Knowledge Management at National Health Services - Essay Example

Case Study: A Matter of Life or Death Introduction Reddix Hospital is a trust hospital under national health services (NHS) in the United Kingdom. It is located between Leicester and Birmingham and has a population of over 900,000 patients. One fourth of these patients are senior citizens and about one tenth of them comprise the female population who are suffering or are thought to have some kind of cancer. Many of its senior citizens are suffering from illnesses that are common with their age profile for example arthritis and cardiovascular diseases and in particular, congestive heart failure. The hospital's busyness is due its annual admission of over 7000 patients. It also has 375 intensive care beds in total, and can accommodate a total of 2000 patients in the intensive care unit. The hospital aims to specialize in care giving for cancer and cardiovascular patients. it has employed around 200 doctors whose expertise includes breast cancer, cardiovascular diseases, musculoskeletal diseases and pediatrics. Reddix also employs nearly 400 nurses and other caregivers. The hospital has entirely integrated faculties for medical tests that are related to cancer and cardiovascular prognosis and diagnosis. Strategy for Successful Change Process One of the major problems that the hospital faces is the difficulty in the interoperability within the department systems. The hospital has different departments that cater to the different information needs. The hospital information system comprises the following six systems: 1. Radiology Information Systems (RIS) 2. Patient Administration System (PAS) 3. Laboratory Information Systems (LIS) 4. Clinical Patient Record (CPR) 5. Pharmacy Systems (PS) 6. Nursing Systems (NS) Considering the number of systems it has it is evident that the hospital could have interoperability issues. Interoperability refers to the capacity of different and diverse systems and or physical components of a single system to work together through the use of agreed standards and specifications (Cetis, 2008). It helps the organization to create synergy in the organization. The whole is greater than the sum of its parts, being inter-operable, the organization is able to work as a whole instead of working as separate entities. A recent report by the National Health Services criticized the Hospital Administration System of Reddix and said that it was extremely outdated and old and stated its concerns about the patient's files not being available to the concerned caregivers when it is direly required. This is because Reddix is unable to meet the IT needs that are needed so that the doctors, nurses and care givers can easily access all patients' files electronically whenever they need them. There are many strategies that the hospital can use in order to bring out a successful change process. In order to do that the Hospital needs to look at the problems individually and then come up with solutions. Specialists of management and healthcare were brought in to assess the current condition The major IT problem at Reddix is that they are using a centralized structured computing system to integrate all its IT applications and the software that is being used was developed nearly forty years ago using proprietary language which could only be used on limited software and did not have a very user friendly interface and there were problems relating to communication with other systems of Reddix such as clinical, diagnostic etc. It was also difficult to connect simple desktop applications such as word processing Reddix needs to develop a business plan that integrates a new IT system that will change its information processing in such a way that it benefits the organization as well as the people involved in it. As technology is progressing as we move into the next generation, there have been changes in the architecture of the information systems that are moving towards distributed computing systems. Distributed computing is a system of computer processing in which the system does not have a central server where all processes are taking place instead a program runs simultaneously on two or more computers that are communicating with each other through a network (Erlanger, 2002). A distributed computing architecture comprises extremely lightweight software agents installed on a couple of client servers, and one or more dedicated distributed computing management servers. It has come along with the introduction of client servers and object oriented technologies. Since most of the other national health services trusts have implemented this distributed system it would be wise for Reddix to follow their footsteps as it is currently ranked it way below other trusts in terms of its workings and productivity. Reddix should invest some of its time and money in a Knowledge Management (KM) system to decrease the occurrence of serious medical errors which has resulted in Reddix being ranked among the bottom ten in patient satisfaction. There is an ever increasing stress and emphasis on all health care organizations to ensure patient security, efficiency, and cost-effectiveness, balance the quality of care, and better health care that has driven them towards a more thorough and effective management of medical knowledge and information that has been derived from biomedical research. Knowledge management technology enlists productive options and tools in speeding up the spread of innovative medical procedures and ensuring that all medical procedures are conducted as they should be so that there are no life-threatening after effects and patients are satisfied with the treatment, as Reddix has an alarming rate of complaints from patients and 60% of them having life-threatening after-effects this is one way to reduce such risks. Opinions and reviews of the success of different methods of top practice distribution show that the greatest and most positive impact is achieved when such knowledge is made available to all health care organizations through the health information system at the instant it is required by care givers and specialists where they work. There is a requirement to take a more clinical viewpoint of health care of patients and to find the suitable organizational and information structures that aid the medical work. Knowledge management is defined as a diverse model, which uses technology to support the attainment, generation, codification and dissemination of knowledge in the background of precise healthcare processes. Explicit knowledge is objective generally is in the form of medical research or documents and is generally easily available to everyone while the tacit or the implicit knowledge is personal and cognitive and does require individual interpretation and analysis. Explicit knowledge is documented and written down and can be available in the form of manuals, reports, books or even in an electronic medium. It can be accessed by anyone and is generally available on the company's intranet. Another area that Reddix lacks that it does not possess a secure and safe information security system, which is extremely necessary to ensure that all the clinical data is encrypted and encoded so that it can be protected from misuse. Reddix needs to add security in its business strategy a sensible Healthcare Information Security system so that it enables it to keep logs and secure sensitive clinical information from the wrong hands and so that the data saved could be used in the long run. (Stefanelli, 2002) Another major area where Reddix needs to work is its employee morale. In today's ever changing environment, common courtesies and respect have been replaced by speed and technology. Higher management and seniors become too busy and too distant from their employees to realize when they do good work and forget to appreciate them for it. They need to motivate employees and give them both, team based appraisal as well as individual appreciation for performance. This means empowering the middle management and staff and training them with the changes in the IT system also giving them training on knowledge management. Their morale will boost up once a more distributed system and by the implementation of knowledge management will help them get their work done on time. Since now it is impossible for any care giver or specialist to have all the clinical knowledge at hand or to remember all the findings and medications, this will help boost their motivation towards their work and the care givers will be aware of the best practices available. (Nelson, 2002) The new system should integrate patients' right from their entry into the hospital and would follow it all the way through their time there. The new KM system would also integrate the patient electronic patient records (EPR) that are with NHS with the process of physicians and general physicians ordering medical tests or medications. In the proposed system, when the physicians and GPs would order a test or medication, the system would use an Artificial Neural Network which is a form of an artificial intelligence that uses prior experience and judges the patients condition accordingly. it uses a series of rules and checks to analyze the patients condition. Although technology is not going to solve the problem in its entirety, it will however reduce the problems such as high absenteeism due to stress at work, high turnover rate of employees, which is twice the rate at Reddix than the NHS average and help increase employee motivation. (Russell, 2008) Creating, Developing and Reinforcing a Pervasive Knowledge Culture In order to appreciate and build up the organization's vision and mission for knowledge culture, it is necessary to find out and research on how the organization currently deals with information and knowledge management, this also includes how it is in comparison other practices in the industry (Reuters, 2008). In order to actually turn the current environment which is mostly based on a centralized system with no sharing of data and not much of team work the senior management will have to help the employees realize the value and importance of a knowledge culture. That is only possible when an effective knowledge management system is implemented within the system that helps that sharing of both explicit data and implicit or tacit expertise. All the problems that Reddix has been facing are due to the very little knowledge and information sharing that takes place. The senior management has to emphasize and stress on is to motivate employee into turning their knowledge and expertise into something explicit and objective so that the rest of the employees and care givers can share the knowledge and be able to benefit from it. Because knowledge management is becoming an increasingly vital part of innovation and value creation, the senior management has to focus on two major aspects of developing a knowledge based environment those are the output generation, in terms of healthcare organizations it would be the amount of cases they are able to successfully treat and fulfillment, that would how successfully they were able to treat these patients as the learning basis. if these two aspects are considered, the employees will learn the importance of having a knowledge base and how important Knowledge management is towards the organization success. (Krogh, 1998) When such knowledge sharing will exist, it will then be available of several communities of practice which should be created by senior management if there aren't any. Communities of practice are groups formed by people who get involved in the process of group learning in a mutual sphere of human effort, in terms of the medical field, it could be a group of surgeons exploring new techniques or researching new practices, so briefly it is: "groups of people who share a belief or a commitment for something they are involved with and learn how to do it better as they communicate with each other regularly". Structures like communities of practice would assist in creating discussions and interactions that in turn would serve as a means of transferring knowledge. (Wenger, 2004) Another way the Senior Management could help in making the organization a learning culture could be by the use of Knowledge maps. Knowledge mapping are basically any sort of visualization of knowledge apart from text for the purpose of sharing, codifying, mapping, protecting, using and increasing knowledge. It is like a geographical map that helps people identify and search where particular data is saved, so for instance if someone needs specific information on a particular case, they can easily find where the data is, hence improving knowledge sharing. (Smelcer & Carmel, 1997) Another thing that the management could do is to develop, within its new distributed computing system, an intranet that has search engines and other facilities through which employees can easily access all data that they require. Intranets are also a good way for employees to share information in real time. Using groupware software and creating a small network within the hospital will ensure accurate and timely information dissemination. WORKS CITED 1. CETIS: Interoperability Standards and Assessment. http://assessment.cetis.ac.uk/FAQs/FAQs/Basics/What%20is%20interoperability 2. Leon Erlanger (2002). Distributed Computing: An Introduction http://www.extremetech.com/article2/0,1697,11769,00.asp 3. Stefanelli M. (2002) Knowledge management to support performance-based medicine. http://www.ncbi.nlm.nih.gov/pubmed/11933761dopt=Abstract 4. Leon Erlanger (2002). Distributed Computing: An Introduction. Types of Distributed Computing Applications. http://www.extremetech.com/article2/0,1697,1154107,00.asp 5. Ingrid F. Russell. Neural Networks. http://uhaweb.hartford.edu/compsci/neural-networks-tutorial.html 6. Susanne Hauschild, Thomas Licht, and Wolfram Stein. Creating a knowledge culture. http://www.civ.utoronto.ca/sect/coneng/tamer/Courses/1299/Ref/knowledge%20culture.pdf 7. Thomson Reuters. Knowledge Culture Vision. http://scientific.thomson.com/quantum2/framework/knowledge_culture/ 8. Etienne Wenger. Communities of practice a brief introduction http://www.ewenger.com/theory/ 9. Xenia Stanford (2001). Map Your Knowledge Strategy. Information Outlook, Vol. 5, No. 6, June 2001. http://www.sla.org/content/Shop/Information/infoonline/2001/jun01/stanford.cfm 10. Knowledge Maps: ICTs in Education. http://www.infodev.org/en/Publication.8.html Read More