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Janet GuptillPresident, KM At Work, Inc.

Colleen ElliottDirector, Knowledge Management, CHI

Creating a Comprehensive

Knowledge Management Strategy: A health system case

study2005 Congress on Healthcare Management

March 14-17, 2005Chicago, Illinois

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Seminar Objectives – You will learn:

What is meant by “knowledge management” and where it is being used

The key components of a Knowledge Management (KM) strategy

How KM can improve hospital performance CHI’s approach & how you can apply this

approachLessons learned in the process of using KM

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So what exactly is KM?

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Healthcare Organization Self Assessment:Same JCAHO issue at more than one of your facilities or nursing units?Same job, done dozens of different ways?Same problem being solved over and over again from scratch in different parts of your organization?Real dollars being spent by numerous different departments to solve the same problem without knowledge of each others’ efforts?Right hand doesn’t know what the left hand is doing?Hire outside expertise, even though available hidden experts may already exist somewhere in your organization?(Source: Detlev H. (Herb) Smaltz, Ph.D., FHIMSS, Chief Knowledge Officer (CKO), Air Force Medical Service)

What is the real total cost of these practices?What would we gain by systematically connecting the dots?

KM Needs Assessment

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Who has expertise inthis area?

Is anyone else working on this?

What is it Really?

What ideas have been tried and

tested?

Who else faces these same challenges?

Is there a recommended way

to do this?

How can I share what I have

learned?

Questions we all face…

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Knowledge Management: CONNECTION to resources for answers & ideas!

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A Question..Imagine if…You had an easy to use, readily available, trusted resource you could go to when you need to find…How to handle an EMTALA violation…

Templates for financial forecasting of a new service line…

Physicians who have adopted robotic surgery…

Guidance on preserving your not-for-profit status…

Etc.

What if this kind of resource were available throughout your organization in a systematic way?

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KM – An Illustration

In June 1995, a health worker in Kamana, Zambia

logged on to the CDC web-site in Atlanta and got the answer

to a question on how to treat malaria

June 1995 not June 2015

A small remote town, not the capital

Zambia, not a middle income country

CDC, not the World Bank

What’s wrong with this picture?!

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Knowledge Management – what is it?

“Knowledge Management”Type it into Google and you get

25,400,000 hits!!!

What is it? What does it mean?

Is it legit?!

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Organizations must excel at knowledge

management in order to compete in the 21st

century

Amazon.com has 2,089 books on KM!

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Knowledge Management –

Who is doing it?

Gained $1.5B in annual wafer manufacturing capacity by sharing “best practices”

More than $1 billion in documented bottom-line savings since 1995

Saved “tens of millions of dollars” by creating a worldwide repository of “best practices”

Saved over $150M in the first year of an initiative to identify and share marketing best practices

$50 million a year in travel cost avoidance and $6 million annually by finding information more quickly through its KM initiative

$1.5 million in savings from 2 of its communities of practice

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APQC: "Ten Years of KM Best Practices" Carla O'Dell , Ph.D., president, APQC(American Productivity and Quality Center)“Since 1995, APQC has led 17 consortium studies involving almost 400 organizations from around the world, to discover and learn best practices in KM. Over 80% of global companies now have some type of knowledge management focus in their operations. KM has become an established management concept and competency, and organizations around the world are using KM tools and principles to enhance bottom-line gains… that range from $7 million to $200 million annually with a median impact of $15 million per year.”

“Every day that a better idea goes unused is a lost opportunity. We have to share more, and we have to share faster. I tell

employees that sharing and using best practices is the single most important thing they can do.”

-Ken Derr, former Chairman and CEO, Chevron Corporation

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What do these health systems have in common? They are all incorporating knowledge transfer in their strategies.

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Health System KM Examples

Implement a One VA information technology framework that supports the integration of information across business lines and that provides a source of consistent, reliable, accurate, and secure information to veterans and their families, employees and stakeholders.

“Knowledge transfer is a strategic imperative. It is our stewardship responsibility to share and adopt ‘best practices’ that have already been identified within our system. Knowledge sharing is no longer a ‘nice to have’, it has become a ‘must have’.” - Chris Carney, former CEO, Bon Secours Health System, Inc.

The Business Process Redesign Initiative is a System-wide approach to improving operations in Supply Chain, Financial Management, and Human Resource/Payroll functions at Catholic Health East. It will accomplish this goal through the utilization of best practices and System-wide standardization of business processes, data and supporting technology, e.g., business process re-design.

The Ascension Health Exchange is a collection of online Communities designed to facilitate sharing and foster innovation and quality improvement across Ascension Health – to achieve our Call to Action:•Healthcare That is Safe•Healthcare That Works•Healthcare That Leaves No One Behind

Each year, CHRISTUS Health presents Touchstone Awards to those practices and programs that stand out as “touchstones” in exemplifying the Mission and Values of one of our Directions of Excellence

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Multi-institutional Catholic Health SystemDedicated to the healing ministry of the Catholic ChurchNational Offices: Denver, Denver-Meridian, Northern Kentucky, and MinneapolisMarket Based Organizations (MBOs)19 states

68 hospitals (64 acute care, 2 psychiatric, 2 rehabilitation)

44 long-term care, assisted living facilities and residential units

$6.1 billion annual operating revenuesApproximately 67,000 employees

Catholic Health Initiatives

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August 2004

National Offices

Service Centers

Catholic Health Initiatives

•Market-Based Organizations, Facilities and Community Health Services Organizations

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Vision for CHI

Catholic Health Initiatives’ Vision is to live out its Mission by transforming health care delivery and by creating new ministries for the promotion of healthy communities.

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People Information

Performance

Growth Core ValuesMission

Vision

Strategic Direction 2005-2009

Quality

CHI’s “Desired Future State” gives focus to its preferred future, and describes the key attributes and imperatives of that future.

Five Core Strategies – People, Information, Quality, Performance, and Growth – will focus the investments in time, money and human energy that CHI believes will be imperative for staying the course and sustaining momentum toward its Desired Future State.

CHI’s strategic focus will also be infused with a spirit of:

Innovation that fosters and rewards creative thinking and accelerates learning and knowledge exchange to ensure CHI’s success in a dynamic health care environment; and,

Partnership with employees, physicians, local communities and other organizations that will advance CHI’s efforts in advocacy, research and development, deployment of medical/information technologies and the creation of new models of care.

CHI Strategic Plan: 2005 - 2009

The Strategic Plan is the renewable map that sets CHI’s course toward its preferred future. That journey’s compass is expressed in CHI’s Mission, Vision and Core Values.

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DFS DFS 20142014

Quality CHI will be a recognized leader in clinical quality, safety and customer loyalty.

People CHI’s distinctive culture will create the work community of choice in every market it serves.

Growth CHI will extend the scope and influence of the Catholic health ministry through growth, development, advocacy and continued transformation.

Performance CHI will be a nationally recognized leader among health care systems for its operating and financial excellence.

Leadership & Culture:Translating Vision into Action

Information CHI will be the trusted health partner in the communities it serves by being the recognized leader in information management.

■ Values

■ Distinctive Culture

■ New Models

■ Innovation

■ Advocacy

■ Quality

■ Health Management

■ Information/Knowledge

Transform Delivery andCreate New Ministries

Promote Healthy Communities

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Information Core Strategy

Core StrategyCore Strategy CHI will be the trusted health partner in the communities it serves by

being the recognized leader in information management.

Objectives

I-1 Organizational Readiness

Achieve organizational readiness to support system-wide implementation of CHI’s information management plan.

I-2 Information Management

Deliver appropriate information across all settings to support CHI health management and quality initiatives.

I-3 Knowledge Management

Build knowledge management capabilities to support innovation and the transfer and effective use of knowledge across the organization.

I-4 Alignment and Relationships

Employ information management strategies to create effective alignment with physicians and preferred relationships with consumers and other partners.

I-5 Support of Core Strategies

Support implementation and ongoing measurement of CHI Core Strategies and Objectives.

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“Our goal is for CHI to become known as an innovative organization. That will be our legacy for the future health care system – that CHI learns to

leverage the wisdom of the whole, efficiently, effectively, and humanely.”

- Kevin E. Lofton, FACHE, CEO, Catholic Health Initiatives

CHI – Leveraging the Knowledge Within

InnovationKnowledge

Management

Performance

Improvement

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Leveraging the wisdom: 2004-2005 Flu vaccine shortage

Started with initial call for help

Led to brainstorming call, collection of information, and a new web-site within 2 weeks

IMPACT – all CHI facilities had adequate supply of flu vaccine; appreciation for CHI’s response to the situation

Influenza situation

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How KM started at CHI2000 Knowledge Management Retreat for senior leadership

explored KM as an enabler to support CHI culture and core strategies

2001 KM Steering Committee created, selected 3 Pilot projects and a minimal budget

Director of Knowledge Management hired in October

2002 Initiated pilots and strategy development

2003 Formalized KM program into the Strategy & Business Development Group

2004 Focused on operational and clinical improvement areas and formalized KM service lines

2005 Leverage as a critical component for innovation & improvement

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KM Progress at CHI

Leading To:

Becoming the “gateway” to internal CHI resources

Connecting key stakeholders

Facilitating the adoption of “best practices”

Becoming a catalyst for change

To a comprehensive Learning Database for all employees

To 5 Resources

To searchable content

To collaboration sitesTo 45 communitiesTo partnering with ITTo on-line practice dbase

From 1 KM person

From public folders

From distribution lists

From 3 pilot knowledge communities

From focus on technology designFrom word of mouth practice sharing

From a compliance eLearning tool

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Connecting the dots between these examples

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Toolkit

Knowledge Community Cultivation Guide:

Captured the process for developing and supporting a community, resulting in an increase in the number of self-started communities

Crystallizing the Dots…

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On-line Collaboration Space

20 Communities currently on-line

Plan to double in number in the next 6 months

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Practice In Action Database

50 Practices collected with initial collection process

Next step – track and celebrate adoption of practices

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Combining learning & collaboration is critical to helping learn and ADOPT new practices

Implementing a Learning Management System

Decreases in: course duplication, instructor costs, employee time in classroom in, travel costs, supply costs could lead to a savings of $19/employee, $1.2 million across CHI!

Improvement in retention of knowledge for learners

Crystallizing the Dots…

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CHI’s LMS - LEARN

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Connect those facing an issue with those who have a solution….serve as the “Gateway” to internal CHI resources…

Facility and employee profile databasePractice in Action databaseContent Management SystemPathfinders

Crystallizing the Dots…

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1. People to People Connection is critical!

2. Executive Support is required to gain acceptance.

3. Link directly to the core strategies of the organization.

4. Tools & Templates simplify the process for participation.

5. Don’t over-engineer the process of sharing!

6. Maintain flexibility – stay focused on needs!

Lessons Learned at CHI

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7. Prototyping – pilot new tools with small groups.

8. Patience – it takes time and behavioral change for this to become the “way we work”.

9. Self Service – make it easy and rewarding for people to utilize the tools themselves.

10. Success Stories – build momentum and recognize the heroes.

11. Partner with IT – technology can greatly enhance the collaboration and sharing process

Lessons Learned at CHI

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Does your Hospital have a Culture of Knowledge Sharing?

1. Are the CEO and other senior executives open to different ideas? Do they routinely seek to learn from their peers’ or others’ experiences?

2. Does the hospital have a formal or informal process for learning from mistakes? Capturing insights from a new practice? Publishing these results for others to use?

3. Do managers routinely ask themselves, “who can benefit from my experience?” and “who else might have already tried this before?”

4. Does your hospital have systems and processes that make it easy to tap into others’ experiences?

5. Are there rewards for sharing knowledge within the hospital? For re-using others’ ideas?

Score these: Always – Sometimes - NeverScore these: Always – Sometimes - Never

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Do YOU have a Culture of Knowledge Sharing?

1. Are you open to different ideas? Do you invest time to seek out new ideas, either through reading, networking, or attending conferences?

2. Do you have a formal or informal process for learning from mistakes? For sharing these insights with others?

3. Do you routinely ask yourself “who can benefit from my experience?” and “who else might have already tried this before?”

4. Do you routinely “package” resources, documents, and templates for others in your organization to access and use?

5. Do you reward knowledge sharing among your team? Do you encourage people to learn from others’ experiences?

Score these: Always – Sometimes - NeverScore these: Always – Sometimes - Never

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Final Thoughts…..Specific responsibility for “connecting

the dots” increases the speed of connection.

Performance improvement can be multiplied by spreading ideas from one department or facility to others.

Recognition for sharing increases participation.

A focus on connection increases the speed of adoption of proven practices.

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Final Thoughts…..

Let’s start up an online community – who is interested in staying connected around these topics?eLearningIntranet collaboration toolsKnowledge communitiesFormally sharing “best” practicesBenchmarking on performance metricsWhat else?

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Colleen Elliott Catholic Health Initiatives

colleenelliott@catholichealth.net(303) 383-2735

Janet GuptillKM at Work, Inc.

janet.guptill@kmatwork.com (314) 963-7710

For a copy of the presentation, go to: www.learnfromeachother.com