Establishing a knowledge hub toenable evidence-based decision

making in healthcare

Alison TurnerChief Knowledge Officer

Overview

• Knowledge as key enabler to effective decisions in planning and commissioning healthcare

• Moving from Information Department to Knowledge Hub, from crunching data to mobilising knowledge

• Learning from achievements and problems along the way

“Clean clear knowledge is the single most important intervention available to improve the health of

populations and the quality of healthcare. Knowledge, like water, is everywhere; knowledge,

like water, needs to be filtered and purified to ensure that it is clean and clear”.

Professor Sir Muir GrayChief Knowledge Officer for the NHS

Knowledge is derived from…

• Data– health needs; health outcomes; service activity and

performance; service quality; benchmarks and comparators; patient-derived data

• Policy and research-derived evidence– clinical effectiveness; cost effectiveness; the

benefits or risks of health care interventions; best practice

• Experience– know-how, lessons learned

Knowledge is needed for…

Identifying unwarranted variations in care

Evaluating bids for new services

Identifying and prioritising improvements/innovations

Planning and delivering new services

Planning patient care pathways

Understanding activity and finance

Monitoring quality and safety

Providing early warning of problems and issues

The “Before” picture

• People– Silo working– No career structure for Information staff– Limited analytical capacity and capability– Poor perception of Information leading to low usage of

intelligence and evidence and low engagement• Processes

– “Feeding the beast”– Too many manual processes– Variable data quality

• Technology– Many sources, tools and flows– Knowledge sitting in different parts of the organisation – Limited sharing– Large spreadsheets

The vision

A Knowledge Hub to:

effectively manage information, evidence and knowledge across the whole of Wolverhampton

City Primary Care Trust, with the objective of delivering intelligence to commissioners and

assisting them in making more informed decisions

How are we doing?

• Some key themes:

– Focusing on business need

– Developing people

– Collecting and managing knowledge

– Presenting knowledge

Focusing on business need

http://www.hsj.co.uk/resource-centre/your-ideas-and-suggestions/commissioning-and-strategic-priorities/5015582.article

Signposting of high quality evidence on effectiveness and best practice will help prioritise high-value interventions

Supporting development of local pathways through provision of intelligence and evidence

Analysis and modelling enables testing of innovations for costs and benefits

Provision of high quality information enabling informed investment decisions

Tools and processes to support knowledge sharing across the local health economy

Access to evidence to learn from experience elsewhere

Analysis and intelligence can help identify areas which would benefit from innovation and improvement

High quality information informs investment and disinvestment decisions

Risk stratification can help identify high-risk patients for follow-up

Analysis and data supports needs assessment and helps understanding of variations, comparators and benchmarks

Access to evidence helps identify low and high value interventions

High quality information will support the QIPP programme

More powerful analysis of activities and outcomes facilitates evidence-based decision making

Access to a series of routine reports, dashboards and information packs enables informed monitoring against quality metrics and benchmarks

Capturing and sharing of tacit knowledge and know how within the Trust

Collection of patient-derived information and ingestion in to the data warehouse

Access to sources of evidence on patient and public involvement

Identification and sharing of significant new information and evidence which may impact local pathways

Developing people

• Workforce planning

• Training and development

• After action reviews

• Communications and engagement

Collecting and managingknowledge

• Confirmed user requirements - translated into info requirements

• Mapped knowledge flows and sources

• Extracting GP data to complement acute, community, mental health data – following patient journey

• Created single point for information collection and management

• Creating a data warehouse solution for managing structured data

• Created a portal for managing unstructured content

• Focusing on quality of knowledge sourced

Presenting knowledge

• Making sense– Adding commentaries, modelling project

• Using appropriate graphics– Funnel plots, control charts, bar charts

• Developing trust– Robust statistical analysis, Quality assurance

• One-stop shop for knowledge– Dedicated portal

• Developing new knowledge products– Evidence Updates, Quality reports, Risk stratification, Dashboards

Problems along the way

• Silo working

• Maintaining Business As Usual

• Changing behaviour

• NHS reform

• Knowledge transfer

• Efficiency savings

Future challenges andopportunities

• Demonstrating value of Knowledge Hub

• Synthesising and contextualising activity/outcomes data, best practice evidence and patient experience

• Automating processes

• Opening up information to patients and the public

• Proactive reporting – “early warning”, modelling

• The Quality and Productivity Challenge

Quality & Productivity

• QIPP (Quality, Innovation, Productivity, Prevention)

• NHS needs to achieve £20bn savings by 2015

• Projects include:– Urgent Care strategy– Pathways– Procedures of limited clinical value

Knowledge in people and networks

Captured Knowledge

Individuals & Teams Goals Results

UsingKnowledge

UsingKnowledge

Learnduring

Learnafter

Learnbefore

A knowledge management framework

Created by Chris Collison and Geoff Parcell

Validate and review

Access and apply

UsingKnowledge

Learnduring

Learnafter

Learnbefore

EVIDENCE UPDATES (monthly)Horizon scanning : new innovations, new evidence on benefits and harm

EVIDENCE REVIEWSRapid review of potential opportunities summarising key evidence from our data, lessons from elsewhere, best practice evidence, benchmarks and variations, soft intelligence, historical trends, benchmarks – establish baselines and KPIs

DASHBOARDS AND REPORTSMonitoring progress on KPIs agreed at PID stage

SHARED SPACEDirectory of projects and people involved, shared space to communicate/collaborate

KNOWLEDGE SUMMARIESCapturing learning and summarising/presenting - to inform future projects & organisational memory

RETROSPECTS/INTERVIEWSShort focused events to capture learning and/or interviews with key staff

Thank you

Alison TurnerChief Knowledge Officer

Wolverhampton City Primary Care Trust

01902 445962 07825 722352

alison.turner@wolvespct.nhs.uk

Linkedin: http://uk.linkedin.com/pub/alison-turner/7/b2b/b4