© Copyright Walter de Ruyter Ph 0417419238

wderuyter@uniting.org 19-12-12 (A compilation of previous papers 2012 to present) Page 1 of 5

Knowledge Communities supporting Practice in a changing Aged Care Environment

“The Role of Governance” Précis:- Policy as a consequence of research and strategic intent is used to introduce variation to existing practice. Conversely practice can be captured and influence existing policy. Corporate structures that flourish in this environment are able to manage variation as opportunity. They apply the variation in a vocational setting by their staff and integrate the knowledge derived into their domains of practice. This is in turn promoted to their customer base as having value in rapidly changing markets. (see Akolade Conference Blog part (1)1 and part (2)2 as to emerging markets.) Before the equation of “Price + Quality = Value based upon relationships built on trust” is adopted by the customer, employee’s need to accommodate variation within their practice to develop the necessary competence in service delivery. This is described in my short papers on adapting to change3 and consumer directed care4.

Information versus Knowledge The organisations knowledge consists of its capability to integrate information with experience and expertise to take effective and productive action. This assimilation is no mean feat, as it may be described; ‘Today we are drowning in information but starving for knowledge.’5

Management of Knowledge

Knowledge is a rare commodity that does not degrade with use but its value is enhanced. Capturing and retaining corporate knowledge is a priority but often an asset left in the hands of key staff who have acquired knowledge over time which has not been systematised. The result is the capture and application of knowledge is inconsistent and is lost with staff turnover. As depicted in the process map of dealing with opportunity, shows the relationship as to how knowledge is applied to deal with opportunity. In a relatively young corporate structure you will find that 30-40% of knowledge applied to opportunities is informal held by ‘experts’ who hold positions but not necessarily reflected in job descriptions or supported by policy and procedure. This is depicted above the broken line.

1 http://akolade-blog.blogspot.com.au/2015/09/guest-blog-by-walter-de-ruyter-transfer.html

2 http://akolade-blog.blogspot.com.au/2015/09/guest-blog-by-walter-de-ruyter-transfer_14.html

3 W de Ruyter 20120318 Revised 11-5-12 Adapting to Change

4 W de Ruyter 20131018 Consumer Directed Care Social Inclusion and Wellbeing

5 Asia-Pacific Economic Cooperation, 2000, p.viii

Opportunity

Is it

Supported

by Policy

or Plan

Urgent

Identify

Stakeholders

& address

key issues

Follow

Advice

Follow

policy & action

Draft Endorsement by relevant Custodian/s

(This can be a Position or Committee)

Action Required;

a)Check / adhere to Regulatory Compliance

b)Determine / monitor Financial Viability

c) Relevant Service review & management

d)Alignment with existing plans & stakeholders

e) Marketing

Final endorsement process;

a) Regional Manager

b) Senior Executive

c) Board

Develop Opportunity

Forward endorsed

polices, procedures

plans to

Custodian for

management

Yes

No

No

Draft version 1

12-10-10

Walter de Ruyter

0417419238

* Write up Brief

a) Verbal Report

b) File / Notes

.

Process Map

Refer to

Team

By IndividualBy

Analysis

External

Advice

Yes No

Yes

© Copyright Walter de Ruyter Ph 0417419238

wderuyter@uniting.org 19-12-12 (A compilation of previous papers 2012 to present) Page 2 of 5

Below the broken line knowledge is increasingly held by custodians expressed through policy and procedure. Action is devolved to positions as reflected in job descriptions that guide individual practice. This contributes to achieving the goals and objectives as articulated in the vision and mission of organisations. The outcome is the capture, retention and application of knowledge is consistent across positions rather than being dependant on key individuals.

Knowledge as a soft form of currency in a vocational setting can be seen in how professions work…. “…graduates who as part of professions apply knowledge in their vocational setting. This becomes their domain of practice which through professional affiliations or unions develop a brand which reflects an association between price + quality = value as perceived by the customer based on confidence, built on trust.”6 An example is the profession of Nursing, its work is codified in policy and procedure and it’s applied in a vocational setting based on that professional meeting competency based standards. The trust and confidence in a professions role is recognised in the broader community through industrial awards (wages). To move to a model where “the capture, retention and application of knowledge is consistent across positions rather than being dependant on key individuals” is evident in the relationship of a social investment bond to a corporation which is analogous to an industrial award for wages to a profession. When seen like this it makes sense to pursue a capture model of knowledge under the auspice of Governance as described in developing social investment bonds7. Governance has a strong role in transitioning the capture of practice vested in key individuals and professions and systematise this knowledge within a corporate framework whilst mitigating risk.

Job Descriptions That Guide Individual Practice.

A key goal of governance is to build on the strengths of each service whilst aligning practice and service provision across organisations. The challenge is to translate a corporate web page which contains a great depth of organisational knowledge into practice by a workforce which does not necessarily have the skills in effectively navigating the intranet. The current process is to manage knowledge as ‘just in case’ rather than ‘just in time’.

The opportunity when developing the systems and processes of the intranet site is to ensure existing tools such as Job descriptions (example per schematic) are utilised when linked to policy and procedure located on the intranet site. This manages knowledge within a framework of just in time.

Referring to the process map on page one and utilising the job description as a sophisticated index (proposed location as an icon on the desktop) to the role duties

6 (20131024 de Ruyter w. “The Role of research generating knowledge”

7 20150826(3) de Ruyter w. Knowledge communities supporting Quality in a changing Aged Care Environment.

Job Descriptions (JD’s)

Extract BSO JD

Key Result Areas:

Provide Receptionist duties

Attend to all enquiries at facility enquiry counter.

Maintain the key register.

Maintain bookings for upstairs family rooms.

Provide back-up telephone support for facility.

Make resident bookings for allied health services.

Cash Handling

Accept cash donations and provide receipts.

Empty public phones monthly.

Do weekly banking for facility.

Duty

Task

Task

Hyperlinked

to procedure

The Goal is to make

the JD a dynamic

document that acts as

a sophisticated Index

to the role, duties and

tasks of the position.

© Copyright Walter de Ruyter Ph 0417419238

wderuyter@uniting.org 19-12-12 (A compilation of previous papers 2012 to present) Page 3 of 5

and tasks of the position creates and easy pathway for staff to access information pertaining to their practice. The value is duties and tasks pertinent to that person’s role and practice are directly ‘hyperlinked’ to policy and procedure supporting their practice. The impact is to cut through the intranet maze. As a consequence this process closes the quality loop resulting in a dynamic measure of practice based upon best evidence. The result is reflected in policy and procedure that is constantly exposed to the rigour of operational practice, thus ensuring its ongoing relevance in guiding practice. This in turn is managed under the auspice of knowledge communities.

Cascade Affect:- From a workforce model this enables the organisation to detect early changes in practice as seen by any additions to the ‘index’ of practice which has implications for education and remuneration. From a marketing perspective this described process is a potential conduit to identify trends and changes in practice that can be communicated to the broader corporate community. The impact is to differentiate the ‘product’ of organisations from other providers. From a structural perspective vertically aligned systems such as Human Resources and Marketing increase their lateral integration with complementary information systems, improving efficiency and effectiveness.

Background:- The challenge for many diverse corporate structures such as Uniting is consistency of practice leading to optimal outcomes. Resistance to change is familiarity and workload which are the watch-spring of habit. This is in an environment where, it is estimated that 4 Exabyte’s which is 4 Billion Billion units of unique information (computer memory) will be generated this year8. Supporting organisational communities as described in the realignment of South workgroups into Knowledge communities will contribute to Uniting practice becoming more aligned with network partnersi based upon best evidence, whilst meeting the expectations of a more discerning consumer.

Retaining staff knowledge by the organisation beyond their tenureSome local stats for Australia; in 2014 there were more people retiring than graduating. Coupled with this 30-40% of knowledge in the business is informal held by ‘experts’ who hold positions but not necessarily reflected in job descriptions or supported by policy and procedure. There is a big

difference in knowing about something and having the experience of putting it into practice.

A sample of a public service workforce questioned about retirement 57% planned to retire over a 5 year period9. Over half that workforce is turning over in five years with a current report stating 1 in 4 workers have been with their employer for less than a year and I in 2 have been with their employer

less than 4 years10.

It is not unlike a weir in a river from which a farmer draws water for their crops; it keeps on filling with more and more people who know about things whilst losing more and more people who have the experience of putting it into practice. The rate of retirement of our working population is unprecedented and makes the imperative of retaining their knowledge by the organization beyond their tenure incredibly important. The enclosed describes a process being put into place in South Uniting NSW/ACT to address this.

The systems to retain knowledge and maintain consistent operational practice is complex as it is based on the intersection of so many performance variables. The translation of theory into practice is through policy based on research and the collation of data into information. The process of translating research into practice is often through the work of professions where research is applied in a vocational setting. This becomes part of the domains of practice of that profession recorded as a

8 https://www.youtube.com/watch?v=4TKbIidbyhk

9 www.sagecentre.nsw.gov.au/

http://www.theaustralian.com.au/careers/shortage-of-nurses-critical/story-fn717l4s-1226359218437 10

https://www.youtube.com/watch?v=4TKbIidbyhk

© Copyright Walter de Ruyter Ph 0417419238

wderuyter@uniting.org 19-12-12 (A compilation of previous papers 2012 to present) Page 4 of 5

narrative describing practice. Elements of this narrative are codified into policy and procedure. This ensures consistency in the application of the professions knowledge. Much of the communication of the professions ‘Art’ is through mentoring from the master to the novice. A key process in the translation from data to information and its application as knowledge (Fig 1) is through policy. Fig 1

The cognitive map11 (Figure 2), describes how research is an important aspect of generating data and its relationship within the knowledge framework of

organisations as captured in policy and procedure. The following cognitive map on knowledge is a visual support showing key markers that act as a guide using information, knowledge and wisdom as a common thread that ties in the essential elements of what makes a corporate structure successful. The purpose of these markers is to facilitate the development of links between various projects and strategies that are designed to enhance brand and market share of the organisation / professions.

Not unlike a puzzle each part is an essential element of the overall picture/business. From this the various stakeholders within the business are able to identify what parts of the puzzle in this cognitive map best reflects their role. Four elements that combine the jigsaw pieces of the business, Sustain, Add Value, Establish the Business and develop Strategic Partnerships, position the service for growth through networks. From this stakeholders such as Clinical Nurse Consultants who auspice the

11

Cognitive maps (also known as mental maps, mind maps, cognitive models, or mental models)

Establish Presence

Governance

(Custodian of Organisational

Wisdom)

Sustains Business

Knowledge Map - Fig 2© W. de Ruyter Dec 2011 revised 16-5-12

Information exposed

To practice Becomes

KnowledgeKnowledge influenced

By values

Becomes

Wisdom

Culture defines

BrandBrand influences

Market Share

Market Share becomes a reflection

Of customer expectations

Customer expectations

Influence research

Research

generates

information

Wisdom underpins

Culture

Strategic Partnerships

© Copyright Walter de Ruyter Ph 0417419238

wderuyter@uniting.org 19-12-12 (A compilation of previous papers 2012 to present) Page 5 of 5

Knowledge Community pertaining to Standard 2 of Australian Aged Care Quality Agency (AACQA)12 create a narrative as to how their involvement contributes to the success of the business. Elements of knowledge as described in the “ACC Additional Notes document” has been superimposed on the knowledge map Fig 2, to demonstrate its relationship to key elements of knowledge as depicted in the shaded ‘bubbles’. This has been broken down into 4 categories as follows; 1) Information exposed to practice becomes knowledge and is where most of the resources of an organisation are applied. Examples tend to be transactional and quantitative such as processes surrounding Learning (CNC’s), Risk Management, Finance and Operational practices. 2) Processes associated with knowledge exposed to the values of the organisation tend to be qualitative. Examples are programs that elicit a link between the values of the organisation and its employees and customers create organisational wisdom. To this end Care Governance has strongly embraced practice development such as Choreography of Change, in association with Gallup Q12. 3) Organisational wisdom underpins the culture of the business and this is what customers see in the brand of the organisation. The stronger the association between values and service the stronger the brand which mitigates risk from unethical practice. 4) Customer expectations determine the product range and the extent of the product range is directly related to the degree of sustainable partnerships with aligned organisations. The ‘glue’ that holds together these partnerships are twofold;

1. Goodwill based upon shared values 2. Research that gives evidence to the quantitative basis for the partnership

Discussion:- Three elements

have been directed to

supporting such an approach

to developing knowledge

communities through the

realignment of South

Workgroups (as below):-

1. A tool – Smart Mobs supporting a knowledge community by capturing “Variation in Practice” and giving it immediate direction.

2. A process – For how we meet and platform used to support Knowledge communities. Examples are

the current migration to SharePoint and Yammer.

3. A framework - for Cognitive thinking that is consistent across internal and external networks to demonstrate quality whilst mitigating risk.

12

https://www.aacqa.gov.au/for-providers/accreditation-standards

South Meeting Chart

Communities of PracticeService e.g. Elanora

MACMeeting

Communities of Practice Southhttp://team.unitingcare.local/sites/RHCSSouth/SitePages/Home.aspx

Oct 2013 Amended 18-12-13 Amended 6-1-14 Amended 5-4-15

Relatives & Residents Meetings

GovernanceSouth

Staff Meeting

ACFISouth

Memo’s

CC MeetingRN Meeting

Hotel Services

Lifestyle

Memo’s

Pastoral Care

HSWL&D Finance

YammerResearch

Group