KM practice: from the corporate world to Hcare

I have been working for a decade to help translate KM experience and know-how from the business sector to health care. Being self-employed, I never had the bandwidth or resources to do what you have done. This lit review should help enable thoughful evidence-based discussions of how we can best crosswalk lessons from business into healthcare to apply KM methods to patient safety.

Kothari A, Hovanec N, Hastie R, Sibbald S. Lessons from the Business Sector for Successful Knowledge Management in Health Care: A Systematic Review. BMC Health Serv Res. 2011 Jul 25;11(1):173. [Epub ahead of print]
http://www.ncbi.nlm.nih.gov/pubmed/21787403

Many thanks to the authors for their work.

Hot off the Presses! Librarians on the KM team.

Zipperer L, Amori G. Knowledge management: an innovative risk management strategy. J Healthc Risk Manag. 2011;30(4):8-14.

In this piece Geri and I advocate that a librarian be a part of the team to roll out a KM strategy. I'd love to here your thoughts on that, and wish I could provide the full text of the article to help faciliate the dialogue, but alas, cannot.

Another call to action!

Temporal trends in rates of patient harm resulting from medical care.
Landrigan CP, Parry GJ, Bones CB, Hackbarth AD, Goldmann DA, Sharek PJ. N Engl J Med. 2010;363:2124-2134.

Free full text

NYT recap

Interesting study with not-so-surprising results: patient safety isn't improving as quickly as hoped -- even in hospitals that are highly engaged in improvement. Systemic solutions need to be in place to help ensure improvements - rather than only the launch of tools (ie checklists)

This patient safety improvement stuff is tough work, yet its frustrating to hear this.

I see the conclusion: “Further efforts are needed to translate effective safety interventions into routine practice and to monitor health care safety over time” as areas where librarians, informationistas, informaticians, etc can make an impact. There are knowledge access, knowledge sharing, evidence assess and sharing, data access and packaging issues that we in the info professions may be able to affect and improve, if the multidisciplinary teams driving improvement initiatives includes information and knowledge sharing experts (not just IT). It also means (in our sphere of influence) that wikis, SharepointTM, EBM etc are not the be all end all of our contributions -- we need to help others see how culture and work process is affected and made more reliable through effective information and knowledge sharing.

The effort continues ....

Knowledge brokers: an opportunity for evidence distribution improvement

This article provides some interesting ideas around how knowledge brokering can be built into education and learning processes within an organization. I see that librarians and others with a tendency toward understanding information and knowledge needs and the ability to build and feed successful networks of knowledge workers could effectively fill this role.

I'd love to hear other thoughts on the matter .....

Dobbins M , Robeson P, Ciliska D, Hanna S, Cameron R , O'Mara L , DeCorby K, Mercer S
A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies.
Implementation Science 2009, 4:23
The electronic version of this article is the complete one and can be found online at: http://www.implementationscience.com/content/4/1/23

Abstract
A knowledge broker (KB) is a popular knowledge translation and exchange (KTE) strategy emerging in Canada to promote interaction between researchers and end users, as well as to develop capacity for evidence-informed decision making. A KB provides a link between research producers and end users by developing a mutual understanding of goals and cultures, collaborates with end users to identify issues and problems for which solutions are required, and facilitates the identification, access, assessment, interpretation, and translation of research evidence into local policy and practice. Knowledge-brokering can be carried out by individuals, groups and/or organizations, as well as entire countries. In each case, the KB is linked with a group of end users and focuses on promoting the integration of the best available evidence into policy and practice-related decisions.

Results
KB activities were classified into the following categories: initial and ongoing needs assessments; scanning the horizon; knowledge management; KTE; network development, maintenance, and facilitation; facilitation of individual capacity development in evidence informed decision making; and g) facilitation of and support for organizational change.

Conclusion
As the KB role developed during this study, central themes that emerged as particularly important included relationship development, ongoing support, customized approaches, and opportunities for individual and organizational capacity development. The novelty of the KB role in public health provides a unique opportunity to assess the need for and reaction to the role and its associated activities. Future research should include studies to evaluate the effectiveness of KBs in different settings and among different health care professionals, and to explore the optimal preparation and training of KBs, as well as the identification of the personality characteristics most closely associated with KB effectiveness. Studies should also seek to better understand which combination of KB activities are associated with optimal evidence-informed decision making outcomes, and whether the combination changes in different settings and among different health care decision makers.

Dr House's knowledge sharing strategy.

Any thoughts here? The poll that came out a few weeks back on TV doctors and their impact on the perception of physicians was interesting. For those of us who watch "House," we aren't surprised that Dr. Gregory House was seen by physicians as detrimental to their public persona.

However one feels about that, my query is more oriented to how House shares "what he knows" and thusly trains his staff to think the way he does -- both in good and bad ways. Now, I am not advocating that we all become gruff, pill popping professionals -- but what lessons can we learn from this character about effective knowledge transfer?

KM in hospitals session

I hope you'll join us for this session in Utah April 16-17th, 2009. We are excited about building on our successful 2007 Chicago workshop with a 1.5 event that engages teams from organizations (a librarian and a peer from outside the library) to help with developing KM strategies through the application of Appreciative Inquiry and Plan-Do-Study-Act mechanisms.

http://nnlm.gov/mcr/education/classes_knowledge_management.html

There is an application process for teams to be considered to participate and the deadline for submitting paperwork is Feb 6th.

Culture and knowledge management

This article provides some thoughtful commentary on how culture and knowledge management intersect. For those of us in health care trying to affect knowledge transfer, I think the strategy of building projects that don't run upstream against the ingrained hierarchical culture, but get you in the door, per se, to establish tools that illustrate value, is a nice approach. Enjoy and share your thoughts!

‘Think of others’ in knowledge management: making culture work for you. (pdf)
Jay Liebowitz. Knowledge Management Research and Practice.2008;6:47-51.

Journal issue of interest

September 2008, Volume 39, No. 4
Organizational Learning, Knowledge and Capabilities Conference Issue:
Guest Editors: Carole Elliott, Michael Rouse and Dusya Vera http://mlq.sagepub.com/content/vol39/issue4/

This looks interesting. I don't have access to the full text, but I would love to see articles focusing on these topics in the medical arena. We best get cookin' ;-).

Learning Organization assessment tool

I wanted to share this article:

Garvin DA, Edmondson AC, Gino F.
Is yours a learning organization? Harv Bus Rev. 2008;86:109-116.

It's worth a look. They mention two examples that relate to the health care field. Edmondson has done a lot of work in the organizational behavior world in health care, so she is aware of the environment and how it can affect the way people in it interact. I love the fact the authors have crafted some measurable elements of a learning organziation, which of course, involves knowledge management, whether they use that word or not.

They also provide access to the tool they used and provide some benchmarks, which will be helpful for anyone trying to begin to understand how their organization learns, and if they efforts they put in place will have any impact over time.

One of the things I'd appreciate some discussion on is that they don't really differentiate between knowledge, information and evidence here. Do others feel that those terms need to be more explictly defined if we do any "deep dive" on the impact of KM initiatives and the professionals that faciltiate them?

Glad to be back!