Managing Knowledge to Improve Healthcare Quality in Banner Health

In 2001 Banner Health launched Care Management and Organizational Performance as a system-wide, collaborative and team-based effort to improve the performance consistency of the organization’s core product: patient care. Functional Teams are composed of recognized knowledgeable clinical leaders who were viewed by peers as being experts with profound knowledge. Functional Teams have created more than 36 Work Groups that cut across organizational boundaries.

Aligning Multiple Knowledge Perspectives in a Health Services System

This chapter reports the results of a feasibility study into electronic collection of service data at “point of delivery” for disability programs. The investigation revealed that while the proposed system would have produced more fine-grained data, it would not have improved any actor’s knowledge of service delivery. The study illustrated the importance of context in the transition from data to knowledge; the diffused and fragmented organisational structure of social service administration was shown to be a major barrier to effective building and sharing of knowledge. There was some value in the collection of detailed service data but this would have damaged the web of relationships which underpinned the system of service delivery and on which the smooth functioning of that system depended. The study recommended an approach to managing the informal and tacit knowledge distributed among many stakeholders, which was not especially technologically advanced but which supported, in a highly situated manner, the various stakeholders in this multi-organisational context.

Moving to an Online Framework for Knowledge-Driven Healthcare

The acquisition of knowledge in healthcare is mostly piecemeal and irregular. Consequently, we believe that the integration of science and patient care into a seamless framework is the key to establishing widespread knowledge-based healthcare organizations. Over the last five years, we have developed a dynamic methodology that completes the full information cycle using a generic online framework that merges science with clinical practice over the continuum of care. Called Protocol Hypothesis Testing (PHT), the framework is an extremely flexible web-enabled system that provides authors (expert groups) with the ability to instantly modify the structure of the system to meet the changing needs of clinical practice and incremental knowledge generation. The fully relational, centralised approach caters to the diversity of local needs whilst providing a global focus. The PHT System: • helps drive collaboration between clinicians, researchers, patients, and healthcare organizations to continually improve and use the latest and best evidence; • interfaces between clinical practice and bio-technology research;conducts randomised clinical trial research; centrally runs local clinical investigations and health service research;provides clinicians and patients with user-generated, decision-support algorithms and evidence-based summaries that are applicable to specific patients and their treatment choices; manages individual patient’s information, automatically distributing information to where it is needed, and providing patients with probable paths their treatment may follow; and provides a process to explore improvements in cost-effectiveness.In sum, the PHT system creates a centralised, seamless framework between research and clinical practice that is responsive to instant change based on hypothesis testing (science), data mining (exploration & thresholds) and expert opinion (authors) — all in the context of the needs of different diseases, clinical specialties and healthcare organisations.

Knowledge Management in Hospitals

The medical field in recent years has been facing increasing pressures for lower cost and increased quality of healthcare. These two pressures are forcing dramatic changes throughout the industry. Managing knowledge in healthcare enterprises is hence crucial for optimal achievement of lowered cost of services with higher quality. The following chapter focuses on developing and fostering a knowledge management process model. We then look at key barriers for healthcare organizations to cross in order to fully manage knowledge.

Knowledge Strategic Management in the Hospital Industry

This work examines the role of knowledge in the strategic process in the hospital industry. The research method consists of multiple case studies with eight hospitals located in Brazil. We analyzed the relationship among information, knowledge and capability creation. The cases shown that knowledge dissemination is a current management practice. Nevertheless, just one case presented a clear idea of the strategic role of knowledge management. Based on this evidence, we propose a three-step theoretical model related to the strategic management of knowledge. Most of the cases analyzed are in the first stage of the proposed model. On the other hand, the hospital in the third stage presented the following characteristics: a clear strategic focus related to knowledge access, dissemination and application, a mix of formal and informal practices related to knowledge creation, and a propitious internal environment in order to develop its capabilities.

Managing Healthcare Organizations through the Knowledge Productivity Measurement

Understanding the contribution of knowledge to business performance is important for efficient resource allocations. It is very true for healthcare organizations. For the best utilization of scare medical expertise in the successful medical service delivery process, knowledge management will play a more important role in the future. In this paper, a performance-oriented knowledge management methodology or KP3 methodology was applied to the medical domain. Through actual data from the six OB/GYN specialty hospitals in Korea, the contribution of knowledge to performance was assessed. Specifically, the productivities of knowledge entities were calculated using DEA (Data Envelopment Analysis) approach to give some important managerial insights for knowledge management activities.

Knowledge Management in Indian Companies

In this chapter we look at knowledge management in India with particular regard to the pharmaceutical industry. In India, changes in government policy linked to global factors are bringing about increased pressures to strategically manage knowledge effectively. At the same time, significant knowledge management initiatives are already underway in other industry sectors. We outline some of the changes affecting the pharmaceutical industry globally, and consider India on some relevant activities. The development of IT solutions is seen as enabling effective knowledge management. We look at a range of knowledge management technologies and their existing or planned use in industry. The IT however merely underpins the knowledge management philosophy, which must be incorporated into processes, strategies and organisational culture for successful adoption. India and its indigenous organisations may be characterised by some specific cultural factors. Effective implementation of KM will depend on a conducive cultural climate, both organisationally and nationally. We also therefore examine the extent of the perceived benefits, that shape the cultural shift from understanding knowledge management as simply an IT problem to recognition of knowledge management as a strategic process as seen by CEOs and top managers in indigenous Indian Fortune 100 companies. We look at how the pharmaceutical industry compares to other organizations of significant size in India across a range of factors concerned with knowledge management activity, using survey and interview techniques. We conclude that while only a few significant sectoral differences are evident, there is generally a heavy orientation towards IT-based conceptions of KM, which may be incompatible with the requirements for future success in the pharmaceutical industry globally.

Tele-Medicine

This chapter reviews the strategic planning of health information systems in New Zealand. This step is deemed necessary to identify the main accelerators and/or impediments that influence technology adoption and diffusion in health organisations in New Zealand. This research introduces the tele-medicine technology as one possible solution to provide continuous, quality, and immediate medical care to rural patients and to encourage networking among the different hospitals in New Zealand. This research suggests that in order to realise tele-medicine benefits in health care delivery in New Zealand, certain issues need to be addressed such as implementing comprehensive cost-benefit analysis and identifying the benefits sought from adopting the tele-medicine technology. The New Zealand context is unique and this perspective with respect to tele-medicine adoption and success is addressed in this research.

Using the Malcolm Baldrige National Quality Award Criteria to Enable KM and Create a Systemic Organizational Perspective

Health care leaders face an intensifying array of changes and challenges that heighten the need for systematic approaches to knowledge management at the organizational level. Healthcare costs are rising, biomedical science and technological advances are burgeoning, and recent reports indicate that medical errors are widespread. In its report on strategies for achieving improvement in the quality of healthcare delivered to Americans, the Institute of Medicine recommends building organizational supports for change such as the redesign of care based on best practices, use of information technologies to capture and use clinical information, and incorporation of performance and outcome measurements for improvement and accountability (Institute of Medicine, 2001). The Baldrige National Quality Program and its Healthcare Criteria for Performance Excellence (Baldrige National Quality Program, 2003) offer both the framework and the tools to guide organizations in building these critical supports. This chapter describes the Malcolm Baldrige National Quality Award and its framework, criteria, and scoring system. It provides insight into the pitfalls that stand between an organization and successful KM, as well as examples of ways in which healthcare groups and institutions are becoming learning organizations — successfully employing cycles of learning and effective knowledge management systems in order to enhance performance and better meet the needs of their patients and other customers. The Baldrige Healthcare Criteria for Performance Excellence offer a useful framework for developing a knowledge management system at the organizational level in an increasingly complex environment. Use of the Baldrige Criteria will enhance the knowledge assets of your organization and enable your organization to deliver more value to patients and other customers. These criteria will also improve organizational efficiency and effectiveness through the management of individual, team, and organizational knowledge.

e-Health with Knowledge Management

The main purpose of this chapter is to bring out and discuss the central facts pertaining to the importance of incorporating knowledge management in the area of e-health. This is accomplished by focusing on the application of knowledge management in e-health and its effects.