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Knowledge into Action for HAI Improvement Facilitators
Suzanne WilsonImprovement Manager (Knowledge into Action)
NHS Education for Scotland
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)
What is Knowledge into Action?
evidence based practice
knowledge translationknowledge implementation
implementation science
“The move beyond simple dissemination of knowledge to actual use of knowledge”
Straus, et al (2009)
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?
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.
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
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
Discussion
How do you find, use and combine different types of knowledge in your practice?
• Know-what
• Know-where
• Know-who
• Know-how
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 communityof practice
Providing actionable, mobile solutions to make it easy to do the right thing
Example – pressure ulcers
What does best practice look like?
Tools and bundles to support implementation
Sharedexperience
http://www.healthcareimprovementscotland.org/our_work/patient_safety/tissue_viability.aspx
Example – Enquiry service
http://www.clear.scot.nhs.uk/
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
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
Discussion
How could these Knowledge into Action approaches support improvement initiatives in your area?
What could you try tomorrow?
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.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
- J.W. Goethe (1749 –1832)?
References
1. McGlynn EA, et al. The quality of health care delivered to adults in the United States. NEJM. 2003. 348:2635-2645.
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/Managingclinicalknowledgeforhealthcareimprovement.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.
4. Straus SE, Tetroe J, Graham ID. Knowledge Translation in Health Care: Moving from Evidence to Practice. Oxford: Blackwell Publishing Ltd. 2009.
5. NHS Education for Scotland and Healthcare Improvement Scotland. Getting Knowledge into Action to Improve Healthcare Quality: Report of Strategic Review and Recommendations. 2012.