Know-How?

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Know-How?

• Exploring the knowledge dimension of Primary Care

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First things first!

• Context Vale of Aylesbury PCT
• Knowledge management
• Knowledge Policy
• Knowledge dimensions of Primary Care

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First questions. for library and information
services

• How much do you understand about the knowledge
  dimensions of the work in Primary Care?
• How far do you want to engage with this broader
  agenda?
• How you can support what needs to be done within
  each organization?
• Where best to site initiatives to meet the needs?

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Vale of Aylesbury PCT
193,500 people 81,000 households
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Vale of Aylesbury PCT sites

• 1,237staff. 15 mile radius of Aylesbury
• 26 practices (inc 2 MOD) on c35 sites
• 2 community hospitals
• Specialist clinics and centres
• Manor House Hospital site
• PCT offices

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Vale of Aylesbury PCT staff
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Information hungry

• Primary Care Groups will be extremely
  information-hungry organizations
•  
• Bruce Donn
• Chapter 6. Information requirements.
• Tom Wilson (ed) The PCG Development Guide

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Vale of Aylesbury PCT

• Young organization
• Mergers
• Business Plan
• Understaffed
• In debt
• New responsibilities
• Moving premises

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Knowledge Managerfrom Primary Healthcare
Information Officer Practice Librarian

• A specialist travelling librarian has been
  employed to spread evidence of effectiveness and
  encourage use of on-line databases p10
• The PCGs and Trust currently provide
  multi-professional workshops, a knowledge
  manager, and computer skills training p15
  
• Creation of a PCT, Public consultation document.
  July 2000

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Do we know how?

• Capacity for action?

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Knowledge Management

• Mobilising
• the knowledge base of healthcare
• in a form that health professionals
• can use and apply

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Knowledge

• Body of knowledge
• Articulated in books, articles, manuals, clinical
  protocols
• Know about
• Acquainted with, or aware of, facts, methods,
  principles, techniques etc
• Know-how
• The capacity for action an understanding,
  sufficient to apply facts, methods, principles,
  techniques etc

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Aim

• Enable staff to access, understand and use
  knowledge derived from research as well as from
  the body of experience of best practice

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Core elements of KM

• Recognize the knowledge component of healthcare
  as an explicit concern
• in policy and practice
• Apply technology and resources
• to give better access to information
• Support a learning organization
• sharing best practice, implementing e-b change

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Knowledge PolicyGuiding principles

• Commitment
• Culture
• Content
• Skills
• IT

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Knowledge Policy Key Objectives

• Commitment Policy
• Culture Supporting a learning culture
• Communities of common interest,
• Sharing experience, Promoting good practice
• Content Facilitating access to the
  knowledge base
• Access to OVID databases (March 2001 -)
• Net navigation (April 2000-), Promoting NeLH
  (March 2002-)
• SLA comprehensive library services (by
  September 2002)
• Skills Training
• Peripatetic knowledge support in the workplace
  (April 2000-)
• ECDL, Critical appraisal, Journal clubs
• IT Intranet (July 2002)
• Public website (Summer 2002)

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The knowledge dimensions of primary care

• Knowledge Needs
• What patients want to know
• What staff need to know
• To inform health care policy
• Keep up to date
• An organizational memory
• Embed evidence into practice
• Make implicit knowledge explicit

• Key activities
• Public involvement.
• Services, Skills, Resources
• Dissemination, Best practice
• Updating services
• Directories,Databases etc
• Research utilisation
• Initiatives to share knowledge

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Collaborative working within the Trust

• Clinical Governance
• Education, Training and Development
• Research Development
• Informatics team
• Primary Care Development team
• Co-operation across the health economy

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What patients want to know?

• Public website
• Local coordination!
• PALS
• Staff awareness

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What staff need to know

• Previous research
• Information needs information seeking behaviour
  of GPs, 1999
• External eg. Information Needs Assessment,
  Community-based Practitioners. Newcastle North
  Tyneside.1998
• Intranet survey of staff preferences
• Vale of Aylesbury PCT, Dec. 2001
• County-wide Knowledge Audit
• due to report May 2002

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Peripatetic knowledge support

• Search skills
• Awareness of info. sources
• Enquiries
• Dissemination of information
• Practice Libraries
• Journal clubs
•  
• Patients libraries

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Library Information services

• 1. Equitable access for ALL staff groups
• 2. Basically librarians need the same skills as
  GPs unless you can consult as a librarian then
  it aint much use, so it doesnt matter how much
  you know about your field, your information
  sources. If youre not a consulter, not good in
  face-to-face consultations with your users, I
  dont imagine youre a busting lot of use and
  so its time that librarians had sort of videoed
  consultations

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Using knowledge to inform practice Pathway for
NICE Guidance
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Keeping up to date

• I hadnt known about it which is always the
  old mans fear that you wont be keeping
  up-to-date enough
• The difficulty with the paperwork is trying to
  be efficient and relevant, and prioritising,
  because it is so overwhelming in terms of the
  amount that comes through
• How can we help?
• Information services Alerts, Current
  Contents
• ..has revolutionized my reading in the fact that
  now I do some, and I am not swamped because ..
  its taught me how to pick out what I want to
  read

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An organizational memory a PCT-wide Intranet

• key communications mechanism
• disseminate information and evidence
• match information to the needs of different
  groups
• share knowledge and best practice
• portal to authoritative sites
• in the local health economy
• And Beyond OVID, NeLH etc

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Intranet Staff priorities
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Embed best evidence into practice

• Research utilisation
• Effectiveness of pathway for NICE guidance
• Impact of in-house research
• Commissioning research

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Making implicit knowledge explicit

• Foster communities of interest
• Person to person
• E-communication
• Expertise database

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Collaborative working across the health economy

• In the Workplace
• Within the PCO
• Within the Health Economy
• Confederation Strategic HA level
• Nationally