1. Building Capacity and Capability to Translate Knowledge into Action Dr Ann Wales Programme Director for Knowledge Management Ann.wales@nes.scot.nhs.uk “Knowing is not enough; we must apply. Willing is not enough; we must do.” - J.W. Goethe (1749 –1832)

2. Overview 1.Building organisational capacity for using knowledge – evidence and tools. 2.Change agency - Knowledge broker network services. 3.Building workforce capabilities in using knowledge.

3. Organisational Capacity for Knowledge Management

4. What the evidence says… 1.Success or failure of interventions depends on the broader organisational environment/culture; 2.Implementation needs to take into account the structural, political, cultural, educational, emotional, physical and technological challenges of organisational change.

5. Conditions for successful implementation 1.Strong leadership from clinical, managerial and political leaders at different levels of the organisation and wider health care system; 2.Ensuring that health professionals (especially doctors) are actively engaged and that they believe that the changes will benefit both staff and patients; 3.Using – and sustaining - a range of interventions at different levels (i.e. individual, team, organisation, the wider health care system); 4.Collecting robust and timely data to monitor changes and to adjust actions as needed. 5.Ensuring that there are adequate resources (e.g. finance, staff, training, IT systems) to support the change.

6. Knowledge Generation  Public Health Observatory  Evaluation Knowledge Management  Knowledge Services  Evidence for Action Knowledge Application  Scottish Public Health Network  Range of Teams in Delivery Directorate

7. Health Scotland – drawing on different types of knowledge

8. Action plan outcomes (focussed on facilitators not structures)

9. 9 High Level Organisational KM Maturity Model Maturity LevelKnowledge Environment State Communities People Knowledge Base Content Knowledge Infrastructure Technology Knowledge Processes Processes LEVEL 5 Leveraging Knowledge Knowledge- Centric Communities have strong community leadership and thought leadership. Level 5 communities are directly responsible for delivering business value. Mature, fully managed knowledge base. KM technology is extensively used for multiple nested and shared domains. It is also used for conducting business. Common processes have become knowledge-based. Full collaboration. LEVEL 4 Using Knowledge Strong community and thought leadership. Business value is clearly a focus of the community action. Knowledge base managed by the community and evolves systematically. Innovations accelerating. KM technologies and supporting infrastructure are in wide use in the domain. Common processes are established and defined. Knowledge-related processes are institutionalized. Collaborative culture taking root. LEVEL 3 Building Knowledge Community leadership and some thought leadership. The knowledge base is managed.KM technology is in common use.Common processes are generally defined. Knowledge-related processes are being institutionalized. Personal learning is appreciable. Collaboration is significantly better than in earlier phases. LEVEL 2 Seeking Knowledge Early forms of community are forming. Not well structured. Leadership issue is in early phases. Organized access to some of the knowledge base. KM technology has been introduced. Effort to establish common processes is underway. Knowledge-related processes have been introduced. Some collaboration exists. LEVEL 1 Unstructured Knowledge- Chaotic Some social forms may exist.Knowledge exists in personal tacit forms only. Some explicit knowledge may be accessible but not well managed, systematically maintained, or focused on business value. Some connectivity is available and regularly used, such as email and document repositories. Process discipline exists, but primary processes may not have become common.

10. Good Practice: Organisational knowledge management toolkit http://www.knowledge.scot.nhs.uk/home/portals-and-topics/goodpractice/organisational-development- toolkit/leadership--strategy/knowledge-management.aspx

11. Knowledge Broker Network Services Developing a Network of Support for Translating Knowledge into Practice

12. Aim Define, develop, apply and evaluate knowledge broker capabilities to support healthcare improvement priorities.

13. Who are knowledge brokers in healthcare? Backgrounds Non-clinical: Library, Informatics, Research, Education, Policy, Management Community: Public health, Health promotion, Social care Clinicians: Medical, nursing, physiotherapy, pharmacy, rehabilitation and long term care staff, in acute, primary care and community settings.

14. Knowledge Broker Practice Three change agency approaches: Problem-solving Building networks and relationships Embedding use of knowledge in organisational systems. Underpinned by: Integration with health and social care teams Collaboration to combine complementary skills.

15. Problem-Solving Planned Action Theory of Change. 1.Inquiry. 2.Source knowledge – research, practice setting, experience. 3.Organise knowledge. 4.Evaluate knowledge. 5.Combine and create knowledge. 6.Translate into format and process for use. (Lomas 2007, Rankin 2008, Davidoff 2011)

16. Building networks and relationships Social theories of change. “Knowledge transfer, linkage and exchange” (Lomas 2012) 1.Facilitate collaboration across traditional boundaries – e.g. communities of practice. 2.Virtual knowledge brokers. 3. Community knowledge navigators - throughout journey of care. (Ward 2012, Dobbins 2009, Henderson 2012).

17. Embedding use of knowledge in organisational systems Organisational theories of change. 1.Assess enablers and barriers for knowledge use. 2.Role modelling 3.Managing organisational knowledge 4.“Change toolbox”. 5.Embedding knowledge in clinical and performance systems and education. (Gerrish 2011, Booth 2011, Psarras 2006)

18. Knowledge Broker Network Capability Framework “An outline of what Scotland’s network of knowledge brokers collectively should be able to do in practice.”

19. Capability Statements The knowledge broker network: 1.Builds organisational capacity and workforce capability for using knowledge, across health and social care. 2.Operates as a coordinated and connected system. 3.Identifies knowledge needs; sources, combines and presents knowledge from research, practice and experience. 4.Delivers knowledge in actionable formats, embedded in practitioner workflow. 5.Supports people and organisations to interact and share knowledge.

20. Knowledge Broker Network Contributing to Health and Social Service Priorities

21. Agreeme nt of approach Literature search Draft guideline eLearning Implementation Package Developing a standardised search protocol developed in conjunction with clinical staff Quality assurance procedures Quality assurance procedures using reciprocal peer review ensured a quality, standard search Support in accessing books and journal articles where not readily available Knowledge brokers were supported by shared learning and support through teleconferences and online communities Formatting of references for publication Implementing Palliative Care Guidelines Web and mobile solutions Social networking

22. Implementing Learning from Adverse Events 1.Process mapping – flow of learning from adverse events in key themes within and across programmes. 2. Identifying and addressing gaps in knowledge flow.

23. Discussion points What is your knowledge broker role? How can you make more use of knowledge broker network services to help translate knowledge into practice in your work environment?

24. Workforce Capabilities in Knowledge into Action

25. Knowledge into Action Cycle of Capabilities

26. http://www.qihub.scot.nhs.uk/education-and- learning/qi-e-learning.aspx http://www.ssks.org.uk/evidence-for- practice.aspx

27. Building Capacity and Capability to Translate Knowledge into Action Dr Ann Wales Programme Director for Knowledge Management Ann.wales@nes.scot.nhs.uk “Knowing is not enough; we must apply. Willing is not enough; we must do.” - J.W. Goethe (1749 –1832)