Tag Archives: chris collison

“Bringing the brain of the company to the field”: behind the scenes look at the production of our book

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If ever there is a great justification for starting a Knowledge Management (KM) programme then the title quote from an interview with John McQuary encapsulates it. KM works when client proposals or solutions draw on the collective wisdom of an organisation.

It’s one of many superb quotes and stories, from the series of research interviews conducted with global practitioners: from Colombia to Australia by way of USA, Canada, UK, France, Belgium, Malaysia and Singapore, for the forthcoming book Patricia Eng and I are co-authoring. In all 18 interviews and more than 40 hours of audio material on KM in Energy, Shipping, Nuclear, Financial Services, Military, Engineering Services, Aviation, Health, Consulting, Manufacturing, Education, Food and Regulatory.

Patricia, who was previously Head of Knowledge Management at US Nuclear Regulatory Commission, and my task is now to turn the material collected into, in her words:

” The book I wish I’d had when I started”

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Which is why she and I spent time in Henley-on-Thames last week analysing what we’d heard in the interviews.

Let me take a step back.

It all began when:

I met Patricia in 2014 while I was chairing KMUK and she was a guest speaker describing the KM programme she’d set up and run for the organisation that oversees the US Nuclear industry.  Learning from near misses and from good practices while improving the way ‘newbies’ are inducted into the business had saved her organisation an estimated US$37 million while she was at the helm of the programme.

About the same time I was running Masterclasses on Effective Knowledge Capture and Retention and seeing real interest from organisations who’d recognised the potential risk of knowledge loss from merging, downsizing and retirements or as a result of having specialist skills resident in a small number of individuals only.

After exchanging ideas post conference we felt we had sufficient synergy to begin collaborating on a book focused on “Proven Knowledge Capture & Retention: Between Theory & Practice.”

Though our combined experience is approaching 80 years of business with a significant slug in KM and related activities we wanted to draw on the experiences of great practitioners.

Establishing criteria / identifying interviewees:

We agreed it was important to approach people who’d actually done it and got their hands dirty: who experienced highs and lows and maybe also seen their programmes wither on the vine after they or their sponsor left.

We knew many global practitioners, from chairing and speaking at/ attending KM related events but we wanted to spread the net wider than our own sphere of influence so in effect conducted a virtual “Peer Assist’ with senior global KM’ers and these are the criteria we set for selecting interviewees:

  •  A KM professional that actually built a KM program for an organization they worked in, as opposed to a consultant who was brought in to work on a KM program and then left.
  •  Have spent at least 2 years on the programme.
  •  Primary person responsible for the KM programme – interfaces with executives
  •  Can point to a clear ROI, e.g., productivity or monetary
  •  A KM professional who can speak to what constituted the ROI:

Our thanks go to Patrick Lambe, David Gurteen, David Williams, Karuna Ramanathan, Shawn Callahan and Chris Collison for their recommendations.

Setting up the interviews, thinking about the questions:

In my Masterclasses I always stress how important the interview set up is.  Apart from thinking about the where its always vital to give the prospective interviewee time to think about the answers and to tell them what the process is. Here’s the questions we asked:

  • Tell me about the circumstances and the drivers behind the original knowledge retention programme and who was involved?
  • How did you go about determining what knowledge to try and capture/retain?
  • Give me a brief snapshot of how you went about capturing it.
  • What was the biggest challenge you had to overcome?
  • How did you convince your management to go for it? ‘Business Case?’
  • What difference do you think it made to your organisation?  What was the actual return on investment?
  • Is there a particular highlight you remember?
  • Having done this if you had to do this over again what would you do differently?
  • And finally what would you tell someone about to set out on a programme to capture and retain knowledge?

We also added:

  • If there is one book you felt helped or inspired you what would it be?

Conducting and recording the interviews:

We had a list which grew from 12 to 18. Patricia volunteered to do the interviews (she is good at it) as we felt continuity in style was important.

We thought about using technology to help with the cataloguing and analysis. Instead we agreed not to transcribe verbatim but to each listen to the interview and make our own notes / key points which we’d discuss face to face in January 2016.

We learned a lot (remembered a lot) about the importance of having technology back ups and also that many corporates don’t allow Skype.  We found that taping the conversation proved good enough for us to listen to and that DropBox was an effective and secure storage vehicle for the tapes.

Analysing & Sensemaking:

And so last week we found ourselves awash with flip charts, postit note, and marker pens. By Friday evening we had a structure for the chapters of the book and a pretty good idea of the examples, stories and quotes that would fill them. Here’s a snapshot of how we went about organising the material:

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What I found interesting, the varying drivers for starting KM across the interview base. Most were due to Risk, a lot were down to Innovation & Process Improvement, some were as a result of the CEO’s Vision and a couple because of Regulatory or Audit findings and a call to action.

And finally:

With an outline (and publisher) in place we can now set about writing to meet the deadline of having a good manuscript that does justice to the insights provided by the interviewees (e.g. KM Bonus Points, ‘Knowvember’ Award, Rock Lite, Adaptive Case Management,  XpressoX, ‘Pick a Problem’, SME Protoge Program…) ready before the summer.

 

 

Importance of KM in Health: the story of Doctor Anwar and making use of what he and others know in Sudan

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Meet Anwar, a Sudanese doctor. Just one of 5 fictional characters created by delegates at the Knowledge Management for Health in Sudan event I spoke at, helped plan and run.

Sudanese Doctor

Anwar

This exercise, Scenarios for the future, was set in 2020 and invited the 80 or so delegates drawn from across the whole of the health industry in Sudan to consider what a day in the life of each character might look like.  This was a new and warmly embraced concept in an environment where my information is my soul and much of the debate about the future takes place against a backdrop of uncertainty and increasing austerity where:

  • 2/3rds of all drugs are purchased ‘out of pocket’ not from health system
  • drugs are proportionately more expensive than in other domains
  • funds from external sources are available to assist with health informatics.

Having settled on a description of each character the delegates who were by this time in groups of 8-10 then set about imagining what their day might look like on January 1st 2020. A vivid imagination is required and was evident in the quality of the stories that were told by each group’s nominated storyteller.

The story of the Health Worker

Ismail’s story – Health Worker

I will in due course and with the organising committee’s permission publish the two ‘winning’ stories; yes we did do voting while the storytellers left the room.

One of Sudan’s leading pharmacists noted in a one:one conversation how important listening was and how difficult a technique this is for many to use when prescribing drugs.

By inviting each of the storytellers to play back the story to each of the other groups it was good to hear them say in the summing up that by the end they really felt they were the character.

 

The previous day I’d invited the delegates to change the way they looked and think about issues and barriers.  Using when you change the way you look at things, the things you look at change exercise conducted in the best breakout rooms I’ve ever worked with, the delegates who are naturally loquacious soon grasped the concept of seeing the room through the lens of different professions.

Breakout room

Breakout room

This change of mindset was important: it allowed the subsequent round table (well round conference room) session that discussed:

‘What are the biggest issues we face in sharing knowledge and information about the health of our nation and how can we overcome them’

I’d invited each delegate to introduce themselves to three people they didn’t know. This worked well and encouraged a very frank discussion. The main issues highlighted were:

  • no systematic collection of information and limited understanding of its value
  • transparency of process (where do the figures go) and credibility of the data
  • lack of human resources to do the collection
  • limited statistical information to undertake scientific research on
  • ownership of data and the whole process – fragmentation
  • accountability to deliver
  • communication/awareness of what each organisation is doing – lots of ‘stuff’ is happening but there is a real risk of duplication of effort e.g. many of the disease control programmes are creating their own informatized information systems

Delegates recognised the tremendous strides being made by the Public Health Institute (one of the event’s sponsors and host of the official dinner) in developing professional public health administration programmes, the creation of a Data Dictionary and the publication of the first Annual Health Performance Review though many bemoaned the lack of official  support for research projects where Sudan has a prominent global position, Mycetoma Research Centre an example.

I came away from reflecting on a discussion I had around the event:

Its all about ‘informization’ – the ability to report from a health centre level with ‘point of sale’ data collected via PDA’s / mobiles as well as computers; about logistics management as a result to ensure supplies get to where they can do the most use.

This can be monitored by the minister, routine reports can be prepared showing which centre reported, which district has complete reporting, which state has complete and timely reporting and % of stock outs of basic drugs or vaccines etc.

And inspired by many of the presentations I’d seen on the morning of the second day from University of Khartoum’s research centre and of course the Public Health Institute who are reaching out to try and create greater awareness through public forum, newsletter and other events.

Perhaps the presentation that struck the biggest chord was from EpiLab
who have achieved impressive results in helping to reduce the incidence of TB and Asthma and whose research and community communication techniques are highly innovative. I loved the cartoons they developed on how to self treat and prevent the incidence of illnesses which were drawn up BY the local communities.  Their pictures and their words are published as guides for the nation and I know they will make them available so I can share them in future blogs.

It was an honour, a challenge but nevertheless great fun enhanced by the warmth of the welcome and a genuine sense of appreciation. Sudan’s people are among the most engaging and intelligent I’ve met. One anecdote from a conversation with a young professional in the communications business illustrates their dilemma:

‘…of the 95 people who graduated in my year a few years back 90 are now working overseas, the majority in highly paid good positions…’

In my address I acknowledged the support I’d had from many people in preparing for the event. They were: Ahmed Mohammed, Dr Alim Khan, Dr Anshu Banerjee, Ana Neves, Andrew Curry, Archana Shah, Chris Collison, David Gurteen, Dr Gada Kadoda, Dr Ehsanullah Tarin, Dr Madelyn Blair, Sofia Layton, Steven Uggowitzer, Victoria Ward

why should Sudan’s health industry embrace Knowledge Management?

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A few month’s back during a Skype call with Dr Gada Kadoda a Professor at University of Khartoum she told me: ‘at last year’s KMCA Sudan many of the health industry delegates who attended expressed an interest in understanding what knowledge management might do for them. How might we do that?’.

Gada is one of those special people who when they pose a question you feel compelled to answer it. Which is why in a week’s time I am going to be back in Khartoum to participate in a two day Workshop on Knowledge Management for Health Care in Sudan.

Knowledge management in health is not new. The NHS Modernisation Agency was one of the early adopters and used a lot of Chris Collison’s thinking from Learning to Fly to build a pretty effective knowledge management operation with one of the first Chief Knowledge Officers in charge of it. Sudan’s health industry does not (yet) practice km in any formal manner so as part of the research for my presentation and the sessions I am facilitating I asked some of the actors in the NHS km story to reflect on more than a decade.  Here’s what they said (names omitted):

I have said on several occasions that when you multiply the number of employees by the years of professional learning,  the NHS is the world’s most knowledgeable organisation.  Or it should be.  With better networking, more curiosity, joined-up systems, a culture of improvement and leaders who value national above parochial, it would live up to its potential.

What I have seen is wonderful pockets of excellence – hospitals with a determination to improve, a passion for learning, and a curiosity which can even transfer lessons learned from Formula One pit teams to the operating theatres of children’s hospitals.  Pockets of excellence indeed, but in threadbare trousers.

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The idea of KM in that particular agency of the Department of Health was to ensure that the knowledge produced by one team (silo) would reach other teams (silos), that the whole organisation had a sense of who knew what, and that we could reuse knowledge across the Service.

We had a team of people and a CKO…a CoP with members from all different teams in the organisation; knowledge audit and SNA that involved quite a few people across the org and which changed the way they perceived the work of the KM team. Yet …our work became too focused on documents and content creation disguised as gathering of lessons learned.

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In my regular interactions with physicians in the NHS, a key frustration has always been the flow of information between doctors and commissioners. Differing agendas, treating patients vs cost-effectiveness, cause breakdown in communication. The problem usually arises from the discrepancies between the notion of an ideal patient and the realities of people walking into the clinic. Pharma is not particularly helpful in addressing this through the research conducted, however the shift in emphasis to real world data by health technology bodies such as NICE is creating a cultural shift in the sector.

A great story of information exchange relates to a melanoma patient who was being treated in London. The patient was a successful business man so he continued with his work. He was treated with a very new drug and experienced severe side effects while on a business trip in Switzerland ending up at a hospital there. Mismanagement of this drug’s side-effects can result in death. The Swiss physicians had never used the drug before, and most were not even aware of its existence as it is a specialist therapy. However, there was extensive global information exchange driven by the company, which meant that as soon as they saw the patient card which all patients on the drug were advised to keep on their person, the Swiss physicians were able to access a database of information and a 24 hour network of world experts in the condition. Luckily for the patient the KM network worked thereby saving his life.

The shift towards greater use of data and increased use of technology (from other industries) is where I hope much of the Khartoum health discussion goes. One of the leaders in Health Information Systems shared this quote:

‘In the next ten years, medicine will be more affected by data science than biology.’

Mobile & Internet penetration in Africa

Mobile & Internet penetration in Africa

Today’s Economist article on the use of mobile technology in Africa is a timely reminder of the strides being made on that continent and how widespread adoption will present huge opportunities as well as challenges for the health industry there.

I am also  going to share this clip from Grey’s Anatomy (US TV drama) about the use of Twitter in an operating theatre. Though fictitious it gives as good an illustration as any I’ve seen about the potential benefits of using mobile technology to share knowledge and mobilise a global community in the same was as the story of the melanoma patient above does.

As the F1 season is nearly upon us I was really struck by this clip from the BBC which shows how the Maclaren F1 Team’s driver and car monitoring system is being adapted/used in a children’s hospital in Birmingham.

And yet for the Sudan health system to adopt some of these technologies (against a backdrop of isolation) there has to be a huge mindshift. I recall with chilling clarity a phrase uttered by a health professional at KMCA Khartoum last year in response to a question I posed as to the barriers to the sharing of knowledge: ‘my information is my soul’.

In an environment where:

  • sharing of information (let alone knowledge) can have serious consequences
  • admitting a lack of current knowledge can cause a loss of face and prestige
  • continuing medical education is not a core requirement for the right to practice
  • the major drug companies have no presence and sell via distribution channels
  • the physician is beyond reproach

we have our work cut out if we are to get positive outcomes from the event.  Its an exciting prospect.