A Summary
of
Learnings…
Presented to the KM Lab, November 10, 2008
Evidence-Based Education and Services Team
NCCMT
• National Collaborating Centre for Methods and
Tools
• Funded by Public Health Agency of Canada
• One of six National Collaborating Centres (others
include, Aboriginal Health, Health Determinants,
Infectious Diseases, etc.)
• Overall mission is to translate existing and new
evidence in public health
• NCCMT is focussed on improving access to, and use
of, methods and tools for KTE
• Hosted by McMaster University
Speakers
• Sir J.A. Muir Gray, Director, National
Knowledge Service
• Brian Haynes, Professor, Clinical Epidemiology
and Medicine, McMaster
• Stephen Kingston, President, MediaDoc
• John Lavis, Canada Research Chair in
Knowledge Transfer and Exchange, McMaster
• Kirby Wright, President, Knowledge Resources,
Inc.
Clean, Clear, Water
• In 19th century, health was transformed by
provision of clean clear water
• In 21st century, knowledge is the analogue
of water ~ the provision of clean, clear,
knowledge is the responsibility of public
health
Sir Muir Gray Keynote
The future is not a
destination waiting for our
arrival…we need to imagine
it, plan it, and build it…
In fact, the future is here
now, it is just not evenly
distributed. There are
puddles of excellence and
innovation everywhere.
Major problems in Health Care
not solved by more Science…
•
•
•
•
•
•
Errors
Poor quality health care
Wasting of resources
Variations in policy and practice
Poor patient experiences
Overenthusiastic adoption of interventions
of low value
• Failure to get new, high value, evidence
into practice
The Water Metaphor
• Rubbish sinks to the bottom (controlled trials
help with the sift)
• Filter (systematic reviews)
• Aquaduct (knowledge needs to move!)
• Water tank (chief knowledge officer houses best
evidence for the organization)
• Tap (knowledge flows clean and clear when
needed)
• Water quality reports (knowledge control
inspections)
Questions from the Audience…
• How do we make them thirsty?
• Water flows through the path of least resistance –
how do we ensure that the best knowledge flows?
• What support is there for knowledge officers to bring
all of the information together, from diverse content
areas?
• Knowledge lies around in puddles and water jugs, how
can we organize this?
• Putting a tap in my house is a messy and difficult job,
when going to the waterhole is what my grandmother
and her grandmother have always done…(managing
resistance to change)
• Is our job filtration and marketing, like bottled water?
Providing Current Best
Evidence for Decision-Makers
• Past: Passive Push Diffusion (publish and
they will come)
• Recent past: Pull Techniques (teach
critical appraisal and search techniques)
• Current: Augmented Push (central
synthesis and send to a targeted group)
• Current: Augmented Pull (infiltrate their
common sources with evidence so they
read it when they come)
Brian Haynes Session
Augmented Push:
Example
• McMaster Plus
60,000
articles
Critical
appraisal
process
3,500
articles per
year
3,500
articles
Relevancy
Filter
25 articles
per year
http://plus.mcmaster.ca/EvidenceUpdates
http://plus.mcmaster.ca/KT
Enabling Knowledge Management
through Web-Based Technologies
• Technology was first used for marketing,
increasingly, it is used to facilitate
interactivity
• Tools to:
–
–
–
–
Create
Capture
Share
Leverage
Stephen Kingston Session
Tools to Create and Capture
• Blog (free: wordpress)
• Wiki (free: mediawiki)
• Document libraries (pay: livelink)
– Electronic repository of documents
• Web analytics (free: google analytics)
• Translation management (pay:
claytablet)
• Collaborative workspaces (free: google
documents)
Tools to Share and Leverage
Share
• All of the above, plus…
• Videoconferences / webinars (pay:
livemeeting)
Leverage
• Community of Practice
Want to stay current?
Digg.com
reddit.com
Evaluating Innovative
Approaches to Policy Briefs and
Deliberative Dialogues
• Barriers to Research Use:
– Research is not valued as input in decisions
• Create a climate for research use
– Research is not relevant to critical decisions
• Produce research that is relevant
– Research is not easy to use
•
•
•
•
•
Translate research into the language of the organization
Communicate findings effectively
Facilitate pull
Prompt professionals to use research
Provide a forum for conversations about research
John Lavis Session
Policy Briefs
• Mobilize global and local data, and
highlight local applicability
– What is the problem?
– Three research-based options for addressing
the problem (and likely costs and
consequences)
– Relevant implementation considerations
Deliberative Dialogue
• Six features:
– Purpose – a full discussion of a relevant issue
– Pre-circulated Policy Brief
– Participants include decision-makers, those
who influence decisions, those who
implement decisions
– Chaired by skilled, neutral facilitator
– Participants positioned to champion the
efforts of the group
– Chatham House Rule
Future Directions for
Knowledge Management
• Call to Action towards a National Knowledge
Service (Muir Gray)
• Require a culture of inquiry
• Need to harness the power of communities
• Content (research) is important, but so are
connections
• Storability is different from “findability” (we
need to be as good as Google with access)
• Appreciate the complexity of the task
Kirby Wright, Closing Keynote
First Principles
• What do we know about decision-making?
– We think we are logical, but most often we
use heuristics and past pattern matching
to affect the
Situation
Action scripts
generates..
Cues
that activate
Patterns
that let you
recognize…
We need to change the patterns to include consideration of
evidence!
The types of problems we face
• Simple (baking a cake)
• Complicated (a rocket to the moon)
• Complex (raising a child)
• Our problems are complex (multiple
variables, not sure of end state, no
defined script…) – the answer is not in a
research repository!
Social Dimensions of
Knowledge
• Learning is about work, work is about
learning, and both are social
• Communities of Practice lend themselves
to situated learning and inquiry
• Knowledge Management is founded on
research and relationships
In summary…
• KM is important! We need to create, share, and
manage knowledge – this should be a core part
of our work
• Start with the decisions that need to be made –
how can evidence be brought to bear?
• Layered, interconnected learning – recognize
the change process
• KM is more than content transfer – it is
dependent on attention to relational issues