Bringing knowledge to bear in a primary care organisaiton Feb 2011
1. Bringing knowledge to bear
on commissioning
Sue Lacey Bryant, Chief Knowledge Officer
11th
February 2011
2. “If Only we knew what we know”
“Knowledge is the
enemy of disease,
the application of
what we know will
have a bigger impact
than any drug or
technology likely to
be introduced in the
next decade”
3. Who are we?
Your virtual knowledge team:
• Anne Gray – Knowledge Officer,
NHS MK Public Health
• Linda Potter – Primary Care Librarian
Library services via a joint SLA
• Sue Lacey Bryant, Chief Knowledge Officer
plus Steve Hance, Project manager
4. The programme
1. What is Knowledge Management? Sue
2. KM - an ABC; starting at A Sue
3. KM in practice: informing referrals management Steve
4. KM from B-C Sue
5. Evidence into practice: Making an IMPACTE Linda
6. Informing commissioning decisions Anne
7. Keeping up to date Anne
8. Transferring knowledge Sue
6. • Using knowledge to improve business
performance, reduce costs and improve
quality
• Consciously moving the right knowledge
to the right people at the right time
to be translated into action to improve
organizational performance
Knowledge management is about:
8. As Chief Knowledge Officer ...
• Ensure strategic and operational activity is informed
by sound evidence
• Ensure information requirements of projects, and of
consortia, are defined
• Ensure the business intelligence team is proactive,
streamlined, focused on users
• Stimulate approaches to capturing knowledge so
that ‘know-how’ is made explicit and transferred
• Manage the Library SLA to deliver proactive services
• Spread and embed good practice
• Support future configurations & current imperatives
10. Business intelligence team
Refining, analysing and combining,
and interpreting
D
A
T
A
I
F
O
R
M
A
T
I
O
N
Meaningful
Timely
Relevant
Quality
assured
Information customersData providers
Data Transformation
Support and education for data suppliers/customers, to improve data quality and information requests
Quality
assessed
12. Knowledge is everyone's business
Across the organisation including -
Communications and Engagement
Corporate Affairs
Human relations & organisational development
Information Technology
Public Health Intelligence
Quality and Standards
System Reform
14. A = Applying knowledge
• Data on activity, cost, outcomes
• Research evidence on clinical outcomes and
cost effectiveness
• “Best practice” including models of service
• Patient experience
16. Adjusted Clinical Groups system: ACGs
• 1 of several predictive models to target case management
• Identifies patients with a high disease burden— who may
benefit from review, improved coordination of care
• Focuses on developing & commonly occurring patterns of
morbidity - looking for convergence of risks defined by
diagnoses, use of health services and prescribing eg. seeing
multiple providers, taking multiple prescriptions
• Supports quality improvement; helps control varying levels of
co-morbidity amongst patients
• From John Hopkins University
17. 3. KM in practice
Informing referrals management
Steve Hance
Project manager, Referrals project
18. • The challenge:
Reducing un-warranted variation in activity and
outcomes of care to increase value and
improve quality
• The solution:
“The application of best practice is massively
beneficial to quality and productivity “
David Nicholson . HSJ 10/09/2009
19. Communication
• So much data: how come I never see it?
• Data : Referral Data, Referral data from Choose & book,
Monthly data report, Practice data, Low priorities data, Audit
data
• Evidence
• Kings Fund report, Understanding patients’ choices at the
point of referral, setting out evidence base and options report
• Communication
• www.qualitymk.nhs.uk , Newsletter – GP Consortia weekly
briefings, Consortia email bulletin, Ad hoc e-mails
20. Education: Learning opportunities
• Referrals wheel
• Top tips
• GP Referral LES
• Practice visits
• Sharing best practice
• Consortia meetings
• CPD events
21. Commissioning:
What next? How can we use these data?
• Identify areas which are performing
well/badly
• Formulate action plan to identify why
• Identify ‘spend to save’ opportunities eg
Lesion clinic?
23. What works best for you in consortia?
• Reviewing the sample of documents on
referrals –
• How would you prefer to receive this
data/information?
– What format? Media?
– Presentation? Level of detail?
– From whom? Frequency?
• How should it be delivered to give you
maximum benefit?
• What else do you want to see/have available?
31. Information specialists: skills
• Information retrieval:
sources, searching and
sourcing
• Information management
• Information skills training
• Research
• Synthesis
• Communications
• Web-editing skills
34. What information do you need?
• Best practice
– guidelines, service specifications, case studies
• How to run a clinical service
– location, processes, workforce, competencies
• Monitoring
– performance, outcomes, audit
• How much does it cost?
– health economics, cost benefit, prioritisation
• Tools
– NICE, DoH, public health
35. Helping you find the evidence
• NHS Evidence www.evidence.nhs.uk
36.
37.
38.
39. Helping you find the evidence
• NHS Evidence www.evidence.nhs.uk
– “upgrade” due in April 2011
– Currently paid for though central agreements,
SHA and local libraries
• But there are lots of other resources too..
40. Commissioning resources
• Commissioning websites
• Expert Bodies eg RCGP, BMA, Pickering, CQC
• Other NHS trusts
• Social Care and Local Authority sites
• Statistical websites eg PHOs, Information Centre
Why not ask a librarian?
Ask the librarian to find the information
• searches based on individual requirements
• for individuals or teams eg Programme Boards
• appraise and summarise the results
41. Knowledge Officer
• Searching for information
– Retrieval, selection, appraisal, synopses
• Provide evidence to support pathway review
and service redesign
• Information skills training
• Links to MK Hospital and other NHS libraries
• Knowledge Zone: www.qualitymk.nhs.uk
• Keeping up to date
47. How do you keep up to date?
• Question 1 - How do you keep up to date with
new evidence around clinical practice?
• Question 2 -How will you keep up to date with
new evidence/policies around
commissioning?
• Answer - Collection of alerting resources on
Quality MK website
49. 8. Your Invitation
Transferring knowledge to successor organisations
Workshop objectives
– Protecting knowledge assets
– Mitigate the risk of knowledge drain 2010-13
– Support GP consortia development
– Support system transition
Workshop outputs
– Identifying key assets
– Prioritised list that informs our planning
– Gap analysis of where we lack knowledge to meet our
organisational priorities 2010-13
50. The future?
• How can we better support current
imperatives?
• Who will manage knowledge in the future?
Notes de l'éditeur
If Only We Knew What We Know: The Transfer of Internal Knowledge and Best Practice O'Dell & Grayson 1997
Healthcare is knowledge-intensive Multiple teams provide information and evidence to bringing knowledge to bear on commissioning – needs assessment, planning, service specification, contract monitoring, health improvements – and I manage these teams directly
Business Intelligence team Performance monitoring of PCT and providers Making best use of analytical tools available Informing planning, programmes and projects Defining measures of success – clinical outcomes, quality improvements
And training from CRD on cost effectiveness And where can Where can knowledge have the most impact? Commissioning Librarian role; Library SLA inc. primary-care e-learning librarian
How can CKOs build the Know-How to improve business performance, reduce costs and improve quality?
Commissioning, Disinvestment and contracting manual describes how we manage the journey we experience when commissioning and contracting. It sets out the phases of work (‘Pipeline’ Fig 1.0) through which requests for changes in the services currently being commissioned are steered. Clearly defined processes and standardised documentation support a shared understanding so that we can effectively navigate / steer a proposed commissioning change through to delivery / implementation.
Techniques to support while-system approach to service redesign
Sharing Know–How, making learning explicit, signposting evidence
Skilled and innovative team
NICE – collection of health and social care publications Healthcare bibliographic databases Links to online resources eg journals “ upgrade” due in April 2011 Currently paid for though central agreements, SHA and local libraries
Good information and intelligence lies at the heart of health improvement. GP consortia will want to be intelligent organisations GP commissioners need to be intelligent users of information Many of the practical challenges we need to address as the Trust is dis-established, and new organisations form, will require the conscious management and transfer of knowledge. As new organisational structure are developed, and we disestablish & hand over responsibilities, we will be taking our corporate memory and relevant aspects of our knowledge base off in different directions, (ie consortia, MKC, NPHS, Commissioning Board). We will also wish to enable successor organisations to accelerate their development, and invite them to build on our learning, if they wish. The aim of this workshop is to look ahead - identify key challenges, prioritise, and consider options and approaches we might take in each key area. Rather than finding that individual managers feel left to work out what is best for one responsibility / resource or another, this is an opportunity to come together as a small group to think ahead, sound out ideas and put in some planning. Outputs Prioritised list that informs our capability and capacity plan Gap analysis of where we lack knowledge to meet our organisational priorities 2010-13 Protecting knowledge; identifying key assets; mitigating knowledge drain 2010-13
NLH Licences cut for journals Nat PH service - ? LA service cuts NHS Library services? Internal / local knowledge
