Knowledge shared is knowledge doubled

Improving eHealth knowledge can release precious clinician time, ultimately improving patient care. NHS Education for Scotland is therefore setting up an eHealth knowledge sharing tool for NMAHPs in the form of an e-Library. Kathy Dallest and Ann Wales from NHS Education of Scotland explain.

The sharing of information surrounding the actual benefits of eHealth is patchy and rarely managed by nurses, midwives and allied health professions (NMAHP). This often leads to inadequately defined requirements for eHealth systems and the consequent lack of uptake by NMAHPs.

Yet real and tangible involvement of informed frontline healthcare practitioners in the specification, design and implementation of health ICT systems has been called for in the recent Audit Scotland report 'Informed to Care' and various UK and international reports. 

To address the critical gap in awareness and information sharing, the Knowledge Services Group within NHS Education for Scotland has been commissioned by the Scottish Executive Health Department to deliver solutions to facilitate development of an NMAHP eHealth Managed Knowledge Network (MKN).

A dedicated special e-Library (or portal) will be created within the NHS Scotland e-Library, incorporating communication, information resource management and retrieval functionality. eHealth is defined, for the scope of this project, as '…the application of information and communication technologies (ICT) to support healthcare provision'.

This project builds upon the existing NMAHP eHealth 'Shared Space', a collaborative workspace employing electronic communication and information resource management tools. Building upon previous lessons learned, this project is an extension of eHealth knowledge management (KM) across all NMAHP disciplines, and is designed to facilitate engagement and leadership development.

Blended methodologies from the clinical, education, business, health informatics and KM domains are being employed. Improving knowledge and understanding and focusing on the benefits of eHealth can release precious clinician time to deliver positive outcomes for practitioners.

Ultimately this improves the patient experience, quality of care and increase patient safety. This project offers substantial benefits through sustainability, and methodology will be transferable to other settings and professional groups. It is an important step towards supporting all clinicians involved in eHealth.

Purpose

Essentially this is a change management project which aims to create an environment where knowledge, experience and information can be shared, created and accessed in order to support NMAHPs at various levels of interaction within the eHealth domain.

The goal of the project is to embed these aspects of quality information management and informatics practice into NMAHP clinical and professional practice.

Objectives

  1. To support clinical engagement necessary to realise the benefits offered by the eHealth strategy and its programmes.
  2. To actively facilitate learning, development and sharing of information and best practice, including use of communication functionality on the e-Library.
  3. To manage the information resources used by the communities of practice.
  4. To identify and provide access to the existing knowledge base on NMAHP eHealth.
  5. To develop and create new information resources.

The Network and Communication

Some of the early network members are clinical leaders. They are influential in the national and local strategic business and development plans. Some have a specific eHealth job within information or IM&T departments and directly support system implementation.

Others are clinical practitioners who regularly use technology in the clinical setting. The network also has a mentoring and facilitative function which supports practitioners new to eHealth/informatics. The 105 member network collectively manages its information resources, communicating through the Shared Space (below).

Figure 1: NMAHP eHealth Shared Space home page

HIF Knowledge screen grab 

NMAHP eHealth is home to six discrete communities of practice and project groups. One such community is the NMAHP eHealth Leads. Each nurse and AHP director from every NHS board in Scotland (14 of them) has sponsored a lead for eHealth in each of acute nursing, midwifery, the allied health professions and primary and community care and mental health areas.

These people support Heather Strachan, the eHealth Lead for NMAHPs within SEHD, to deliver a portfolio of projects aimed at maximising benefits offered by the National eHealth Programme. Communication within this community is multidirectional and this group transcends organisational and role boundaries to share knowledge, experience and information.

Special e-Library

The NMAHP eHealth Special e-Library, which incorporates and builds on the existing Shared Space, will be a dedicated portal that provides focused and targeted information resources specific to the needs of the MKN. It will provide access to all the e-Library services such as NHS Scotland fulltext online journals (over 5,000), bibliographic databases and other information resources.

Additionally, information relevant to this domain will be filtered and organised in ways that help NMAHPs find what they are looking for. Appropriate subject headings will be identified and/or developed. Federated search technology will be used to retrieve information into the portal dynamically from remote sources. Further functionality that supports the communication processes of the MKN will be developed.

Methodology

The project team is currently undertaking an information and knowledge audit with key stakeholders, analysing information flows, sources, needs, user characteristics and gaps. The audit also includes a KM competency training needs analysis. This will inform the technical specification and information content for the Special e-Library and future plans.

Given the short timeframe for the project, and the many competing demands upon precious clinical resource, a novel approach to requirements gathering for the portal construction has been taken. The project team is delivering a KM CPD package that maps to the Knowledge and Skills Framework (KSF) Information and Knowledge Dimensions 1 and 3 at Level 4.

The data and information outputs of the various learning exercises within the package are being analysed to inform the specification for the portal, and development of a knowledge management strategy and outcome focused implementation plan for the MKN. Evaluations of the approach so far have been positive.

Additionally an online questionnaire survey gathers information on relevant content such as journals and other published sources as well as information seeking behaviours. Another will gather self assessment data about KM competencies. This will be fed back to the participants and also informs the MKN's future plans.

A robust communication plan ensures relevant targeted communications reach the community the project needs to engage. A leaflet gives basic information about the project and how to get involved. Key messages are reinforced throughout all CPD activities at key events.

A conference poster has been accepted for the NHS Scotland event in June, a bi-monthly electronic newsletter is produced and a communications pack for the MKN launch in November is being prepared.

Benefits

Since introduction of the Shared Space to the NMAHP eHealth community in October 2006 the Shared Space membership has increased to 105. Steadily increasing activity has been monitored through the e-Library web log statistical package, with the number of visitors increasing month on month to 185 in March.

Activity has increased to 4365 hits in March, with more areas of the site visited. Resources are now being added by the membership and knowledge exchange through discussion is increasing.

The way forward

The Shared Space is growing organically with members contributing to the knowledge base. The facilitator adds relevant news, resources and discussion topics to keep the site current.

With the development of the Special e-Library with content and functionality that meets the needs of NMAHPs there is realistic optimism that this will be a collaborative and knowledge sharing tool that can really help prevent duplication and reinventing of the wheel.

The MKN will launch its Special e-Library on 6 November at the Scottish Clinical Information Management in Practice (SCIMP) conference.

Kathy Dallest is a nurse informatician and presently MKN facilitator, knowledge Services Group, NHS Education for Scotland. Ann Wales is programme director for knowledge management, NHS Scotland. Contact: Kathy.Dallest@nes.scot.nhs.uk

References

1. Informed to Care: Managing IT to Deliver information in the NHS in Scotland Audit Scotland December 2006, 15 Jan 2007

2. Delivering successful IT enabled business change National Audit Office November 2006, http://www.nao.org.uk/publications/nao_reports/
06-07/060733-i.pdf
, 12 December 2006

3. Digital Healthcare, the impact of information and communication technologies on health and healthcare, The Royal Society December 2006

4. Informed to Care: Managing IT to Deliver information in the NHS in Scotland Audit Scotland December 2006