Supporting the Knowledge into Action Review May 2011 A Conversation Between Knowledge Management and Quality Improvement Leads Supporting the Knowledge into Action Review May 2011

Getting Knowledge into Action for Healthcare Quality Review of Knowledge Services and the Librarian Role to Establish a New Knowledge Management Model

Overview Why a Knowledge into Action Review: Drivers and Aims Who, How, When: Governance and process Why should librarians and Quality Improvement Leads get involved? Co-creating the new model

Why: Drivers and Aims

Yes, it’s quite a noise – but are we having any impact?

From Accessing to Applying Knowledge 12 million + resources How much of this gets used in a meaningful way to improve safe, effective, person-centred care?

Knowledge-Practice Gap Only 55% in US healthcare system receive recommended care McGlynn et al (2003) Estimated 30-40% of care in UK not based on available scientific evidence Grol, R. and Grimshaw, J. (2003) 5 year gap between publication of guidelines and changes in routine practice in Western healthcare systems. Lomas et al (1993) 17 year gap between publication of clinical research and its incorporation into routine practice. Grant et al (2000)

12 Quality Outcome Indicators Quality Strategy All we do must contribute to…. Our shared aim To become a world leader in healthcare quality 3 Quality Ambitions Safe, Effective, Person-Centred Care 12 Quality Outcome Indicators Care experience, Adverse events, Resource use

Drivers for change Librarian Role Quality Strategy Economic Downturn Local Reviews Use of Knowledge User expectations Changing models of care Technology

Evolving the Librarian Role “It is not the strongest of the species that survives, nor the most intelligent, but rather the one most adaptable to change.” Charles Darwin (Attrib)

Who, How, When Governance and Process

Who? Knowledge into Action Steering Group NHS KS staff, QI Hub, ISD, OD, clinical education, eHealth, Health Scotland, clinical governance, social care, clinicians, academia Board Executive Lead sponsors Change team Wider KM, clinician and QI community ie you!

How? Review of research evidence/synthesis of knowledge translation models Identify ideas for improvement/map examples of innovation Test new ideas at local level Model structures and processes Define the new model Consultation

When? March-July 2011 Gathering evidence August 2011 Stakeholder workshop - review evidence to define improvements September 2011-January 2012 Demonstrators projects to test improvements March 2012 Model defined and issued for consultation

Is a change an improvement? Define aims What are we trying to accomplish? What change can we make? Test, develop, implement solutions Is a change an improvement? Measure impact Assess knowledge use and evaluate outcomes Evidence-based quality indictors Case studies After action reviews Cost-benefit analysis How do we embed the change? Spread Quality improvement processes Inquiry and Knowledge Synthesis Knowledge Exchange and Dissemination Knowledge Exchange and Dissemina-tion Knowledge Flow Problem definition People & skill Expert Searching directories Capture experiential knowledge Evidence synthesis Organise knowledge CoP Social marketing Knowledge for action packages Knowledge Management activities and tools Knowledge Management Capabilities – personal & organisational

Why should Librarians and Quality Improvement Leads get involved? Co-creating the new model

Bringing two worlds together Knowledge Management Quality Improvement

Transfer of Knowledge into Quality Healthcare Clinical Knowledge: MEDLINE, Cochrane etc Clinical Decisions Doing the right thing Doing it right Know-What Quality Patient Care Process/System Changes Improvement Knowledge: IHI, experience, etc Know-How

Bridging the Knowledge-Practice Gap “The transfer of knowledge is care”

Conclusion “The application of what we know will have a bigger impact than any drug or technology likely to be introduced in the next decade.” Sir Muir Gray Director NHS National Knowledge Service & NHS Chief Knowledge Office

Getting Knowledge into Action for Healthcare Quality Contact: Ann.wales@nes.scot.nhs.uk Karenritchie@nhs.net

Connecting KM and QI in NHS Greater Glasgow and Clyde Michelle Kirkwood, Knowledge Services Manager Knowledge Management “Network” – Library/Knowledge Services Clinical Governance Public health Learning and Education Medicines Information Organisational Development Chaired by Head of Clinical Governance KM framework and demonstrator project Align with national review to develop KM framework for Board approval

Next steps and support 1. Questionnaire survey for knowledge services: Evidence search and synthesis Use of physical resource 2. Engagement and communication Clinicians and other stakeholders Board visits Knowledge Services communication network Bringing Knowledge Together website 3. August stakeholder workshop Review evidence and identify improvements Handover to Boards for demonstrators 4. “Leading with knowledge” – role development programme