Meeting report: NHS Education for Scotland Conference

Delivering Knowledge for Health: Developing a Keystone Strategy
24^th October 2006
Dunblane Hydro

This conference was open to a range of health professionals working across NHS Scotland, Scottish Executive, academia, and private health organisations, as well as numerous library and information professionals from NHS Scotland and outside of the service.

The focus of the conference was on developing ‘keystones’ or areas of interdependence where knowledge can be managed to mutual benefit through all stages of the patient journey.  The conference aimed to:

• Facilitate the mainstreaming of knowledge services within healthcare delivery and development
• Engage key stakeholders in a fuller understanding of the strategic, practical, and economic benefits associated with knowledge services development
• Map out the future direction of travel for knowledge services strategy for NHS Scotland, identifying opportunities for engaging and involving the healthcare community in collaborative development.¹

Dr Ann Wales (Programme Director for Knowledge Management, NES) opened the proceedings with a welcome to the delegates, followed by an introduction by Prof. Jack Rae, Deputy Chair of NES, who outlined the reliance of education on knowledge, and how frequently knowledge is seen as power.  His key message was that for knowledge to be valuable it must be reliable, easily accessible, and from a robust source, with literacy skills and knowledge sharing also being vital in the quest for knowledge.

Managing knowledge for service modernisation

The first speaker to take the floor was Derek Feeley, Director of Healthcare Policy and Strategy for NHS Scotland.  His address focussed on the contribution knowledge support makes to the key actions outlined in Delivering for Health,² which include:

• Reducing the health inequalities gap
• Shifting the balance of care to prevention
• Separating planned from unscheduled care
• Involving patients as partners.

Mr Feeley outlined how knowledge management can help to achieve these goals by:

• Providing ‘hard’ evidence to facilitate service change, ensuring that what we are doing is the right thing - enabling rather than inhibiting
• Developing a capacity for sharing knowledge and learning to bind clinical teams together
• Changing the knowledge culture to inform and support self management
• Supporting quality, integration and value
• Embracing new challenges of complexity – less is more.

This final point was illustrated with the scenario of a GP requiring simple information in order to manage a patient, but instead being faced with searching various resources and reviewing lengthy documents in order to retrieve this knowledge.

Developing a keystone strategy for knowledge services

Dr Wales delivered a presentation on Developing a keystone strategy for knowledge services.  This built on the implementation plan outlined in From Knowing to Doing which includes: applying knowledge to patient care; health inequalities and patient/public involvement; sharing knowledge; and creating a knowledge-competent workforce.³  Detailed examples of developments within the NHS Scotland e-library illustrated how knowledge services link with Delivering for Health; for example, the specialist e-libraries and shared space encourage knowledge sharing throughout NHS Scotland and therefore deliver knowledge at the point of local need.

Workshop: Knowledge support for workforce modernisation

Following the coffee break, the first of two sets of workshops took place.  This workshop looked at ways of optimising efficiency and effectiveness of current knowledge services and their future direction in light of current service modernisation initiatives.  After a summary of resources and facilities offered by the e-library, small groups were given time to reflect on various knowledge dilemmas and asked how the resources could be exploited to address these dilemmas, how to engage staff, and what the keystones to enable use of the knowledge services might be.  Given the variety of occupational backgrounds included in the groups, the discussion was lively and offered opportunities for future development.

The resulting keystone themes were displayed in the exhibition area for delegates to review.  These included: KSF; access/connectivity; function and usability; promotion; training; alerting services; and desktop icons for easy access.

Ending the document game: seamless access to knowledge to support patient care

After lunch and an opportunity to explore the exhibitions (including NES e-library demonstrations; NSS – Information governance; Health Protection Scotland – Knowledge management and access), the second keynote address was delivered by Prof. Jeremy Wyatt, Director of Health Informatics Centre, University of Dundee.  Prof. Wyatt addressed the issue of seamless access to knowledge to support patient care.  He began with his definition of knowledge, the differences between explicit and tacit knowledge, and some of the potential problems associated with explicit knowledge, such as delays in dissemination and rate of growth.  Numerous studies were used to underpin the discussion on how knowledge can be used to support clinical questions, especially in relation to access via ‘The Medline Button.’⁴  The concluding points emphasised that providing access is difficult without human intermediaries in order to understand clinical questions fully, and that ‘info button’ technology is still used infrequently.  Furthermore, a variety of techniques should be employed to suit all users and types of question.

Workshop: Delivering knowledge for e-health: Developing the Scottish Health Information Environment

The groups in this workshop examined how knowledge support can be developed to underpin the e-health programme outlined in Delivering for Health and again defined keystones for knowledge services.  The workshop groups were asked to select one of the people, organisations, or other sectors (e.g. local authorities or voluntary organisations) represented in the patient journey and highlight the knowledge resources they may use.  For each of these resources the groups identified where else in the patient journey these resources may be used or created.  This demonstrated the vast quantity of health information available and the diverse audiences to whom some resources may be relevant.  The final part of the workshop allowed the groups to explore the challenges and keystones of various enablers, such as creating a knowledge sharing culture, or the use of a common language to describe knowledge consistently.

Delivering knowledge for Scotland’s health

The final plenary session was delivered by Prof. Phil Hanlon, Professor in Public Health, University of Glasgow.  Prof. Hanlon demonstrated the importance of delivering knowledge through a series of revealing slides illustrating the vast health inequalities apparent across Scotland, from the most deprived areas to the most affluent.

Summary

Dr Wales closed the event with an overview of the day and indicated that the findings of the day would feed into the keystone strategy that would be available in the early part of 2007.  In the meantime, supporting one of the key themes of the day (sharing knowledge), some of the presentations have been made available on the shared space accessible via the e-library.

The event reinforced the value of resources such as the e-library and the shared space to those of us already familiar with their functionality, as well as reminding us of the ever-increasing library of resources, tools, and research we can access.  To those less familiar, the event demonstrated the importance of embedding such knowledge services resources into the NHS culture, in line with the aims of Delivering for Health.

Suzanne Wilson

Assistant Information Scientist
NHS Quality Improvement Scotland
suzanne.wilson@nhshealthquality.org

References

1. NHS Education for Scotland.  2006.  Delivering knowledge for health: Developing a keystone  strategy. Conference proceedings.

2. Scottish Executive. 2005. Delivering for health.  Available at: http://www.scotland.gov.uk/Resource/Doc/76169/0018996.pdf Last accessed: 7/11/2006

3. NHS Education for Scotland. 2006. From knowing to doing: Transforming knowledge into practice in NHS Scotland.  Available at: http://www.nes.scot.nhs.uk/documents/publications/classa/NES_KnowingDoing.pdf Last accessed: 21/11/2006

4. Cimino JJ, Johnson SB, Aguirre A, Roderer N, Clayton PD. 1992.  The MEDLINE Button.  In: Frisse ME. (ed.) Proceedings of the Sixteenth Annual Symposium on Computer Applications in Medical Care. 81-5.