage indicates safer, more desirable practice)
  3. Anticoagulation in atrial fibrillation and risk of stroke: 63.0%
  4. Secondary prevention of myocardial infarction: 54.6%
  5. Diabetes control: 43.2%
  6. Blood pressure control in hypertension: 71.7%
  7. Blood pressure control in chronic kidney disease: 74.2%

These differences against quality indicators are perhaps expected, and demonstrate that some GP practices are struggling to achieve evidence-based practice in key areas of patient care.

2) A marked variation in performance between practices

The second key finding of interest to us is that the likelihood of receiving evidence-based treatment varied substantially as a consequence of the practice attended. Even accounting for contributing factors (such as the age profile of patients), the study found considerable variation in achievement of the seven quality indicators between GP practices.

What can we draw from this? It highlights that there are likely to be several contributing factors at play that prevent evidence-based recommendations from being implemented. According to the authors, this is likely to be due to differences in culture and behaviours:

“The odds of patients receiving recommended care or achieving recommended treatment targets varied between two- and over ten-fold by indicator according to the practice attended. These marked variations were partly explained by a range of routinely available practice and patient variables; it is likely that much variation is related to clinical and organisational behaviours.” (p11)

Library and Knowledge Services can play an active part in enhancing clinical and organisational information behaviours in health care systems. This may be through ensuring easy and timely access to the evidence base, equipping health care staff with skills in information searching and critical thinking, or embedding optimal knowledge management behaviours to encourage a learning culture. Accordingly, our contribution to organisational culture and behaviours can support health care systems to reduce unwarranted variation and improve the quality of care.

As knowledge specialists working in health, we are keenly aware that there is a gap between evidence and everyday practice, but perhaps most people attending an appointment at their local practice isn’t?

Reflecting on the findings of this study presents some interesting challenges to us as a profession. Firstly, as our perspective shifts towards supporting the knowledge requirements of health care systems, how can we work more effectively together to help the NHS tackle unwarranted variation in treatment? Secondly, knowledge management is more than simply disseminating evidence across our networks. How can we use our skills to influence behaviour, and how far should our role extend into embedding evidence into practice? Finally, library and Knowledge Services have a role in ensuring citizens are supported to self-manage their conditions effectively and are empowered them with knowledge. How can we do that most effectively?

Please share your thoughts on the issues discussed here, and if you have any interesting studies on this topic please share them too!

Victoria Treadway, Knowledge Management Facilitator, NHS RightCare Email: victoria.treadway@nhs.net Twitter: @librarianpocket

References

Willis, Thomas A, West, Robert, Rushforth, Bruno et al. (5 more authors) (2017) Variations in achievement of evidence-based, high-impact quality indicators in general practice : An observational study. PLoS ONE. e0177949. ISSN 1932-6203 https://doi.org/10.1371/journal.pone.0177949

Knowvember: honing your skills

Now we’re at the end of Knowvember I thought it would be a good moment to remind you of all the great resources we have via the Learning Zone and Knowledge Management sections of this blog to help you hone your KM skills or revisit some of the basics. There are resources to help you with searching, synthesis and critical appraisal.

If you want to support your organisation and your colleagues in mobilising evidence and knowledge then remember the NHS Knowledge Mobilisation Framework Postcards and the Knowledge Mobilisation Framework programme are designed for a general audience plus we have the Evidence and Knowledge Self-assessment Tool.

If you haven’t already done so sign up for the CILIP Knowledge & Information Management Special Interest Group (K&IM) and for our new KM community of practice which is a lively discussion group.

David Stewart
Workforce Planning and Development Workstream lead.