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.