Fastfood giant Jollibee Foods Corp. on Monday said it is buying 70 percent of Mang Inasal Philippines Inc. — a Filipino food chain — for P3 billion.
In a filing with the Philippine Stock Exchange, Jollibee Foods said it will pay Mang Inasal owner Edgar Injap Sia III of Injap Investments Inc. a P200 million downpayment.
About 90 percent of the balance will be paid upon closing of the agreement, with the remaining 10 percent to be paid three years onward after the deal is reached, Jollibee Foods said.
Injap will keep 30 percent equity in Mang Inasal, the disclosure read.
The deal will be completed in 30 days, subject to due diligence by Isla Lipana & Co. and law firm Romulo Mabanta Buenaventura Sayoc and De Los Angeles, it added.
The purchase of Mang Inasal will add 5 percent to the fastfood giant’s worldwide system sales and 7 percent to its profits, according to Jollibee Foods.
It will also increase by 16 percent Jollibee Foods' worldwide store network.
Like Jollibee, much of Mang Inasal’s success is due to chicken. The chain serves primarily grilled chicken and other Filipino food in 303 stores, 24 of which are company owned and the rest are franchised outlets.
Mang Inasal has revenues of P2.6 billion and system-wide sales of P3.8 billion a year.
Jollibee Foods, founded by businessman Tony Tan Caktiong, has 1,578 stores in the country and 375 abroad.
Locally, the Jollibee brand has 703 stores, Chowking (404), Greenwich (218), Red Ribbon (215), Delifrance (23), and Manong Pepe’s (15).
Overseas, Jollibee Foods has 185 Yonghe King stores in China, 64 Jollibee stores in the US, Vietnam and Brunei, 38 Red Ribbon stores in the US, 37 Chowkings mostly in the US, and 51 Hong Zhuang Yuan branches in China. — JE/VS, GMANews.TV - See more at: http://www.gmanetwork.com/news/story/203720/money/jollibee-to-buy-mang-inasal-for-p3-billion#sthash.G1XbOsgE.dpuf
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Tuesday, August 30, 2016
Friday, May 6, 2011
Antonov An-2
The Antonov An-2 was designed to meet a 1947 Soviet requirement for a replacement for the Polikarpov Po-2 which was used in large numbers as both an agricultural aircraft and a utility aircraft. Antonov designed a large single bay biplane of all-metal construction, with an enclosed cockpit and a cabin with room for seats accommodating twelve passengers. The first prototype, designated SKh-1, and powered by a Shvetsov ASh-21 radial engine, flew on 31 August 1947. The second prototype was fitted with a more powerful Shvetsov ASh-62 engine, which allowed the aircraft's payload to be significantly increased from 1,300 kg (2,870 lb) to 2,140 kg (4,720 lb), and in this form it was ordered into production
By 1960 the USSR had produced over 5,000 units. Since 1960, most An-2s have been built at Poland's WSK factory in Mielec, with over 13,000 made there before full production ended in 1991. Limited production from parts stocks, as well as spares and maintenance coverage continued until 2001, when 4 aircraft were produced for Vietnam. China also builds the An-2 under license as the Shijiazhuang Y-5.
The An-2 was designed as a utility aircraft for use in forestry and agriculture. However, the basic airframe is highly adaptable and numerous variants have been developed. These include hopper-equipped versions for crop-dusting, scientific versions for atmospheric sampling, water-bombers for fighting forest-fires, flying ambulances, float-equipped seaplane versions, lightly armed combat versions for dropping paratroops, and of course the most common An-2T version, which is the 12-seater passenger aircraft. All versions (other than the An-3) are powered by a 750 kW (1,000 hp) nine-cylinder Shvetsov ASh-62 radial engine, which was developed from the Wright R-1820
Tuesday, December 14, 2010
Real-World Solutions from World's Youth
Students from around the world are invited to register now for the Imagine Cup 2011, which this year offers a way for organizations working on the world’s big problems to get help from brilliant, passionate young people.
As I travel to different countries I often get a chance to talk with students, and when I do I’m often very impressed by their passion for helping solve some of the world’s toughest problems. To encourage them and get them even more involved in finding solutions, Microsoft created the Imagine Cup, which is now in its ninth year. As I wrote about last year’s competition, hundreds of thousands of students around the world participate in the Imagine Cup by coming up with creative solutions to big social and environmental problems like education and literacy, disaster relief, environmental sustainability and global healthcare.
This year, Microsoft has added a new program to help inspire young people to focus on the practical needs of organizations that are grappling with these problems every day. Imagine Cup Solve This is a kind of marketplace of ideas where organizations describe their needs for creative ideas that they hope students will think about and work on.
We’ve seen in past years that Imagine Cup projects can truly make a difference. Last year, for example, the Imagine Cup national team winner from the Czech Republic developed a mapping software program known as GINA, for Geographical Information Assistant. The program was used in Haiti last year to help coordinate the efforts of earthquake rescue and recovery workers. More recently, the GINA team launched an online portal to follow the latest developments in Haiti.
Imagine Cup Solve This is intended to facilitate more such real-world impact from the creativity of students. The first organizations that are participating include several United Nations agencies focused on development, youth, food and agriculture, world health and the environment. Also participating are the U.S. Agency for International Development (USAID) and the Robin Hood Foundation, a local New York City non-profit. It’s a new effort, and Microsoft expects that the list of participating organizations will grow.
One of the initial organizations, the UN Programme on Youth, is seeking help in developing ways for young people around the world to communicate and collaborate on achieving the UN’s Millennium Development Goals, such as ending hunger and poverty, achieving universal education and combating HIV/AIDS. The agency says traditional social networks have not been effective because of various barriers – linguistic, technological, social and cultural. They’re hoping that Imagine Cup teams will work on devising an innovative solution that would use mobile, video or other technologies to overcome these hurdles.
Meanwhile, USAID is looking for help on one of the most important educational challenges of poor countries: ensuring that all children learn how to read, write, count, add and subtract in their first three years of school. Studies show that students who do not achieve this goal are on course for a lifetime of poverty. USAID hopes Imagine Cup teams will help them identify creative technology solutions for promoting literacy among infants and children from poor families.
I want to encourage young people from around the world to participate in this year’s Imagine Cup; registration is now open. Check out the project ideas put forward by organizations as part of Imagine Cup Solve This.
And I want to encourage more organizations to participate by soliciting help from participating Imagine Cup teams. Intergovernmental organizations, non-governmental organizations (NGOs) and other not-for-profit organizations are all eligible. It's a tremendous opportunity to tap into the remarkable brain power and enthusiasm of these young technology leaders.
Regardless of who wins, everyone involved in the Imagine Cup, and the world as a whole, always emerges victorious.
source: http://www.thegatesnotes.com/Thinking/article.aspx?ID=183
As I travel to different countries I often get a chance to talk with students, and when I do I’m often very impressed by their passion for helping solve some of the world’s toughest problems. To encourage them and get them even more involved in finding solutions, Microsoft created the Imagine Cup, which is now in its ninth year. As I wrote about last year’s competition, hundreds of thousands of students around the world participate in the Imagine Cup by coming up with creative solutions to big social and environmental problems like education and literacy, disaster relief, environmental sustainability and global healthcare.
This year, Microsoft has added a new program to help inspire young people to focus on the practical needs of organizations that are grappling with these problems every day. Imagine Cup Solve This is a kind of marketplace of ideas where organizations describe their needs for creative ideas that they hope students will think about and work on.
We’ve seen in past years that Imagine Cup projects can truly make a difference. Last year, for example, the Imagine Cup national team winner from the Czech Republic developed a mapping software program known as GINA, for Geographical Information Assistant. The program was used in Haiti last year to help coordinate the efforts of earthquake rescue and recovery workers. More recently, the GINA team launched an online portal to follow the latest developments in Haiti.
Imagine Cup Solve This is intended to facilitate more such real-world impact from the creativity of students. The first organizations that are participating include several United Nations agencies focused on development, youth, food and agriculture, world health and the environment. Also participating are the U.S. Agency for International Development (USAID) and the Robin Hood Foundation, a local New York City non-profit. It’s a new effort, and Microsoft expects that the list of participating organizations will grow.
One of the initial organizations, the UN Programme on Youth, is seeking help in developing ways for young people around the world to communicate and collaborate on achieving the UN’s Millennium Development Goals, such as ending hunger and poverty, achieving universal education and combating HIV/AIDS. The agency says traditional social networks have not been effective because of various barriers – linguistic, technological, social and cultural. They’re hoping that Imagine Cup teams will work on devising an innovative solution that would use mobile, video or other technologies to overcome these hurdles.
Meanwhile, USAID is looking for help on one of the most important educational challenges of poor countries: ensuring that all children learn how to read, write, count, add and subtract in their first three years of school. Studies show that students who do not achieve this goal are on course for a lifetime of poverty. USAID hopes Imagine Cup teams will help them identify creative technology solutions for promoting literacy among infants and children from poor families.
I want to encourage young people from around the world to participate in this year’s Imagine Cup; registration is now open. Check out the project ideas put forward by organizations as part of Imagine Cup Solve This.
And I want to encourage more organizations to participate by soliciting help from participating Imagine Cup teams. Intergovernmental organizations, non-governmental organizations (NGOs) and other not-for-profit organizations are all eligible. It's a tremendous opportunity to tap into the remarkable brain power and enthusiasm of these young technology leaders.
Regardless of who wins, everyone involved in the Imagine Cup, and the world as a whole, always emerges victorious.
source: http://www.thegatesnotes.com/Thinking/article.aspx?ID=183
Saturday, August 28, 2010
Little Experience Needed For These Online Business Ideas
Quitting your day job and making money at home is something that many people want to do these days. You have so many different online business ideas to help you achieve this.
There are many internet business ideas that you can choose to use, but most people want something that doesn't require a lot of experience.
Here are a few of the best ideas you can choose to use to earn money from home and none of them require a lot of experience.
1. Affiliate marketing - This is free to get started with and it is very easy to start earning money with it. You just need to find one or two affiliate programs that you can promote.
Then sign up and you will be given everything that is needed to get started right away. The one thing that you have to do to make money with this is to advertise the programs you are promoting as much as you possibly can.
2. Freelance writer - There are many writing opportunities online that you can take advantage of to start making money. There are so many people online that need reports, articles, eBooks and lots of other things written for them.
Just be sure that writing is something that you enjoy because once you get your business started, you will have a lot of people wanting to use your services, as long as you market your business and let them know you are available.
3. Ebay - Selling products on eBay through their auctions or through your own eBay store is a good way to make money. It doesn't matter what products you sell, just make sure they are ones that people are looking to buy.
4. Copywriter - Internet business owners always need coypwriters for their website and many other tasks. Let them know you are available and willing to do their copywriting for them.
5. Website designer - If you know how to build websites or blogs, then this could be a good business for you to start. Many people online need a website or blog, but they have no clue how to go about setting it all up.
You can provide your expertise and save them a lot of time. There are many people that will gladly give you their money for this service.
These are just some of the many online business ideas that can be chosen which require little experience. Just be sure you find a business that you will enjoy making money with because this will make it so much easier to achieve your goal.
There are many internet business ideas that you can choose to use, but most people want something that doesn't require a lot of experience.
Here are a few of the best ideas you can choose to use to earn money from home and none of them require a lot of experience.
1. Affiliate marketing - This is free to get started with and it is very easy to start earning money with it. You just need to find one or two affiliate programs that you can promote.
Then sign up and you will be given everything that is needed to get started right away. The one thing that you have to do to make money with this is to advertise the programs you are promoting as much as you possibly can.
2. Freelance writer - There are many writing opportunities online that you can take advantage of to start making money. There are so many people online that need reports, articles, eBooks and lots of other things written for them.
Just be sure that writing is something that you enjoy because once you get your business started, you will have a lot of people wanting to use your services, as long as you market your business and let them know you are available.
3. Ebay - Selling products on eBay through their auctions or through your own eBay store is a good way to make money. It doesn't matter what products you sell, just make sure they are ones that people are looking to buy.
4. Copywriter - Internet business owners always need coypwriters for their website and many other tasks. Let them know you are available and willing to do their copywriting for them.
5. Website designer - If you know how to build websites or blogs, then this could be a good business for you to start. Many people online need a website or blog, but they have no clue how to go about setting it all up.
You can provide your expertise and save them a lot of time. There are many people that will gladly give you their money for this service.
These are just some of the many online business ideas that can be chosen which require little experience. Just be sure you find a business that you will enjoy making money with because this will make it so much easier to achieve your goal.
Saturday, June 6, 2009
How Important is Knowledge Management for Businesses?
Knowledge is a philosophical idea defined by Plato as a popular credence supported by an account or an basis (Blair, 2002). Under the context of knowledge-view of an organization, the definition proves the current knowledge comes based on data from firm's increased ability to build use and sense of around info to craft value for the shareholders (Leiponen, 2006). There has been a extensive growth in the knowledge-based school of thought, which suggests that producing and retention of knowledge can undergo positive effects on the firm's performance (Di Mattia & Scott, 1999). To manage this intangible asset to leverage firms for benefits is considered to be its core capability. Knowledge management (KM) has been aimed at capturing, integrating and using existing organizational knowledge and later creating a knowledge asset that can be a source of sustained competitive advantage in the long run (Brooking, 1999; Havens & Knapp, 1999). The revolution in the KM came with the rise of technology and there has been a misconception of linking IT through KM although it just facilitates the process (Papers4you.com, 2006).
The literature has divided knowledge to two major categories depending upon its nature to be codified for the use in a KM system. The structured and systematic knowledge the current can be described in formal language and clearly communicated and shared for the duration of formal means qualify for the explicit knowledge type (Elizabeth, 2001). It has been established so these kinds of knowledge is easy to codify in the form of databases and is witnessed as a base resource because of its inherent nature of easy imitation by other organizations. The other craft of knowledge that has gained tremendous importance is the automatic collective behavior and is identified tacit knowledge (Richard et al, 2001). Tacit knowledge, according to Sajjad et al (2005), comprises of mental models, values, beliefs, assumptions and perceptions which are deeply entranced into the intellectual capital of an organization. It has been suggested too tacit knowledge is faced surrounded by an discernable dichotomy i.e. the feature of inimitability that make it a source of sustained competitory advantage also makes it hard to capture and share within the firm to appreciation the potential benefits.
Therefore it can be concluded which the elusive asset of knowledge, where provides an organization with capability to undermine competition also suggests to be a challenge to leverage itself (Papers4you.com, 2006). Any organization should not alone look at the ‘best practices' in the field but might customize every system to its own unique culture and arrangements to be able to successfully use KM.
References:
Blair, D.C. (2002), “Knowledge management: hype, hope, or help?”, Journal of the American Society for Information Science and Technology 53(12), 1019–1028
BROOKING, Annie (1999), “Corporate Memory: Strategies for Knowledge Management”, Intellectual Capital Series London: International Thomson Business
Di Mattia, S. & Scott, I. A. (1999), “KM: hope, hype or harbinger?”, Library Journal, 15 September, 122(15), p. 33
Elizabeth A. Smith, (2001), “The role of tacit and explicit knowledge in the workplace”, Journal of Knowledge Management; Volume: 5 Issue: 4; 2001 Research Paper
Havens, C. & Knapp, E. (1999), “Easing into Knowledge Management, Strategy and Leadership”, 27(2), p. 4
Leiponen, Aija (2006), “Managing Knowledge for Innovation: The Case of Business-to-Business Services”, Journal of Product Innovation Management, May2006, Vol. 23 Issue 3, p238-258
Papers For You (2006) "P/M/440. Tools of knowledge management", Available based on what i read in http://www.coursework4you.co.uk/sprtmgt8.htm [22/06/2006]
Papers For You (2006) "P/M/325. Knowledge management: definition of the concept", Available from Papers4you.com [21/06/2006]
Richard T. Herschel, Hamid Nemati, David Steiger (2001), Tacit to explicit knowledge conversion: knowledge exchange protocols Journal of Knowledge Management; Volume: 5 Issue: 1; 2001 Research paper
Sajjad M. Jasimuddin, Jonathan H. Klein, Con Connell (2005), The paradox of using tacit and explicit knowledge: Strategies to are dealing with dilemmas”, Management Decision; Volume: 43 Issue: 1; 2005 Conceptual paper
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The literature has divided knowledge to two major categories depending upon its nature to be codified for the use in a KM system. The structured and systematic knowledge the current can be described in formal language and clearly communicated and shared for the duration of formal means qualify for the explicit knowledge type (Elizabeth, 2001). It has been established so these kinds of knowledge is easy to codify in the form of databases and is witnessed as a base resource because of its inherent nature of easy imitation by other organizations. The other craft of knowledge that has gained tremendous importance is the automatic collective behavior and is identified tacit knowledge (Richard et al, 2001). Tacit knowledge, according to Sajjad et al (2005), comprises of mental models, values, beliefs, assumptions and perceptions which are deeply entranced into the intellectual capital of an organization. It has been suggested too tacit knowledge is faced surrounded by an discernable dichotomy i.e. the feature of inimitability that make it a source of sustained competitory advantage also makes it hard to capture and share within the firm to appreciation the potential benefits.
Therefore it can be concluded which the elusive asset of knowledge, where provides an organization with capability to undermine competition also suggests to be a challenge to leverage itself (Papers4you.com, 2006). Any organization should not alone look at the ‘best practices' in the field but might customize every system to its own unique culture and arrangements to be able to successfully use KM.
References:
Blair, D.C. (2002), “Knowledge management: hype, hope, or help?”, Journal of the American Society for Information Science and Technology 53(12), 1019–1028
BROOKING, Annie (1999), “Corporate Memory: Strategies for Knowledge Management”, Intellectual Capital Series London: International Thomson Business
Di Mattia, S. & Scott, I. A. (1999), “KM: hope, hype or harbinger?”, Library Journal, 15 September, 122(15), p. 33
Elizabeth A. Smith, (2001), “The role of tacit and explicit knowledge in the workplace”, Journal of Knowledge Management; Volume: 5 Issue: 4; 2001 Research Paper
Havens, C. & Knapp, E. (1999), “Easing into Knowledge Management, Strategy and Leadership”, 27(2), p. 4
Leiponen, Aija (2006), “Managing Knowledge for Innovation: The Case of Business-to-Business Services”, Journal of Product Innovation Management, May2006, Vol. 23 Issue 3, p238-258
Papers For You (2006) "P/M/440. Tools of knowledge management", Available based on what i read in http://www.coursework4you.co.uk/sprtmgt8.htm [22/06/2006]
Papers For You (2006) "P/M/325. Knowledge management: definition of the concept", Available from Papers4you.com [21/06/2006]
Richard T. Herschel, Hamid Nemati, David Steiger (2001), Tacit to explicit knowledge conversion: knowledge exchange protocols Journal of Knowledge Management; Volume: 5 Issue: 1; 2001 Research paper
Sajjad M. Jasimuddin, Jonathan H. Klein, Con Connell (2005), The paradox of using tacit and explicit knowledge: Strategies to are dealing with dilemmas”, Management Decision; Volume: 43 Issue: 1; 2005 Conceptual paper
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Knowledge Management in Healthcare: Succeeding in Spite of Technology
Technology and healthcare ever have had an uneasy relationship. On one hand, there is the promise of technology and the enhancements it offers healthcare. These include improved medical information access, streamlined reporting, automation, reduced errors and more compact processes. On the other hand, technology has fallen very brief of its complete potential in healthcare, as too many fighting systems make integrated information difficult to obtain. Additionally, the burdens of data entry and analysis burdens overwhelm rather as opposed to streamline processes.
Healthcare faces these mistakes if it applies technology to organizational Knowledge Management (KM) without mostly identifying KM goals and understanding how a KM system will be able to be exhausted by administrators, physicians, managers, and staff. Technology facilitates knowledge exchange, but it is not the end-all to managing knowledge effectively. Technology designed to enhance the interaction among a state of similar-minded participants, such as healthcare employees, can greatly enhance the exchange of knowledge. But it is the method and culture of an organization instead than the level of applied technology the current make a KM system a wealth or void of retrievable information.
An effective KM system is constructed on communication and education and thrives in organizations encouraging shared learning both within and outside of the hospital walls. These systems store historical knowledge and knowledge created during exchanges of data among people who are interested in learning. Knowledge management authorities designed with goals in mind, versus just recently acquiring the most advanced technology, is what will be able to validation healthcare organizations in streamlining processes, reducing costs and improving care.
Why Knowledge Management in Healthcare?
Healthcare industry professionals are identifying this previous efforts, (e.g. search for the elusive best practice and applying it as a commodity), bureaucratic and toothless performance improvement initiatives and poorly thought-out IT implementations, hold not led to improved results and reduced costs. As a mindset, KM attaches importance to knowledge and identifies the cost of knowledge at distinct levels. As a framework, KM facilitates knowledge access and transfer, which helps adjust behaviors and improve decisions. Knowledge management institutions validation healthcare workers in utilizing available knowledge to develop organizational learning. This learning aides the employees in critiquing a compilation of practice tools and successfully designing a customized Best Practice for the organization. A good KM system can help employees make and triumph new knowledge. It is capable of driving decisions, tweak and renovations to all levels of the organization. And, in this era of escalating costs and declining reimbursements, an effective KM technique is virtually principle to a healthcare organization's process improvement and cost reduction strategies.
Hospitals can be isolated places, which construct it tough to gather knowledge'. The clinical side has the measurable investigation and knows the outcomes, but the operational portion of the hospital lacks currently information. Consider this example. A hospital's operational members may be well abreast of the increased benefit to changing one of its products used for patient attention management. Nevertheless, the staff struggles when it comes to demonstrating the cost/benefit to administration and to the physicians. A KM system offers a hospital realtors access to strategies and contacts so properties can figure out how others have successfully carried out similar situations.
Can We Talk?
Hospital staff is willing to share such a knowledge provided others in the field, although it's often done informally, such as networking at a convention or conversations with internal and external peers. Effective KM systems capitalize on these kinds of opportunities.
How performs a KM system change behaviors and improve decisions? One hospital department is concerned with retaining staff, actually in sunbeams of the the most recent nursing shortage. Typically, the manager struggles through the staffing issues alone or relies on a few peers within the department. Yet, how if the manager could connect with a peer internally and solicit his or her advice, a good deal though this employee runs in an unrelated department? The insight and perspective from an outsider may be very useful. How in regards to contacting peers at other facilities? An effective KM system would facilitate experience sharing' among people struggling with staffing issues. It also archives the solutions brainstormed based on what i read in the interaction to use as a basis for going up the collective knowledge of the group. This information is then readily accessible the next era a hospital manager (within the hospital or from one more facility) faces retention issues.
Another method hospitals typically use to gain knowledge is gathering ideas from a multitude of experts, as is done when attending a conference or a convention. Yet, how is that information disseminated throughout the hospital or healthcare organization if just two employees attended the convention? If it is difficult to share and form ideas within one department or that much throughout one hospital, how can any person expect cross-hospital exchanges to prove fruitful? Obviously, it is more difficult to share information when individuals are not physically together and continuing to more complex when the individuals are workforces of different healthcare organizations. The help of sharing such a huge tank of knowledge are colossal. Technology is a must in these cases.
Knowledge Management ≠ Information Technology
Effective KM cannot be believed of, nor treated, as simply another exercise in information technology. Unfortunately, due to the access and distribution enhancements technology provides, healthcare administrators often have a distorted view of a KM system as an info technology system or as a solution that needs to be applied. While technology enhances sharing and information exchange, even the most technologically advanced KM process might not solve most any dilemma. The keys to a successful KM implementation are:
· Identify the knowledge to exchange and distribute
· Determine how knowledge will be managed
· Match technology and resources appropriately to the culture and needs of the organization
Another fallacy about KM is that “knowledge” can be reduced to documents and then warehoused in a computer database for people to access as needed. The improvement resulting from a KM system comes from personal interaction, the sharing of experiences, taking action and recording the results, growing collective knowledge of a group and building new knowledge from the experiences of others. Technology based solely on warehousing knowledge “documents” or perfect practices are not lucrative in driving change and improvement in the organization.
It takes resources beyond technology to manage knowledge effectively. Group interactions must be facilitated, results must be archived and reinvested in the knowledge pool and management actions and change must be supported by the organization. Effectively managing and leveraging knowledge in an organization cannot be abdicated to the IT system.
Apply Thoughtful Technology
Organizations own a habit of buying the latest, greatest KM method on the market, if for no other rationale as opposed to while others have done the same. Yet, elaborate governments that aren't called for tend to breed reluctance. Does the hospital or healthcare association outstandingly need the latest and greatest? When analyzing the implementation of a KM system, first determine what is really required to meet the hospital's needs. For instance, take the uncomplicated suggestion box. Are the workers building practical suggestions or snide comments? Is the indication box readily accessible? Does the hospital culture encourage suggestions and incorporate them into the organization's routines? If so, this is a struggling and useful KM system. This is when technology can really enhance the system by extending its reach and initiating a historical warehouse of implementations. But, when the proof box isn't used appropriately, then holding the latest, greatest, technologically advanced computer suggestion box won't improve anything. Once again, an organization requires a “learning” culture to value the collaborative learning obtained throughout KM systems.
Some corporations overcome such obstacles by making the most of technology as a tool instead of as a solution. Technology can enhance knowledge exchange by providing multiple access cases (interactive events and data warehouses) and ubniquitous distribution of new and innovative ideas. Thoughtful abstracting and archiving of incidences and documents enable managers to actively apply lessons learned by others and applies knowledge to their daily work.
Managing Competing Expectations of Users and Administrators
Unless it fills specific need and is easily accessible in one's daily routine, a KM system will probably be ignored. Healthcare runs at a hectic rate and real estate agents needs to spend as little time as possible navigating a KM system to construct useful information. Administrators will not validation KM efforts unless properties see provided evidence results. Consider the approaching criteria when weighing the experts and cons of a KM system:
· What is the organization's purpose for the KM system?
· Where is the existing knowledge?
· How is the knowledge transferred?
· Who will have access to the system?
· How will access privileges vary among staff members?
· How am able to every department use the system?
· How will innovations be exchanged, in-house exclusively or
with other organizations?
· What is the property of the KM system? Will it just
create directories of establishments or will it also create active learning communities (active learning)?
· What total amount of validation will be major at each level?
· How user-friendly is it?
It never serves an association to design a system with all the like bells and whistles, just for the sake of having slick features. Create a KM system long&wshyp;term with the way the hospital staff should use it. If the purpose is to inspire employees to think ‘outside the box', systems can be intended to facilitate this. The best way to manage competing anticipations is to understand it all upfront. The healthcare industry, especially, performs not have the bankroll to pay for underutilized features.
Key Components for A Successful KM System:
1. Fulfills organizational goals. A KM system structured around an organization's goals will support the efforts of employees to reach these goals. John Ager, Team Coordinator of the Endoscopy Department for Sentara Healthcare Systems, located in Virginia Beach, Virginia, has participated in monthly teleconference calls with colleagues nationwide. “It is part of my hospital's aspiration to do benchmarking. This hospital is very strong on sharing information and the previous supplies were not effective. Prior to the teleconference calls, we were doing phone communication, that was difficult at best. Now we have set scheduled times on a monthly motive and we just recently picked up using computer-based knowledge.”
2. Addresses social networks. If employees feel like properties belong to a particular group, then they are more likely to share successes and failures in on that group. Sharing failures is especially beneficial to a knowledge management system from the time of people tend to learn more effectively when they're told/shown what not to do. Develop knowledge communities or communities of practice (COP's) out there functional and clinical topics. Orchestrate events where staff can share experiences (especially failures) without fear of censure.Collective history of a social network is important. The background information from all participants in a COP builds a shared, historical base, that solidifies commitment to the group process and swells exchanges. “I've really enjoyed the participation,” says Ager. “It has really helped me get a better picture of the field I'm in while I'm actually having a one-on-one immediate interaction through a person as opposed to the old method where you'd have a fixed set of questions you'd e-mail to them. Then, you'd try to requirement them to get answers or properties would fax their answers back to you. It wasn't as clear and concise. This is ongoing and I like the immediate and personal response back,” explains Ager.
3. Archives existent knowledge. Create historical records by categorizing and abstracting knowledge gleaned out of interactions. Make it easy for users to locate relevant learning. Ager uses his KM system to share documentation prior to the actual teleconference in on the other participants. They use spreadsheets and data management for references when speaking on the telephone. “I've discovered this aspect beneficial as as we are talking, I'm able to look at the information firsthand and it spurs queries for me too,” says Ager. Additionally, all participants receive e-mail summations of the teleconference (created by the KM method coordinator). Call inquiries are established on the suggestions and queries introduced in previous teleconferences. If one facility has a specific question, the coordinator will request patterns related to this question from all participants, summarize the information and then forward it to all facilities.
4. Facilitates “new” knowledge. Knowledge comes from many resources combined with knowledge forums, conference calls, research articles, surveys, and opinion polls. Encourage participants to exchange innovations and share experiences, challenges and successes. Most people are not able to develop an action plan simply by reading or analyzing data. Rather, they are a larger amount of inspired by talking and exchanging ideas. According to Ager, “Participating in the teleconference calls is one of the highest quality ways of sharing information that I've been exposed to in the last nine years since I've been working for now facility. It's given me true time information and true people to language to. Issues constantly change. At one point, staffing was a priority at the majority of of the facilities and because we shared information, opposite facilities implemented the shared tools when it was the right time for them. It's straightforward than looking at a piece of paper with raw info on it wondering what to do with it.”
Moving Forward
The explosion of information technology and its minute accessibility have came up with powerful solutions for the healthcare business. Healthcare are required to invest its resources and technology wisely. A carefully mulled over and well-resourced KM implementation will enable organizations to leverage data, knowledge and experience to improve patient care and fewer healthcare costs. Why ‘reinvent these conversations' when they've already taken place countless times? KM institutions designed to serve an organization's goals, and put up to foster social interactions that encourage the exchange of knowledge, plans to aide organizations in revolutionizing healthcare.
Sidebar: Keys to Generating New Knowledge
Use these ideas when designing a KM system:
· Create Communities of Practice (COP)
· Moderate COP processes to extract learning
· Make continuous learning available
· Determine how successes are shared and how failures are communicated
· Analyze failure for coming years learning
· Generate, abstract and categorize historical knowledge records
· Provide multiple access paths for participants
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Healthcare faces these mistakes if it applies technology to organizational Knowledge Management (KM) without mostly identifying KM goals and understanding how a KM system will be able to be exhausted by administrators, physicians, managers, and staff. Technology facilitates knowledge exchange, but it is not the end-all to managing knowledge effectively. Technology designed to enhance the interaction among a state of similar-minded participants, such as healthcare employees, can greatly enhance the exchange of knowledge. But it is the method and culture of an organization instead than the level of applied technology the current make a KM system a wealth or void of retrievable information.
An effective KM system is constructed on communication and education and thrives in organizations encouraging shared learning both within and outside of the hospital walls. These systems store historical knowledge and knowledge created during exchanges of data among people who are interested in learning. Knowledge management authorities designed with goals in mind, versus just recently acquiring the most advanced technology, is what will be able to validation healthcare organizations in streamlining processes, reducing costs and improving care.
Why Knowledge Management in Healthcare?
Healthcare industry professionals are identifying this previous efforts, (e.g. search for the elusive best practice and applying it as a commodity), bureaucratic and toothless performance improvement initiatives and poorly thought-out IT implementations, hold not led to improved results and reduced costs. As a mindset, KM attaches importance to knowledge and identifies the cost of knowledge at distinct levels. As a framework, KM facilitates knowledge access and transfer, which helps adjust behaviors and improve decisions. Knowledge management institutions validation healthcare workers in utilizing available knowledge to develop organizational learning. This learning aides the employees in critiquing a compilation of practice tools and successfully designing a customized Best Practice for the organization. A good KM system can help employees make and triumph new knowledge. It is capable of driving decisions, tweak and renovations to all levels of the organization. And, in this era of escalating costs and declining reimbursements, an effective KM technique is virtually principle to a healthcare organization's process improvement and cost reduction strategies.
Hospitals can be isolated places, which construct it tough to gather knowledge'. The clinical side has the measurable investigation and knows the outcomes, but the operational portion of the hospital lacks currently information. Consider this example. A hospital's operational members may be well abreast of the increased benefit to changing one of its products used for patient attention management. Nevertheless, the staff struggles when it comes to demonstrating the cost/benefit to administration and to the physicians. A KM system offers a hospital realtors access to strategies and contacts so properties can figure out how others have successfully carried out similar situations.
Can We Talk?
Hospital staff is willing to share such a knowledge provided others in the field, although it's often done informally, such as networking at a convention or conversations with internal and external peers. Effective KM systems capitalize on these kinds of opportunities.
How performs a KM system change behaviors and improve decisions? One hospital department is concerned with retaining staff, actually in sunbeams of the the most recent nursing shortage. Typically, the manager struggles through the staffing issues alone or relies on a few peers within the department. Yet, how if the manager could connect with a peer internally and solicit his or her advice, a good deal though this employee runs in an unrelated department? The insight and perspective from an outsider may be very useful. How in regards to contacting peers at other facilities? An effective KM system would facilitate experience sharing' among people struggling with staffing issues. It also archives the solutions brainstormed based on what i read in the interaction to use as a basis for going up the collective knowledge of the group. This information is then readily accessible the next era a hospital manager (within the hospital or from one more facility) faces retention issues.
Another method hospitals typically use to gain knowledge is gathering ideas from a multitude of experts, as is done when attending a conference or a convention. Yet, how is that information disseminated throughout the hospital or healthcare organization if just two employees attended the convention? If it is difficult to share and form ideas within one department or that much throughout one hospital, how can any person expect cross-hospital exchanges to prove fruitful? Obviously, it is more difficult to share information when individuals are not physically together and continuing to more complex when the individuals are workforces of different healthcare organizations. The help of sharing such a huge tank of knowledge are colossal. Technology is a must in these cases.
Knowledge Management ≠ Information Technology
Effective KM cannot be believed of, nor treated, as simply another exercise in information technology. Unfortunately, due to the access and distribution enhancements technology provides, healthcare administrators often have a distorted view of a KM system as an info technology system or as a solution that needs to be applied. While technology enhances sharing and information exchange, even the most technologically advanced KM process might not solve most any dilemma. The keys to a successful KM implementation are:
· Identify the knowledge to exchange and distribute
· Determine how knowledge will be managed
· Match technology and resources appropriately to the culture and needs of the organization
Another fallacy about KM is that “knowledge” can be reduced to documents and then warehoused in a computer database for people to access as needed. The improvement resulting from a KM system comes from personal interaction, the sharing of experiences, taking action and recording the results, growing collective knowledge of a group and building new knowledge from the experiences of others. Technology based solely on warehousing knowledge “documents” or perfect practices are not lucrative in driving change and improvement in the organization.
It takes resources beyond technology to manage knowledge effectively. Group interactions must be facilitated, results must be archived and reinvested in the knowledge pool and management actions and change must be supported by the organization. Effectively managing and leveraging knowledge in an organization cannot be abdicated to the IT system.
Apply Thoughtful Technology
Organizations own a habit of buying the latest, greatest KM method on the market, if for no other rationale as opposed to while others have done the same. Yet, elaborate governments that aren't called for tend to breed reluctance. Does the hospital or healthcare association outstandingly need the latest and greatest? When analyzing the implementation of a KM system, first determine what is really required to meet the hospital's needs. For instance, take the uncomplicated suggestion box. Are the workers building practical suggestions or snide comments? Is the indication box readily accessible? Does the hospital culture encourage suggestions and incorporate them into the organization's routines? If so, this is a struggling and useful KM system. This is when technology can really enhance the system by extending its reach and initiating a historical warehouse of implementations. But, when the proof box isn't used appropriately, then holding the latest, greatest, technologically advanced computer suggestion box won't improve anything. Once again, an organization requires a “learning” culture to value the collaborative learning obtained throughout KM systems.
Some corporations overcome such obstacles by making the most of technology as a tool instead of as a solution. Technology can enhance knowledge exchange by providing multiple access cases (interactive events and data warehouses) and ubniquitous distribution of new and innovative ideas. Thoughtful abstracting and archiving of incidences and documents enable managers to actively apply lessons learned by others and applies knowledge to their daily work.
Managing Competing Expectations of Users and Administrators
Unless it fills specific need and is easily accessible in one's daily routine, a KM system will probably be ignored. Healthcare runs at a hectic rate and real estate agents needs to spend as little time as possible navigating a KM system to construct useful information. Administrators will not validation KM efforts unless properties see provided evidence results. Consider the approaching criteria when weighing the experts and cons of a KM system:
· What is the organization's purpose for the KM system?
· Where is the existing knowledge?
· How is the knowledge transferred?
· Who will have access to the system?
· How will access privileges vary among staff members?
· How am able to every department use the system?
· How will innovations be exchanged, in-house exclusively or
with other organizations?
· What is the property of the KM system? Will it just
create directories of establishments or will it also create active learning communities (active learning)?
· What total amount of validation will be major at each level?
· How user-friendly is it?
It never serves an association to design a system with all the like bells and whistles, just for the sake of having slick features. Create a KM system long&wshyp;term with the way the hospital staff should use it. If the purpose is to inspire employees to think ‘outside the box', systems can be intended to facilitate this. The best way to manage competing anticipations is to understand it all upfront. The healthcare industry, especially, performs not have the bankroll to pay for underutilized features.
Key Components for A Successful KM System:
1. Fulfills organizational goals. A KM system structured around an organization's goals will support the efforts of employees to reach these goals. John Ager, Team Coordinator of the Endoscopy Department for Sentara Healthcare Systems, located in Virginia Beach, Virginia, has participated in monthly teleconference calls with colleagues nationwide. “It is part of my hospital's aspiration to do benchmarking. This hospital is very strong on sharing information and the previous supplies were not effective. Prior to the teleconference calls, we were doing phone communication, that was difficult at best. Now we have set scheduled times on a monthly motive and we just recently picked up using computer-based knowledge.”
2. Addresses social networks. If employees feel like properties belong to a particular group, then they are more likely to share successes and failures in on that group. Sharing failures is especially beneficial to a knowledge management system from the time of people tend to learn more effectively when they're told/shown what not to do. Develop knowledge communities or communities of practice (COP's) out there functional and clinical topics. Orchestrate events where staff can share experiences (especially failures) without fear of censure.Collective history of a social network is important. The background information from all participants in a COP builds a shared, historical base, that solidifies commitment to the group process and swells exchanges. “I've really enjoyed the participation,” says Ager. “It has really helped me get a better picture of the field I'm in while I'm actually having a one-on-one immediate interaction through a person as opposed to the old method where you'd have a fixed set of questions you'd e-mail to them. Then, you'd try to requirement them to get answers or properties would fax their answers back to you. It wasn't as clear and concise. This is ongoing and I like the immediate and personal response back,” explains Ager.
3. Archives existent knowledge. Create historical records by categorizing and abstracting knowledge gleaned out of interactions. Make it easy for users to locate relevant learning. Ager uses his KM system to share documentation prior to the actual teleconference in on the other participants. They use spreadsheets and data management for references when speaking on the telephone. “I've discovered this aspect beneficial as as we are talking, I'm able to look at the information firsthand and it spurs queries for me too,” says Ager. Additionally, all participants receive e-mail summations of the teleconference (created by the KM method coordinator). Call inquiries are established on the suggestions and queries introduced in previous teleconferences. If one facility has a specific question, the coordinator will request patterns related to this question from all participants, summarize the information and then forward it to all facilities.
4. Facilitates “new” knowledge. Knowledge comes from many resources combined with knowledge forums, conference calls, research articles, surveys, and opinion polls. Encourage participants to exchange innovations and share experiences, challenges and successes. Most people are not able to develop an action plan simply by reading or analyzing data. Rather, they are a larger amount of inspired by talking and exchanging ideas. According to Ager, “Participating in the teleconference calls is one of the highest quality ways of sharing information that I've been exposed to in the last nine years since I've been working for now facility. It's given me true time information and true people to language to. Issues constantly change. At one point, staffing was a priority at the majority of of the facilities and because we shared information, opposite facilities implemented the shared tools when it was the right time for them. It's straightforward than looking at a piece of paper with raw info on it wondering what to do with it.”
Moving Forward
The explosion of information technology and its minute accessibility have came up with powerful solutions for the healthcare business. Healthcare are required to invest its resources and technology wisely. A carefully mulled over and well-resourced KM implementation will enable organizations to leverage data, knowledge and experience to improve patient care and fewer healthcare costs. Why ‘reinvent these conversations' when they've already taken place countless times? KM institutions designed to serve an organization's goals, and put up to foster social interactions that encourage the exchange of knowledge, plans to aide organizations in revolutionizing healthcare.
Sidebar: Keys to Generating New Knowledge
Use these ideas when designing a KM system:
· Create Communities of Practice (COP)
· Moderate COP processes to extract learning
· Make continuous learning available
· Determine how successes are shared and how failures are communicated
· Analyze failure for coming years learning
· Generate, abstract and categorize historical knowledge records
· Provide multiple access paths for participants
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Knowledge Communities: Transforming Best Practice into Action
Healthcare managers are discovering that a best practice imported from another organization is not a panacea. First, one size never fits all. Second, managers charged with process improvement often think of the search for a best practice as a one-time effort. In truth, performance improvement is always ongoing. That's why smart organizations are intensifying the search for best practices with knowledge communities groups of people who share a common interest and are committed to exchange information and solve common problems together on a continuing basis. Here's how knowledge communities can make a difference in patient care and the organization's bottom line.
Why the Search for Best Practices Fails
There are five approaches to best practice search and implement missions that strangle management. They all begin with a vague project to find a best practice without any certainty on search parameters or desired outcome. What usually happens is one of the following:
Scenario 1:
The manager cannot find a better performer that is similar to his or her own organization in terms of size, scope, structure, environment, trauma level, profitability, etc. Therefore, there is no one from whom to learn.
Scenario 2:
Hospitals that are insufficiently diverse swap best practices, which then become inbred rigidities or sacred cows. No innovation occurs because there is no diversity in the learning pool.
Scenario 3:
The manager searches and searches for the “holy grail” or elusive best practice. The search continues with no end in sight, and nothing is accomplished. Or, the best practice is found, but never implemented. Searching doesn't bring results. Doing does.
Scenario 4:
The manager at Hospital A succeeds in finding a best practice. Hospital B has standardized on a single vendor for artificial knee implants. The manager copies the practice by standardizing on a single vendor from Hospital A. The result? The physicians revolt because no one was consulted! Or, by signing a two-year exclusive agreement to get a lower price, Hospital B misses out on new advances in orthopedic implants and the high-volume, well-respected surgeon defects. The moral? Best practices are not commodities. Mindlessly mimicking a best practice is a recipe for disaster. Adapt, evolve, customize!
Scenario 5:
The manager finds that the best practice in pharmacies is computerized order entry, which is extremely costly and challenging to implement. He or she is overwhelmed by the grand plan, freezes and does nothing, instead of taking incremental steps to arrive at the goal. Best practice should be about motivation, not intimidation.
So, what's a manager to do?: Join a Knowledge Community
No two organizations have the same clientele, physicians or environment. It follows that knowledge management processes must be as different as the organizations that practice them. The process has to meet the specific needs of the organization and provide managers with experience and knowledge they can use for improvement.
Knowledge communities offer a concrete starting point – a first place for managers to turn when they want to customize a successful practice to the organization and make it an ongoing part of their management style. In discussions with other members of the community, they gather ideas, test hypotheses, solve common problems, compare implementation strategies, and build courage to change and leverage shared knowledge. Available anywhere, anytime through the Web and technology such as teleconferencing, knowledge communities are the 21st century version of the professional society networking experience.
As part of a knowledge community, Baystate Medical Center in Springfield, Massachusetts participates in telephone conferences with eight to ten similar hospitals across the country. Sally Kaufmann, Manager of Rehabilitation Services, explains, “The members of our knowledge community share information on clinical topics that are of interest to us as rehabilitation managers in an acute care setting. As a benchmarking group, we compare data on the types and volume of services we provide and the cost of providing care. And, when clinical questions arise, any member of the community can generate a question and email it to the knowledge community facilitator, who then generates a survey that helps compare information on the topic. For example, we just completed a series of discussions on using whirlpools in the treatment of wounds. The therapy has become somewhat controversial recently, which raised some uncertainty about our current whirlpool practice. Hospitals participating in the discussion completed a pre-conference call survey to compare our programs, followed by a live discussion of specific issues. I then arranged a follow-up call with a member of the network who turned out to be particularly expert in this area. She gave me some solid advice, which helped me create a packet of information for physicians who are referring patients to our whirlpool service. It alerts them to alternatives and recommends a new referral process that may or may not include whirlpool.”
Utah Valley Regional Medical Center in Provo, Utah, a division of Intermountain Healthcare, has been a member of a knowledge community for several years. Ron Liston, Director of Rehabilitation Services, reports, “Periodically, the knowledge community administrator runs a comparison of our hospital with some of our IHC sister hospitals, as well as hospitals throughout the U.S. For example, our inpatient rehabilitation program has been compared against similar units in terms of productivity, cost per unit per discharge and cost per patient day. If you're the most expensive in the group, you can call the other hospitals and learn what they are doing to keep costs down. The procedure is simple. The knowledge community administrator schedules a time for a conference; you call in with a password, and you're on the phone with ten of your peers all discussing your issue.”
Liston has participated in focused phone conferences concerning staffing mix and productivity. “Providing excellent outcomes while increasing staff productivity is always a challenge,” he says, “but when you share knowledge with ten other hospitals, someone always has a creative idea.” He in turn has shared IHC's seven-on-seven-off staffing model which works well in a hospital that provides physical therapy seven days a week. IHC's policy and procedure were posted on the knowledge community's Web site, available for other members to learn from.
Small Steps to Big Goals
Incremental steps are the best way to improve, manage change and make a difference. Knowledge communities simplify the process of adapting and evolving a practice to fit the organization because managers can learn the incremental steps others took to arrive at the goal. Rather than searching for an elusive best practice or finding one too overwhelming to implement, managers can obtain practical information in digestible bite-size pieces. In Scenario 5, for example, a member of a knowledge community might learn that Pharmacy Manager X at Hospital A began by giving the physicians preprinted drug prescription forms. This approach worked well and eventually evolved into computerized order entry.
The healthcare industry has traditionally shied away from obtaining and utilizing external information from other healthcare systems and other industries. A knowledge community makes the process easy and comfortable because the member organizations are not competitors, but span the country. More importantly, a knowledge community expands the collective knowledge of the group and raises the bar for everyone.
“I highly recommend joining a knowledge community,” says Kaufmann. “Busy managers who do not have the time to research topics on the Internet or in the medical library can network with hospitals in different parts of the country. We learn what financial or clinical issues our peers are struggling with or have solved in creative ways. For newcomers, a knowledge community can seem a bit daunting, but once you get in the habit of sharing information, you realize that it's a very valuable educational resource. It's the perfect way to connect with peers on specific business and clinical issues. The time spent is well worth it in the long run.”
“Any organization that is small or lacks a solid peer group needs to belong to a formal or informal group to bounce ideas off each other, ask questions and get answers,” says Liston. “Sometimes we need to go beyond our own organization to learn how others are wrestling with problems that are similar across the industry. I can't imagine being in a single hospital, or even a small group of hospitals, and not having instant access to peers to help deal with questions and concerns of daily operations. It's not just for the benefit of hospital leadership. Department managers or senior physical therapists who are struggling with certain issues can get help from their counterparts in other organizations,” he added.
Solutions for Better Care
Knowledge communities are most successful when the sharing of information and experiences is accessible to the people (often department managers) who can effectively create change. Providing these people with readily accessible peer groups empowers them to learn from others to create solutions for themselves. This in turn expands the organization's ability to change and improve. Everyone in the organization, not just a few executives, are now thinking about the kind of process improvement that will not only better the organization, but enhance the patients' experience, which is what healthcare is all about.
Sidebar:
How to Advance or Doom Knowledge Management
Advance:
·Put knowledge where the action is, the front lines of the organization.
·Leverage internal and external peer-to-peer interactions to grow the collective knowledge of the group.
·Make historical knowledge available – easy to access, readily retrieved.
·Encourage a flexible, risk-taking culture to encourage positive change and growth.
·Maintain organizational curiosity for new ideas to germinate.
Doom:
·Focus on IT as the answer. IT may provide a shell to contain knowledge, but human intervention is necessary to actively manage knowledge exchange.
·Rely on written documents to transfer knowledge. Interactive sharing is to effective knowledge exchange.
·Breed a culture that inhibits action.
·Restrict or convolute access to knowledge.
·Decline to resource knowledge. Knowledge distribution, archival, use, interactions and access will not be valuable unless they are thoughtfully managed and facilitated with appropriate manpower.
·Refuse to participate. Asking for information from others without sharing ideas and information in return creates an unsatisfactory relationship.
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Why the Search for Best Practices Fails
There are five approaches to best practice search and implement missions that strangle management. They all begin with a vague project to find a best practice without any certainty on search parameters or desired outcome. What usually happens is one of the following:
Scenario 1:
The manager cannot find a better performer that is similar to his or her own organization in terms of size, scope, structure, environment, trauma level, profitability, etc. Therefore, there is no one from whom to learn.
Scenario 2:
Hospitals that are insufficiently diverse swap best practices, which then become inbred rigidities or sacred cows. No innovation occurs because there is no diversity in the learning pool.
Scenario 3:
The manager searches and searches for the “holy grail” or elusive best practice. The search continues with no end in sight, and nothing is accomplished. Or, the best practice is found, but never implemented. Searching doesn't bring results. Doing does.
Scenario 4:
The manager at Hospital A succeeds in finding a best practice. Hospital B has standardized on a single vendor for artificial knee implants. The manager copies the practice by standardizing on a single vendor from Hospital A. The result? The physicians revolt because no one was consulted! Or, by signing a two-year exclusive agreement to get a lower price, Hospital B misses out on new advances in orthopedic implants and the high-volume, well-respected surgeon defects. The moral? Best practices are not commodities. Mindlessly mimicking a best practice is a recipe for disaster. Adapt, evolve, customize!
Scenario 5:
The manager finds that the best practice in pharmacies is computerized order entry, which is extremely costly and challenging to implement. He or she is overwhelmed by the grand plan, freezes and does nothing, instead of taking incremental steps to arrive at the goal. Best practice should be about motivation, not intimidation.
So, what's a manager to do?: Join a Knowledge Community
No two organizations have the same clientele, physicians or environment. It follows that knowledge management processes must be as different as the organizations that practice them. The process has to meet the specific needs of the organization and provide managers with experience and knowledge they can use for improvement.
Knowledge communities offer a concrete starting point – a first place for managers to turn when they want to customize a successful practice to the organization and make it an ongoing part of their management style. In discussions with other members of the community, they gather ideas, test hypotheses, solve common problems, compare implementation strategies, and build courage to change and leverage shared knowledge. Available anywhere, anytime through the Web and technology such as teleconferencing, knowledge communities are the 21st century version of the professional society networking experience.
As part of a knowledge community, Baystate Medical Center in Springfield, Massachusetts participates in telephone conferences with eight to ten similar hospitals across the country. Sally Kaufmann, Manager of Rehabilitation Services, explains, “The members of our knowledge community share information on clinical topics that are of interest to us as rehabilitation managers in an acute care setting. As a benchmarking group, we compare data on the types and volume of services we provide and the cost of providing care. And, when clinical questions arise, any member of the community can generate a question and email it to the knowledge community facilitator, who then generates a survey that helps compare information on the topic. For example, we just completed a series of discussions on using whirlpools in the treatment of wounds. The therapy has become somewhat controversial recently, which raised some uncertainty about our current whirlpool practice. Hospitals participating in the discussion completed a pre-conference call survey to compare our programs, followed by a live discussion of specific issues. I then arranged a follow-up call with a member of the network who turned out to be particularly expert in this area. She gave me some solid advice, which helped me create a packet of information for physicians who are referring patients to our whirlpool service. It alerts them to alternatives and recommends a new referral process that may or may not include whirlpool.”
Utah Valley Regional Medical Center in Provo, Utah, a division of Intermountain Healthcare, has been a member of a knowledge community for several years. Ron Liston, Director of Rehabilitation Services, reports, “Periodically, the knowledge community administrator runs a comparison of our hospital with some of our IHC sister hospitals, as well as hospitals throughout the U.S. For example, our inpatient rehabilitation program has been compared against similar units in terms of productivity, cost per unit per discharge and cost per patient day. If you're the most expensive in the group, you can call the other hospitals and learn what they are doing to keep costs down. The procedure is simple. The knowledge community administrator schedules a time for a conference; you call in with a password, and you're on the phone with ten of your peers all discussing your issue.”
Liston has participated in focused phone conferences concerning staffing mix and productivity. “Providing excellent outcomes while increasing staff productivity is always a challenge,” he says, “but when you share knowledge with ten other hospitals, someone always has a creative idea.” He in turn has shared IHC's seven-on-seven-off staffing model which works well in a hospital that provides physical therapy seven days a week. IHC's policy and procedure were posted on the knowledge community's Web site, available for other members to learn from.
Small Steps to Big Goals
Incremental steps are the best way to improve, manage change and make a difference. Knowledge communities simplify the process of adapting and evolving a practice to fit the organization because managers can learn the incremental steps others took to arrive at the goal. Rather than searching for an elusive best practice or finding one too overwhelming to implement, managers can obtain practical information in digestible bite-size pieces. In Scenario 5, for example, a member of a knowledge community might learn that Pharmacy Manager X at Hospital A began by giving the physicians preprinted drug prescription forms. This approach worked well and eventually evolved into computerized order entry.
The healthcare industry has traditionally shied away from obtaining and utilizing external information from other healthcare systems and other industries. A knowledge community makes the process easy and comfortable because the member organizations are not competitors, but span the country. More importantly, a knowledge community expands the collective knowledge of the group and raises the bar for everyone.
“I highly recommend joining a knowledge community,” says Kaufmann. “Busy managers who do not have the time to research topics on the Internet or in the medical library can network with hospitals in different parts of the country. We learn what financial or clinical issues our peers are struggling with or have solved in creative ways. For newcomers, a knowledge community can seem a bit daunting, but once you get in the habit of sharing information, you realize that it's a very valuable educational resource. It's the perfect way to connect with peers on specific business and clinical issues. The time spent is well worth it in the long run.”
“Any organization that is small or lacks a solid peer group needs to belong to a formal or informal group to bounce ideas off each other, ask questions and get answers,” says Liston. “Sometimes we need to go beyond our own organization to learn how others are wrestling with problems that are similar across the industry. I can't imagine being in a single hospital, or even a small group of hospitals, and not having instant access to peers to help deal with questions and concerns of daily operations. It's not just for the benefit of hospital leadership. Department managers or senior physical therapists who are struggling with certain issues can get help from their counterparts in other organizations,” he added.
Solutions for Better Care
Knowledge communities are most successful when the sharing of information and experiences is accessible to the people (often department managers) who can effectively create change. Providing these people with readily accessible peer groups empowers them to learn from others to create solutions for themselves. This in turn expands the organization's ability to change and improve. Everyone in the organization, not just a few executives, are now thinking about the kind of process improvement that will not only better the organization, but enhance the patients' experience, which is what healthcare is all about.
Sidebar:
How to Advance or Doom Knowledge Management
Advance:
·Put knowledge where the action is, the front lines of the organization.
·Leverage internal and external peer-to-peer interactions to grow the collective knowledge of the group.
·Make historical knowledge available – easy to access, readily retrieved.
·Encourage a flexible, risk-taking culture to encourage positive change and growth.
·Maintain organizational curiosity for new ideas to germinate.
Doom:
·Focus on IT as the answer. IT may provide a shell to contain knowledge, but human intervention is necessary to actively manage knowledge exchange.
·Rely on written documents to transfer knowledge. Interactive sharing is to effective knowledge exchange.
·Breed a culture that inhibits action.
·Restrict or convolute access to knowledge.
·Decline to resource knowledge. Knowledge distribution, archival, use, interactions and access will not be valuable unless they are thoughtfully managed and facilitated with appropriate manpower.
·Refuse to participate. Asking for information from others without sharing ideas and information in return creates an unsatisfactory relationship.
Knowledge Quest, Inc. And Homeschooling ABCs. Resources For Home Educators.
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