1. Knowledge into Action for HAI Improvement Facilitators Suzanne Wilson Improvement Manager (Knowledge into Action) NHS Education for Scotland

2. Bridging the Knowledge-Practice Gap 45% defect rate in US healthcare system – patients not receiving care as recommended in guidelines. (McGlynn et al, 2003) 17 years to get research recommendations into practice. (Balas et al, 2000; Morris et al, 2011)

3. What is Knowledge into Action? evidence based practice knowledge translation knowledge implementation implementation science “The move beyond simple dissemination of knowledge to actual use of knowledge” Straus, et al (2009)

4. From Accessing to Applying Knowledge in NHS Scotland Knowing 66 libraries 116 library staff 12 million+ resources Doing How much of this gets used in a meaningful way to improve safe, effective, person- centred care?

5. Knowledge into Action review help practitioners to apply knowledge to frontline practice. embed use of knowledge in healthcare improvement. support practitioners and managers to translate knowledge into better health outcomes, i.e. safe, effective, person- centred, efficient care.

6. Knowledge as process Know-what Journals MEDLINE Cochrane Know-where Systems Processes Variation Know-who Service user Practitioner Teams Practice Experience Research Know-how: Actionable Relational Organisational

7. Knowledge as process Relational use of knowledge Communities of Practice Social networking Social learning Organisational enablers Knowledge broker Building workforce capabilities Tests of change to demonstrate impact Know-how: Actionable Relational Organisational Actionable knowledge Checklists Pathways Mobile apps Sourcing and combining different types of knowledge

8. Discussion How do you find, use and combine different types of knowledge in your practice? Know-what Know-where Know-who Know-how

9. Example – Sepsis Sourcing and presenting ‘know what’ and ‘know where’ in an actionable format to inform the ‘know how’ Sharing experience and knowledge via a community of practice Providing actionable, mobile solutions to make it easy to do the right thing

10. Example – pressure ulcers What does best practice look like? Tools and bundles to support implementation Shared experience http://www.healthcareimprovementscotland.org/our_work/patient_safety/tissue_viability.aspx

11. Example – Enquiry service http://www.clear.scot.nhs.uk/

12. QI Hub resources Take the knowledge management module on the QI Hub http://www.qihub.scot.nhs.uk/education-and- learning/qi-e-learning.aspx http://www.qihub.scot.nhs.uk/education-and- learning/qi-e-learning.aspx

13. QI Hub resources http://www.qihub.scot.nhs.uk/safe/healthcare-associated-infections.aspx http://www.qihub.scot.nhs.uk/safe/patient-safety-tools.aspx

14. Discussion How could these Knowledge into Action approaches support improvement initiatives in your area? What could you try tomorrow?

15. Summary Knowledge into Action is a national strategy which aims to develop the skills of frontline practitioners for applying knowledge into frontline practice and improvement. This is not something new rather about embedding this approach into existing opportunities. Tools, resources and people are available to support this.

16. “Knowing is not enough; we must apply. Willing is not enough; we must do.” - J.W. Goethe (1749 –1832)?

17. References 1.McGlynn EA, et al. The quality of health care delivered to adults in the United States. NEJM. 2003. 348:2635-2645.The quality of health care delivered to adults in the United States 2.Balas, EA, Boren, SA. Managing clinical knowledge for health care improvement. Yearbook of Medical informatics. 2000. Available via: http://www.ihi.org/resources/Pages/Publications/Managingclinicalknowledg eforhealthcareimprovement.aspx http://www.ihi.org/resources/Pages/Publications/Managingclinicalknowledg eforhealthcareimprovement.aspx 3.Morris ZS, Wooding, S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. Journal of the Royal Society of Medicine. 2011. 104:510-520.The answer is 17 years, what is the question: understanding time lags in translational research 4.Straus SE, Tetroe J, Graham ID. Knowledge Translation in Health Care: Moving from Evidence to Practice. Oxford: Blackwell Publishing Ltd. 2009.Knowledge Translation in Health Care: Moving from Evidence to Practice 5.NHS Education for Scotland and Healthcare Improvement Scotland. Getting Knowledge into Action to Improve Healthcare Quality: Report of Strategic Review and Recommendations. 2012. Getting Knowledge into Action to Improve Healthcare Quality: Report of Strategic Review and Recommendations