accelerating clinical transformation using community collaboration tools

Copy write 2006 The NewSof Group & KM at Work

Accelerating Clinical Transformation Using Community

Collaboration Tools

Janet Guptill, PresidentKM At Work, Inc.

Using online communities to accelerate innovation adoption

Neal Sofian, CEOThe NewSof Group, Inc.


Clinical Transformation and Communities of Practice

Why do we know that communities are a key component to accelerating adoption of innovative practices and technologies? The science behind individual behavior change The basis behind organizational change The role that communities and social networks play in creating change

How do we systematically address accelerating adoption of innovative practices within hospital systems? Lessons learned from the practice of knowledge management Examples of hospital systems engaged in communities of practice to

accelerate transformation

How can Perot Systems, KM At Work, and NewSof bring a combined solution to its hospital system clients?


The Problem

Medical costs are too high Access to medical care is inconsistent Patient outcomes are not as good as they should

be Practices are not optimal and significant variations

persist, even with evidence-based medical guidelines

Limited means to measure change and progress Knowledge remains in unusable silos


Creating Systemic Change Within & Across Hospital Systems is Critical

Hospitals need a simple way to learn from their peers in order to:

Share both formal and informal successful practices, success factors and lessons learned

Access a searchable repository of content, both internally developed and externally contributed, to identify evidence-based practices, relevant research, and context-sensitive knowledge

Identify and extend the reach of expert resources across member hospitals

Connect with peers for just in time access to critical new knowledge at the point of care and the point of need

Create and develop new knowledge regarding business and care practices

Improve formal and informal communication regarding common projects, challenges, and environments.


10 Critical Dynamics of Innovation Diffusion:

1. Relative Advantage2. Trialability3. Observability4. Communications Channels5. Homophilous Groups6. Pace of Innovation/Reinvention7. Norms, Roles, and Social

Networks8. Opinion Leaders9. Compatibility10. Infrastructure

Source: Diffusion of Innovations, Everett Rogers, 1995

• Transferring knowledge is often not enough; need to figure out how to transfer capabilities as well, through human and technology enabled support systems• Getting an organization to adapt new ideas requires a process of re-invention—people need to own the result as their own idea--

Guiding Principles – Diffusion of Innovation

“Diffusion is the process by which an innovation is communicated through certain channels over time among the members of a social system.”


Requirements of Effective System Change

It Ain’t Dog Food if the Dog Don’t Eat It!The program is only as good as the users willingness to use it

Suction, Not Pressure!Develop internal motivations, align incentives

Information is Not EnoughIf it was we wouldn’t be talking today

Watch What They Do, Not What They Say!People often tell you what they wish rather than how they actually behave. Design interventions and communication accordingly.

Listen to Your MoM!(Microcultures of Meaning) Useful information is made relevant through people


Creating Systemic Change

Focus on the reach and richness of content (information alone is not enough)

Creating change is both an individual and organizational process

Think of behavior as a transaction by creating a health action, medical event, care process, or business exchange

Create micro-cultures of meaning (to create context, tacit knowledge, and connectivity) at both the individual and organizational level

Make contextual information available at the point of care or need

Incent all parties toward the same outcomes Integrate multiple mediums and learning styles Focus on what people do, not what they say Start with the person, not the risk, issue, or technology Build relationships and process, not products and programs


The Science

Recent report: human beings are “Hardwired to Connect” We are “biologically primed” for finding meaning through

attachment to others Learning is social Acting on learning comes from context Context comes from the groups of like meaning or Micro-

cultures of Meaning (MoM) Social Constructionism demonstrates that learning is always

based on the context and language or stories of the group


Change drivers in an online community

Communication – pervasive, ongoing, and multi-modal – don’t rely on email alone

Context – Information is not sufficient to create change; it must be presented with the context to make it useful

Coaching – A suite of tools over time using multi-modalities and learning styles based on the degree of complexity or challenge in adopting the new behavior

Connections – Change processes and support resources need to be customized to the audience - Build relationships, not products – Strive for continual improvement not a single event

Coin – Align incentives of all the stakeholders and participants Culture – It is part of the core, not peripheral to a strategy -

Personal stories/experience are a key driver in transmitting this strategy - Start with the person, not the technology or problem

Create Microcultures of Meaning (MoM)


Timeline of Behavior Models1927 Pavlov1930s Skinner1935 Lewin Field Theory and Group Process1950s Hockburn, Rosenstock, Health Belief Model

Kasl, and Cobb1957 Festinger Cognitive Consistency Model1958 Heider Attribution Theory1968 Slovic and Liechtenstein Prospect Theory1972 Sayeki Multiattribute Utility Theory1975 Rogers Protection Motivation Theory1977 Bandura Social learning theory1979 Bettman Consumer Information Processing1980 Green PRECEDE1982 Kotler Social Marketing1982 Leventhal, Zimmerman, Self-regulation theory

and Guttman1982 Prochaska and Transtheoretical model

Diclemente1982 Ajzen Theory of Planned Behavior1985 Marlatt and Gordon Relapse Prevention Model1986 Bandara Social Cognitive Theory1991 Green and Kreuter PRECEDE-PROCEED1992 Langer and Warheit Pre-adult Health Decision-Making Model2000 Newton and Sofian Microcultures of Meaning

Celeste Cafiero, Fern Carness, Changing Patient Behavior


A community of people with common need or purposeIt’s about connecting people and their knowledge (explicit

& implicit): allowing them to communicate, share common experiences, interpret information, solve problems (personal, social, work), collaborate

It assumes the consumer as well as the provider of information is a valuable source of actionable knowledge

It can be a virtual support group, a form of intervention, training extension or a community of practice

It is a way to build a comfortable ‘place’ which facilitates action - intertwining interaction with contextual and professional information

It is designed to turn information into usable knowledgeIt is far more than a collection of applicationsInteractions match normal community behavior with the

added benefits of the reach and richness that technology can support

What is a Microculture of Meaning?


The beliefs, values, institutions, customs, labels, laws, divisions of labor, and the like

that make up our social realities are constructed by members of a culture as they interact with one another. That is, societies (communities) construct the ‘lenses’ through which their members

interpret the world” (Freedman, 1996). We see this as central for empowering effective

change at an individual or organizational level.

What is Context?


Why is Context Important?


Creating Community within a Hospital System and Across Systems

Make networking explicit & expected

Knowledge requires connecting people and content

Create room for reflection & re-invention

Technology is essential but not sufficient


Me can be based on:Demographics: age, sex, ethnicity, marital status, geography, work typeCircumstances: disease/risk state, club affiliation, employer, job role, a

common problem and/or task, intra/inter mural work team, a common passion and/or need

Common experience: professional affiliation, alumni/veteran, an academic pursuit, attending particular events, caring for someone with a disability, hobby

Me can be any or all of the above and more!

In a hospital setting Me is often defined in terms of:Physicians: similar specialties, training, patient mixNurses: similar care setting, job responsibilities, roles in care process

improvementManagers: similar functional responsibility, strategic priorityPatients and Families: based on disease, condition, or medical

experienceFacilities: demographics of patients, physical setting, affiliation

Who is Like Me?


Five Key Elements to Effective Collaboration

1. Trust: Participants must feel this is a trusted source of useful knowledge

2. Relevance: The knowledge that is shared applies directly to them

3. Urgency: The resources shared will help a member solve a problem quickly

4. Incentive: Collaborating helps advance career and/or job status or even personal health – it’s worth it

5. Reciprocity: “If I help someone with my knowledge or experience, someone will help me”

These are encouraged and reinforced within a MoM


Key Technology Considerations for Supporting Communities of Practice 1. Presence and visibility2. Rhythm3. Variety of interactions 4. Efficiency of involvement5. Short-term value6. Long-term value7. Connection to the world8. Personal identity 9. Communal identity 10. Belonging and relationships11. Complex boundaries12. Evolution: maturation and integration13. Active community-building

Source: Etienne Wenger, Supporting Communities of Practice, March 2001

Connecting people through online/offline communities of practice involves building a set of tools that simplify communication, link people to content, and provide measurements of value and impact--

Guiding Principles – Communities of Practice

“Ideas and products and messages and behaviors spread just like viruses do.”-Malcolm Gladwell, ‘The Tipping Point’


Personal Behavior The Online Functionality*

Greeting/Welcome Registration, Personal Web Page & Profile, Welcome email Prepackaged links (based on profile) of applications,

people, content, resources for new users

Gathering Member Directory, Search, ‘Friends List” Chat

Giving/Referring Discussion and Chat, Resource Contributions and opinion givingRatings, volunteering, and Expression Gallery

Finding Help, Sharing Resources, Ask the Community Manager, Search

Helping/Instructing Multimedia Stories, Talk shows, Web logs, Moderated Chats and Discussion Boards, Web casts

Family/Patient/Peer Web logs. Secure internal email, External email Updates/notification

Connecting Email, Chat, Discussion Boards, Group Web logs

Relationship forming Tailored newsletters, personalization filters and email notification of relevant knowledge, people, status within the community, and resources

*All functionality must be tied together matching human behavior. The whole is always greater than the sums of the functional parts

How a MoM Works Online


Professional Behavior The Online Functionality*

Greeting/Capabilities Registration, Personal Web Page & Profile, Welcome assessment, team building, email Prepackaged links (based on profile) of applications,

people, content, resources for new users

Team Development Member Directory, Search, ‘Friends List”, Chat, Web connection interface

Collaborating, Co-development Discussion with Presentation and Chat, Resource Contributions and Ratings and Expression Gallery

Proven Practices Resources, Ask the Community Manager, Search

Training, Online seminars Multimedia Stories, Talk shows, Web logs, Moderated Professional Development Chats and Discussion Boards, Web casts

New Research, Innovations Web logs. Secure internal email, External email Collaboratingnotification

Networking, Shop Talk Email, Chat, Discussion Boards with Presentations, Group Web logs with controls over access

Grand Rounds, In-service Tailored newsletters, personalization filters and email Project Status notification of relevant knowledge, people, and resources

*All functionality must be tied together matching human behavior. The whole is always greater than the sums of the functional parts

How a MoM Works Online


Sample Collaboration Tools

Community building and connectivity tools: Personal repository for all user saved content, presentations/education

sessions attended and the members who attended, people of personal interest, resources, lessons learned, web logs, identified discussion boards, external weblinks, etc.

System-generated messages, surveys, announcements, service offerings, education schedules, etc.

Community Member web pages, sharing contact information and member interests and needs, to support expertise locator function

Ad-hoc communities for attendees of events to support ongoing discussions

Discussion boards (asynchronous) Chats (real-time) Email tied to existing email systems, as desired Individual and/or group web logs Special events capabilities: Web casting, moderated chats, etc.


Sample Collaboration Tools

A searchable content repository: Audio, video, presentation, and support materials of in-person,

teleconference or other educational programs Email notification of all new content, resources and connections as

desired Searchable and rate-able research, resources, people Accessible intuitive web pages and directories for individual users Easily searchable successful practices, case studies and lessons

learned (can be submitted and/or retrieved) and attached documents Resource/document sharing in multiple formats Online surveys with ability to deliver tailored responses and

information Benchmarking capabilities regarding successful practices, resources

and lessons learned


Clinical Decision Support - Incorporating evidence-based medical knowledge

Performance Improvement - Using scorecards, analysis methodologies, etc.

Multi-Site Collaboration - Collaborative knowledge-sharing forums

Build trust

Facilitate peer-to-peer knowledge transfer

Knowledge ManagementThree typical uses in hospitals


Who has expertise inthis area?

Is anyone else working on problems like mine?Is anyone else working on problems like mine?

What ideas have been tried and

tested?

What ideas have been tried and

tested?

Who else faces similar challenges to mine?

Is there a recommended way to do this?

Is there a recommended way to do this?

How can I share what I have learned?

How can I share what I have learned?

Collaboration Tools – Connecting Resources and People in Real Time and When There is Time


Collaboration Tools Lessons Learned from Other Industries

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 more than $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 two of its communities of practice

Virtual collaboration has become the way business is conducted - APQC.org


Health System Collaboration Examples

Implementing a One VA information technology framework that supports the integration of

information across business lines and provides a source of consistent, reliable, accurate and secure

information to veterans and their families, employees and stakeholders.

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

“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

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 Calls to Action


Health System KM Examples…

Catholic Health Initiatives — 67 hospitals in 19 states, 67,000 employees, $6 billion annual operating revenues – focus on Knowledge Communities

Ascension Health —67 hospitals in 20 states, 100,000 employees, $9 billion annual operating revenues – focus on Content Management

Bon Secours Health System Inc. – 24 hospitals in 8 states, 27,000 employees, $2.3 billion annual operating revenues – focus on Capability Transfer

CHRISTUS Health –34 hospitals in 5 states and Mexico, 25,000 employees, $2+ billion annual operating revenues – focus on Best Practices Knowledge Transfer

Veterans Health Administration — 23 integrated service networks, $24 billion in annual operating expenses – focus on Tracking and Metrics

Air Force Medical Service –74 hospitals and clinics distributed all over the globe, $6.2B expenses, 39,000 employees – focus on technology and support infrastructure


What does it take to make change happen in hospital systems?

Proven Practices –Data, Benchmarks, Success Stories –

To illustrate what is desired and attainable

Adoption Accelerators –eLearning,

Packaged content,Facilitated workshops,

IT platforms (CPOE, EHR, Dashboards),Performance Improvement processes –To facilitate getting new practices adopted

Communities of Practice –Knowledge Networks - MoMs –To build trusted peer relationships


The Process for Effective KM

A Knowledge Management Infrastructure Requires These Elements

Content Creation and Use

• Core work products organized for broad access• Experience knowledge base continually updated• Internal and external “best practices” research

Strategic Leadership

• Knowledge envisioned as a strategic asset• Knowledge sharing part of corporate culture• Continual innovation for competitive advantage

Strategic Leadership

• Knowledge envisioned as a strategic asset• Knowledge sharing part of corporate culture• Continual innovation for competitive advantage

Collaboration

• Peer to peer interaction and collaboration• Internal education and competency development• New product design and development

Systems Integration

• Communication and collaboration tools• Data storage, indexing, and retrieval • KM templates, tools, and technologies

3


The Elements of Comprehensive KM


Key Components of System-wide KM

System External Communities

System Internal Communities

System KnowledgeWarehouse

System ValueMeasurement

System ProfessionalDevelopment

ResearchProven Practices

Facility ProfilesPerformance

Improvement

DirectoryKnowledge CommunitiesLink to national strategySMEs

Satisfaction surveysSuccess storiesActivity metrics

Health information resourcesHealth risk assessments

Community service & mission

ELearningLeadership DevelopmentMentoringCareer OpportunitiesPerformance Appraisals

System KnowledgeCultivationKnowledge CreationKnowledge TransferKnowledge StewardshipKnowledge Coaching


Content Management

Knowledge andCapability Transfer

Tracking and

Results Metrics

Community Activation and

Support

Infrastructure and

Support Center

Leadership/Management

People/Culture

ProcessTechnology

Knowledge Transfer for Performance Improvement – A Framework


Knowledge Management –How do we do it?

1. Create the infrastructure Access – Make it easy for people to find the knowledge they need Apply – Provide the context for making the knowledge relevant Accelerate – Inoculate the organization with successes

2. Build knowledge transfer into organizational goals Strategy – clearly articulate the expected outcomes Design – Understand the processes and supporting technology needed Operations – Integrate into existing staff roles and responsibilities

3. Measure the results Value – connect knowledge sharing to organizational impact Metrics – Collect satisfaction, process, and outcome measures Communicate – Share success stories, continually educate


Create the Infrastructure to Share Knowledge

Access: Simplify electronic access to critical knowledge and the people who created it and become more transparent in sharing hospital performance indicators

Web-based repositories Best practice libraries Experiential knowledge sharing Search and submit capabilities Data and benchmarks Guidelines Embedded clinical rules & alerts Community creation toolkits



Apply: Facilitate peer connections to:1. Share explicit (documents) and tacit (experience) knowledge

2. Apply general knowledge to specific issues

3. Talk about performance improvement

4. Build trust to support change

5. Innovate

Blended Learning: Email, telephone, face-to-face Codified community roles: Moderator, recorder,

coordinator Formalized ways to legitimize participation Communication tools Connect people with experience and need Success stories



Accelerate: Consider dedicated resources to accelerate adoption of new knowledge: Documents, educational forums, personalized support

Peer exchange “bank” Project management Consulting Train-the-trainer Pilots Packaged documentation Awards and incentives Ongoing community facilitation


Build knowledge acceleration into strategic goals – an example

Knowledge Management Definition:Knowledge Management is the ability to create and retain value from actionable information - information that isavailable when it is needed, and has meaning, context, and purpose so that it can be utilized to provide qualityservice to our patients and communities. Knowledge management applications are the key to helping bring theright information to the right people at the right time.

KM activities will support an environment in which knowledge sharing and learning lead to actions that supportCHI's goals. This will enable the rapid development, evaluation, and spread of effective programs andinnovations across CHI. In this environment, people are encouraged to share what they know, learn from eachother, and apply that learning in their daily work.

KM can ultimately enable CHI's ability to harness the intellectual capital across the organization and get themost from our investment in our workforce and information technology. By developing a culture that promotesknowledge sharing and individual learning, the long term benefits include attracting and retaining high-qualityemployees, a workforce that focuses on continuously improving its service, and an environment that candevelop and rapidly adopt innovation methods to meet the health care needs of the people we serve.

Vision:The Vision for the KM team at CHI is to improve knowledge transfer & use across CHI, so that every part ofCHI can leverage the strength and wisdom of the whole when we care for the patients and communities weserve.

Initial Strategic Focus (1-5 years):1) Connect people across CHI and enable teams and knowledge communities to virtually collaborate and shareknowledge.2) Capture the internal and external critical knowledge that CHI needs to improve our ability to provide qualityhealth care services3) Effectively manage and disseminate the knowledge that we capture.4) Foster the learning and application of this shared knowledge.

Core Functions1. Cultivating Knowledge CommunitiesDefine process and develop tools to support KnowledgeCommunity Coordinators in their formation, operation andevaluationProvide consultation, facilitation, and coaching for KCCoordinators through all phases of the cultivation processincluding strategy development, implementation andmeasurementSupport KC's in the selection, acquisition, implementation anduse of appropriate tools to support community activitiesDesign and support the maintenance of membership profileinformationCommunicate and market Knowledge Community activitiesand organizational impact

2. Implementing learning strategiesDevelop and manage a CHI integrated learning strategy thatprovides direction for the support and development of educationprograms.Provide support and governance for the learning managementprogram toolsFacilitate the “Learning Network” knowledge community fordeveloping and sharing knowledge related to education topics

o Develop policies and guidelines for instructionaldesign and other education topicso Share best practices and content to streamlineeducation activities and leverage universal material

Provide consultation for the development, implementation, andevaluation of national education projects

3. Content mgt & collaboration - Develop &support techniques and tools to effectivelyorganize and distribute information andenable virtual collaborationDevelopment of organization-wide content managementguidelinesSupport for content management tools and processesDevelopment and maintenance of content classificationsystemIdentify needs, advocate for acquisition and support theutilization of collaboration & communication tools (ex:distribution lists/list servs, Live Meeting, Portal)

4. Spread - Develop & support models fordeveloping and spreading effective, innovativeprograms across CHIDevelop tools and techniques for developing and validating CHIleading practicesDevelop a comprehensive methodology to spread provenpractices and innovations, including measurement andcommunication of success storiesProviding consulting for the application of spread models andleading practice models

K nowledge Management at CHICHI’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; 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.


Measure the results – examples

Global Professions and Service Lines KM Dashboard

Overall KM StrategyProgram

Mgmt

CHS Develop-

mentContent Mgmt

Global Refs.

SLIC Updated

News-letters / Communi-

cation

KLM/ Perform Content

Points of View

Alliance Partner KM

Strategy

Market & Comp.

Intelli-genceMeasure-ment Plan

Strategy & Transformation

AD&I

AM

BPM/IM

NISTechnology Consulting

CRM

Supply Chain

Support Services

EEA/ERP

SAP

Oracle Euro Transformation

JD Edwards

PeopleSoft

B2B

DareStep

RRed = Significant barriers or challenges exist which impede accomplishment of deliverable

Yellow = Barriers or challenges exist, but deliverable is likely to be accomplished

Green = Minimal barriers or challenges at the present time, Star = Deliverable is complete Blank Box = Deliverable not started

Y G

Y Y G G G YY YY Y Y

G G GY

G G Y Y YY G G R RY

Y Y Y Y Y Y G Y G

Y Y R G G Y G R Y YY

G Y Y YY G GY Y

Y YYYG R R R R R

Y Y Y YYY Y

G G G

G G G G G G GY Y Y YY R

Y Y Y Y Y Y Y Y Y

YY Y Y Y G Y R G G G Y

Y Y

Capability Rating Scale:

0=Nascent1=Developing2=Practicing3=Optimizing4=Leading

Current/Optimal Effectiveness Rating Scale:

0=Negative1=Null2=Neutral3=Material4=Strategic

Innovative Global Development Organization

0

1

2

3

4K-Capture and Retrieval

Learning

Branding

Collaboration

Providing KM Expertise

Expertise Location

Benchmarking

Internal CoPs

External CoPs

Cross-Team Innovation

Thought Leadership

Sensing & Operationalizing

Embedding

Company Culture

Supporting Technology

Metrics


Building Communities within/across Hospital Systems – Key Phases

1. Strategy – clarify objectives, envision the future2. Assessment – understand current state, identify

needed changes3. Design – delineate the components to be built,

create a working prototype, develop implementation plan, specifications document, and cost

4. Build – create knowledge creation & transfer processes, develop the tools and templates, integrate with IT strategy

5. Operationalize – support, customization, training, documentation, maintenance & updates


Phase 1 - Strategy

Clarify Objectives – WIIFM? For relevant participants (physicians, nurses, managers, patients) Increase customer satisfaction, improve service quality,

reduce response time Improve outcomes Reduce unnecessary variation Recruit and retain qualified staff Reduce costs, streamline operations, avoid duplication

Picture Future Success - Describe the future from all stakeholder perspectives

Identify Oversight team and key contact points to synchronize on KM aims


Phase 2 - Assessment

Current state – how well do current tools and processes work? What needs to be kept, eliminated, enhanced, created? How do people currently communicate/share with each other?

Culture – what barriers exist regarding sharing and reuse of knowledge? What are the most effective means of communication between individuals and teams?

Processes – how do we “bake it in” to create, capture, share, and reuse knowledge?

Vitality – what are key roles needed to keep the knowledge current, relevant, and critical?

IT Infrastructure – what currently exists and what are the gaps? How will the databases integrate? What are internal vs. external access points? Where do current IT plans fit in?


Phase 3 - Design

Feedback – identify pilots to model the new vision and try out the new approaches

Prototype – create a working example – for clinicians, managers, patients if appropriate - to generate detailed user feedback and develop roll-out plans

Context – create links to existing data sets, tools, and people; incorporate external resource links and resources

Learning – refine and create new knowledge creation & transfer processes

Assessment – determine how to measure and track the value Innovation and New Directions – incorporate planning for the

future, including new care delivery, staffing, and payment models


Phase 4 - Build

Create core processes Communities of practice – roles, rules, requirements Knowledge creation & transfer techniques Integrated clinical information systems Data Warehouse and Reporting Education and Development

Develop technology plan Develop collaborative spaces – internal and external Integrate the underlying database model into the overall IT

strategy Develop and conduct training programs Integrate user feedback tracking and value metrics reporting Modify processes, tools, and reporting based on how people

actually use them Develop operations plan

Knowledge community roles, rules, support Content management roles, rules, support Professional development program Knowledge cultivation program Customer relationship management programs Communications plan


Phase 5 - Operationalize

Identify & recruit key opinion leaders/magnets to participation and leadership

Ongoing coaching of knowledge community leaders, content librarians, and technology stewards

Ongoing execution of knowledge creation & transfer processes Ongoing training and adoption support Ongoing tool development, software maintenance, capability

upgrades Ongoing communication strategy support Ongoing integration with overall IT strategy


Catholic Health Initiatives (CHI)


Ascension Health


CHRISTUS


Bon Secours Health System


Knowledge Junction

Hierarchical Site Map

SCORM (Learning Objects)

Document Repository

Keywords,

Concepts & Phrases

People with Known

Expertise & Know-how

Learning Mgmt

System

Expertise

Locator

All Documents Related to the Node

(Explicit)

People with Experience & Know-how Concerning the

Node (Tacit)

Communities and Affinity Groups within the Node

(Tacit)

External Links related to the Node (Explicit)

Collaboration Concerning the Node’s Business (Tacit)

Education & Training Topics Relevant to the Node

(Explicit)

Collaboration Areas

Threaded discussions, email, etc.

Enterprise Taxonomy

Air Force Medical Service

Knowledge Junction TM Concept


Lessons Learned

People to People Connection is critical!

Executive Support is required to gain acceptance.

Link directly to the core strategies of the organization.

Tools & Templates simplify the process for participation.

Don’t over-engineer the process of sharing!

Maintain flexibility – stay focused on needs!


Lessons Learned

Prototyping – pilot new tools with small groups.

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

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

Success Stories – build momentum and recognize theheroes.

Partner with IT – technology can greatly enhance thecollaboration and sharing process.


Final Thoughts

Specific responsibility for “connecting the dots” increases the speed of connection – define who will be responsible for the knowledge sharing strategy.

Performance improvement can be multiplied by spreading ideas from one department or facility to others – integrate performance improvement resources into the design.

Recognition for sharing increases participation – both formal and informal communication is key.

A focus on connection increases the speed of adoption of proven practices – proactively manage the social networks.

accelerating clinical transformation using community collaboration tools

Documents

critical new knowledge

social system

medical care

support systems

perot systems

online communities

communities of practicewhy

hospital system clients