Bringing knowledge to bear on commissioning

Sue Lacey Bryant, Chief Knowledge Officer

11th February 2011

“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”

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

The programme

1. What is Knowledge Management? Sue2. KM - an ABC; starting at A Sue3. KM in practice: informing referrals management Steve4. KM from B-C Sue5. Evidence into practice: Making an IMPACTE Linda6. Informing commissioning decisions Anne7. Keeping up to date Anne8. Transferring knowledge Sue

1. What is knowledge management?

• 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:

Practical and pragmatic

• Applying knowledge

• Building ‘know-how’

• Continuing to learn

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

Director of GP Commissioning Consortia Development

Business intelligence team

Refining, analysing and combining, and interpreting

DATA

IFORMATION

MeaningfulTimely RelevantQuality assured

Information customers Data providers

Data Transformation

Support and education for data suppliers/customers, to improve data quality and information requests

Quality assessed

Implementing primary care systems

Knowledge is everyone's business

Across the organisation including - Communications and EngagementCorporate Affairs Human relations & organisational development Information TechnologyPublic Health IntelligenceQuality and StandardsSystem Reform

2. Knowledge management – an ABC

Starting at A

A = Applying knowledge

• Data on activity, cost, outcomes

• Research evidence on clinical outcomes and cost effectiveness

• “Best practice” including models of service

• Patient experience

KM in practice: opportunities for innovation

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

3. KM in practice Informing referrals management

Steve Hance Project manager, Referrals project

• 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

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

Education: Learning opportunities

• Referrals wheel• Top tips• GP Referral LES• Practice visits • Sharing best practice• Consortia meetings• CPD events

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?

Referrals support service

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?

4. Knowledge management

from B- C

B = Building Know-How to improve performance

Establish commissioning methodology

Commissioning, Disinvestment and Contracting Manual, July 2010

NHS MK Model of improvement

C= Continuing to learn

• Master-classes• 1:1 sessions• Group presentations• Shadowing• Learning sets

• www.qualitymk.nhs.uk• After Action Reviews• Education steering group

www.qualitymk.nhs.uk

5. Evidence into practice

Information specialists: skills

• Information retrieval: sources, searching and

sourcing• Information management• Information skills training• Research • Synthesis• Communications• Web-editing skills

Making an IMPACTE

Improving Medical Practice by Assessing CurrenT Evidence

6. Informing commissioning

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

Helping you find the evidence

• NHS Evidence www.evidence.nhs.uk

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..

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

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

www.qualitymk.nhs.uk

information and resources brought together by NHS Milton Keynes to support the development of GP Consortia

GP Consortia

Knowledge Zone

Local and national statistics

7. Keeping up to date

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

Keeping up to date

8. Your InvitationTransferring 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

The future?

• How can we better support current imperatives?

• Who will manage knowledge in the future?