Towards Capturing Implicit Knowledge:

A Practical Application of Intranet Development.

Dr C J Mimnagh

Clinical Knowledge Manager

St Helens & Knowsley Health Informatics Service

St Helens

Setting the Scene

Introduction Organisational background The developmental approach The product development The products themselves The commercial comparisons The implementation to date Strengths and weaknesses The lessons learned

Introduction

Intranets basic tools in the commercial world 1 Within NHS in its infancy, potential for misuse under scrutiny 2

Commercial experience suggests intranets are sine qua non for the capture of implicit knowledge 3

Culture,not technical infrastructure influences the dissemination of knowledge,4

Implicit knowledge capture built on the existing culture not an imposed organisational directive

Intranets are often designed with explicit knowledge in mind, NELHs section on knowledge management, is titled “managing

explicit knowledge” 5

Our Aim

Our focus -on implicit knowledge management

The aim-to build on existing cultural structures to capture organisational implicit knowledge

Existing NHS wide KM -to be integrated rather than reinvented

The Organisational Background

St Helens & Knowsley health community 320,000 Patients/ Citizens Two primary care trusts (PCTs) One acute trust

The Health Informatics service February 2001 Merging staff from

Primary care Community trust Secondary care

The Intranet Development

Clinical Knowledge Manger Part Time Post “to bring about the learning organisation”

Webheads 5 Person Team.

The intranet is a community wide initiative, Evolved from the trust network

Developmental Approach

Scenario mapping, Considering the communication flows Multiple system levels Primary care was considered at

The practice level, The primary care group/trust (PCG/T) level Functionally adjacent structures, e.g. Other PCGs

Developmental Approach

Secondary care was considered at the level of: Ward Department Directorate Functionally adjacent organisations, e.g. Other hospitals

Results and Development

The output form this phase of the development was a categorisation of the knowledge artefacts/sources

The means by which knowledge is gained by one component of the health community from another

Three kinds of artefacts/sources; “Person” sources

Individuals whose experience could be accessed directly to gain information

Results and Development

Departmental sources Documents which were circulated within the unit

containing explicit knowledge Communal sources

Which occurred in intra-departmental meetings, disease specific groups, or process specific meetings

Product Development

These artefacts consistent with the principles of knowledge management outlined by Davenport and Prusak

They suggest three essential components in any attempt at managing implicit knowledge;

Directory services Communities of practice Lessons learned

The Challenge:

Create a health community wide intranet That builds on existing activity Synergistic effect of a KM focus

New Home

Directory Services

A directory service is not a phone book knowledge /skills /learning repository Minimum data set of demographic details Includes soft issues

Current projects Clinical and non clinical skills Hobbies and interests

The user controls the content, through a secure password Provides a single log on for all the intranet functions

newslog

Return

people2

Lessons Learned Database a.k.a. PADI

Collates documents and forms No web publishing needed Rating by users Searching free text (for now)

Accessible from all parts of the community, Context

individual submissions departmental submissions

Submissions are linked to directory services Enables “grounding” within the submitters’ experience

Padi

Web Communities

Communities of practice / Communities of Interest cover a range of topics from managerial to disease

specific

The framework enables those groups to Share their work, Engage members and non members in discussion Contribute to the organisational knowledge base Provides approval process for documents

Implementation to Date

The current version of the intranet was launched in February 02 The roll out has been on a departmental basis, Currently 10% of the health community with access to the intranet has

registered in the directory service Across all community, not just hospital or primary care.

Over 800 Documents have been uploaded Over 1000 Websites Submitted 40 Web communities created Bedstate on Line Library development ongoing CHI impressed with ease of use

Future Implementation

Peoplepages V2 Integration with HR record Induction process online “So long and thanks for all the fish” Whistleblowing

E-Round enters second phase Monitoring usage live webcast?

Knowledge Map function Mobile Intranet/Extranet

PDA Remote access

Future Implementation 2

Internet facility Patient stories Expert Patient Input non NHS access

Lessons Learned and Conclusion

Departments that are geographically dispersed have showed the greatest interest in the web communities,

Access to the network is still a problem Elbowing Ward Clerks

Other interested parties include groups that do not represent a distinct organisational entity

To date the nature of the artefacts submitted tends not to be personal work, but departmental or organisational in nature

This possibly suggests that the confidence to share our “own work” will take time to be established

It could be argued that explicit knowledge management must be in place for implicit KM to work, and that personal knowledge will be the hardest commodity to share

References

1. Davenport TP, l. Working knowledge. June 2000 ed: Harvard business school press, 2000

2. Neame R, Kluge E-H. Computerisation and health care: some worries behind the promises. Bmj 1999;319(7220):1295-

3. Senge P. The fifth discipline- art & practice of a learning organisation. 1999 ed: random house, 1990

4. O‘Dell RMAC. Overcoming cultural barriers to sharing knowledge. Journal of knowledge management 2001;volume 5(number 1):76-85

5. NELH knowledge management 2002 http://www.Nelh.Nhs.Uk/knowledge_management.Asp nelh 22.02.02 2002