Knowledge Management Seminar Webster University

1. Knowledge ManagementSeminarWebster University Janet Guptill, President KM At Work, Inc.

2. Knowledge Management Seminar Class member introductions What is “knowledge” and what are attributes of valuable knowledge? What is “knowledge management” (KM)? Where has KM been used in companies? What are examples of KM tools and technologies? What are examples of KM results? What are barriers to effective implementation of KM? Small group case study break-outs

3. KM Seminar Outline • What is KM? (slides 5-11) • Fundamentals to drive KM (12-25) • Components of a KM program • Communities (26-31) - CHI • Content Mgt (32-34) – AH • Capability Transfer (35-40) – BSHSI, Christus • Metrics (41-47) – VA, CHI, AH • Infrastructure (48-52) – AFMS • Lessons Learned (53-77) • ROI (65-66) • Case Study Reports (71-76)

4. Playing with words

5. Knowledge Management • What is it? • How does Knowledge get transferred – in general? In an organization? • Why might it be relevant to transfer Knowledge within your type of organization? • What makes this process complex?

6. “Land, labor, and capital now pale in comparison to knowledge as the critical asset to be managed in today’s knowledge economy.” Peter F. Drucker

7. Knowledge Management - A Definition “KM is the systematic processes by which knowledge needed for an organization to succeed is created, captured, shared, and leveraged.” The Complete Idiot’s Guide to Knowledge Management, Melissie Rumizen What does this mean to you??

8. How do these relate to each other? Best practice sharing Knowledge transfer Innovation diffusion Performance improvement

9. Perspectives… “Knowledge transfer is a strategic imperative. It is our stewardship responsibility to share and adopt ‘best practices’ that have already been identified within our system. Knowledge sharing is no longer a ‘nice to have’, it has become a ‘must have’.” - Chris Carney, CEO, Bon Secours Health System, Inc. “Every day that a better idea goes unused is a lost opportunity. We have to share more, and we have to share faster. I tell employees that sharing and using best practices is the single most important thing they can do.” -Ken Derr, former Chairman and CEO, Chevron Corporation What prevents organizations like hospitals from effectively sharing their knowledge?

10. “Ideas and products and messages and behaviors spread just like viruses do.”-Malcolm Gladwell, ‘The Tipping Point’ Perspectives… “Diffusion is the process by which an innovation is communicated through certain channels over time among the members of a social system.” -Everett Rogers, ‘Diffusion of Innovations’ How can we orchestrate how knowledge gets shared within an organization to impact results?

11. Group Exercise • Illustration of knowledge exchange • Class participants describe their organization: • Business type • Size • Type of organization structure • Your role in the organization • Form groups of 4; tell a story (60 seconds) that illustrates the problems that arise from inadequate knowledge sharing • Change groups, tell the same story • Find the person whose story affected you the most • What made these stories compelling?

12. Fundamentals of Knowledge Management LEADERSHIP CULTURE Leadership/Management Culture/People Process Technology TECHNOLOGY PROCESS Developed by: Janet Guptill and Douglas E. Goldstein, 2003

13. Leadership Knowledge transfer will only succeed if accountability and authority are clearly defined and imbedded in existing operational decision making structures.

14. Discussion • How do leaders transfer their Knowledge? • How do they model how others share Knowledge? • What are potential barriers to sharing Knowledge in an organization?

15. Culture Knowledge transfer will only be effective if managers find the process a useful and productive way to meet performance objectives.

16. Discussion • What is an example of organizational culture? • How does culture get shaped? • How does one go about changing an organization’s culture? • How might a KM strategy affect culture – and vice versa?

17. Process Knowledge transfer must become the way performance is awarded and managed, not an “extra” task or process.

18. Transferring knowledge is often not enough; need to figure out how to transfer capabilities as well through human and technology enabled support systems • Getting an organization to adapt new ideas requires a process of re-invention—people need to own the result as their own idea-- 10 Critical Dynamics of Innovation Diffusion: • Relative Advantage • Trialability • Observability • Communications Channels • Homophilous Groups • Pace of Innovation/Reinvention • Norms, Roles, and Social Networks • Opinion Leaders • Compatability • Infrastructure Source: Diffusion of Innovations, Everett Rogers, 1995

19. Basic Steps to Innovation Diffusion-- Set goals, look for solutions Evaluate alternatives Clarify, implement Evaluate, confirm, routinize Decide: adopt, reject, redefine, restructure Centralized/Decentralized Continuum to Diffusion Process-- Dedicated execution resources Mandated targets Mgt endorsed best practice Performance linked to transfer success Proscribed approach Centralized: Awards, incentives Knowledge exchange Peer consultation Scorecard results Decentralized: CoP best practices Developed by Janet Guptill and Douglas E. Goldstein, 2003, adapted from Diffusion of Innovations, Everett M. Rogers, 1995

20. Technology Managers will need to develop an “electronic attitude” which will require an investment in collaboration technology infrastructure, and training and modeling on how to work in a new web-centric manner.

21. Leadership Goals Internal/External SME Support Community Member SMEs • Sharing & Supporting • Adapting Best Practice & Innovation Database (Web) Web and Multi-media Technology • Intranet critical for supporting KTPI • Best Practice DB of Resources, Assets & Tools

22. Connecting people through online/offline communities of practice involves building a set of tools that simplify communication, link people to content, and provide measurements of value and impact-- Key Technology Considerations for Supporting Communities of Practice • Presence and visibility • Rhythm • Variety of interactions • Efficiency of involvement • Short-term value • Long-term value • Connection to the world • Personal identity • Communal identity • Belonging and relationships • Complex boundaries • Evolution: maturation and integration • Active community-building Source: Etienne Wenger, Supporting Communities of Practice, March 2001

24. Leadership and Management People/Culture Technology Process

25. Health System KM Examples… • Catholic Health Initiatives — 67 hospitals in 19 states, 67,000 employees, $6 billion annual operating revenues – focus on Knowledge Communities • Ascension Health —67 hospitals in 20 states, 100,000 employees, $9 billion annual operating revenues – focus on Content Management • Bon Secours Health System Inc. – 24 hospitals in 8 states, 27,000 employees, $2.3 billion annual operating revenues – focus on Capability Transfer • CHRISTUS Health –34 hospitals in 5 states and Mexico, 25,000 employees, $2+ billion annual operating revenues – focus on Best Practices Knowledge Transfer • Veterans Health Administration — 23 integrated service networks, $24 billion in annual operating expenses – focus on Tracking and Metrics • Air Force Medical Service –74 hospitals and clinics distributed all over the globe, $6.2B expenses, 39,000 employees – focus on technology and support infrastructure

26. Community Operations and Support • Sponsorship, facilitation, support, accountability, and authority • 2. Integration with Strategic Plan • 3. Member participation, roles, and guidelines; naming conventions; content ownership • 4. Communities of Practices (CoP) start-up, operations and sunset

27. Vision for Knowledge Management at CHI To improve the quality of our health care system, by enhancing the ability for CHI to access and share actionable information, and creating a culture that allows every part of CHI to have the strength and wisdom of the whole.

28. CHI KM Strategy: Focus is on supporting… Knowledge Communities with the intent to integrate knowledge sharing & learning into the CHI organization.

29. Examples of CHI Knowledge Communities – 4 Types

31. Quotes from various CHI Knowledge Community Members • “I am learning practical skills, such as how to get people to volunteer, that I could not have done as effectively without the insights and lessons learned that have been shared in this learning group.” • “This Healthy Communities Course is a rich treasure trove of resources; there is no way, with my busy schedule, that I could possibly have pulled together this set of reference documents on my own, much less have created such a valuable peer learning group with similar values and goals.” • “There would be a rebellion if we disbanded this group.” • “This is the value-add of belonging to a national system.”

32. Content Management 1. Build and manage virtual library of knowledge assets and resources 2. Content accuracy, currency, and linkage to Strategic Plan 3. “Best practices” vetting process 4. Alerts & content tailored to Communities 5. Search, retrieval, and use 6. Public /private sharing 7. Innovation / leading practice identification and profiling

33. Ascension Health Exchange Home

34. Search…of internal resources is always available! Community specific Alerts, Calendar, Surveys and Private Database are Available Special Collaboration Tools to facilitate sharing and problem solving CNEs from local hospitals serve as Mayors and Topic Leaders for critical issues

35. Knowledge and Capability Transfer 1. “Triage” and “diagnostic” processes to apply successful practices 2. Extending human resources (internal/external SMEs) 3. Replication processes and resources 4. eLearning tools and system 5. Integrated Performance Improvement staff and resources

36. Approaches for Embedding Knowledge Management Dedicated execution resources Performance linked to transfer success Proscribed approach Mandated targets Mgt endorsed best practice Centralized: Strategic Goals, performance incentives Tools and resources posted on intranet Peer SME, and external consultation Performance Reporting on intranet to strategic targets Decentralized: CoPs “vet” best practices Example-- Year 1: Focus on Centralized diffusion: top-down “push” Year 2: Expand functions and number of KM efforts based on strategic priorities – use mix of diffusion strategies Year 3: Decentralized (pull; peer-to-peer). KM is woven into the culture Developed by: Janet Guptill and Douglas E. Goldstein, 2003

37. Bon Secours Health System - Pilot

38. Increasing Retention Rate DMAIC Execution - Quality Project Tracker ¨ ý Problem Statement: CTQ: Retention Rate BB Project GB Project Defect: < 80% Annual Turnover Rate Of 28% In ‘97 Too High Champion: Sunita Holzer Beginning DPMO: 720,000 MBB: Brian Swayne Final DPMO: 242,000 Project Scope: Project Leader: Sunita Holzer Estimated Benefits: $ 200,000 John Kenny, Josh Friedlander See Process Map - HR Dept. Process Impacts On Employee Life Cycle Team: Actual Benefits: Jane Decolvenaere, Rocco Cocchiarale $ 908,000 Define Measure Analyze Improve Control • Start Date: 3/1/98 Assemble Team & Assign Roles • ID Project Scope • Develop Team Charter • Create Project Timeline • ID Customer CTQ’s • ID Compliance CTQ’s • High Level Process Map • Estimate Benefits • Formal Champion Approval • End Date: 5/30/98 • Start Date: 5/30/98 • Select Key Product/Process • Create Product Tree/Process Map • Define Performance Variables • Baseline Performance Measures • Develop & Execute Data Collection Plan • Formal Champion Approval • End Date: 6/30/98 • Start Date: 5/30/98 • Map CTQ’s to Function/Process • Select Key Performance Variable/Sub process • Benchmark Performance • ID Variation Sources & Improvement Opportunities • Root Cause Analysis • Define Performance Objective • Formal Champion Approval • End Date: 6/30/98 • Start Date: 5/30/98 • Diagnose Variable Performance • Establish Operating Tolerances • Develop Solution • Cost Benefit Analysis • Develop & Implement Execution Plan • Formal Champion Approval • End Date: 9/1/98 • Start Date: 6/30/98 • Validate Control System • Develop & Implement Monitoring Plan • Implement Sustainable Process Controls • Develop & Deploy Response Plan • Standardize & Translate • Net Income Benefit Tracking System In Place • Formal Champion Approval • End Date: 12/15/98 Tools/Attachments: Tools/Attachments: Tools/Attachments: Tools/Attachments: Tools/Attachments: • Charter • High Level Process Map • CTQ Matrix • HR One Page Plan • Sigma / DPMOCalculations • HR One Page Plan • Sigma / DPMOCalculations • WorkforceOptimization • Monthly RetentionTracking Tool & Review • Directions: • Replace All Of The Italicized, Blue Text With Your Project’s Information • Fill in ýþ by clicking on item then clicking on Format / Bullet… / then clicking onýþ as appropriate (look in the lower right hand corner for ýþ symbols) • Not Complete • Complete • Not Applicable Author: Sunita Holzer Date: December 16, 1998

39. CHRISTUS Intranet for Sharing

40. CHRISTUS Best Practice Sharing The 2003 winners include: Clinical QualityCHRISTUS Medical Group – CHRISTUS Southwest Community Health Center in Houston: Diabetes Management in an Immigrant Population Service QualityBaptist St. Anthony Health System: How We Got to 90 Percent in Patient Satisfaction and Stayed There Business LiteracyCHRISTUS Health Ark-La-Tex – CHRISTUS St. Michael Health System: Linen Management Program Community ValueCHRISTUS Spohn Health System - CHRISTUS Spohn Hospital Alice: Jim Wells County Healthy Families Project: Domestic Violence Program Spirit ExchangeCHRISTUS Health Gulf Coast – CHRISTUS St. Catherine Hospital: Up-Front Cash Collections

41. Tracking and Results Metrics 1. Linkage to Strategic Plan 2. Dashboard and performance reporting 3. KTPI effectiveness measures 4. Tied to formal and informal rewards 5. Technology infrastructure and reporting module

42. “VHA’s integrated health information system, including its framework for using performance measures to improve quality, is considered one of the best in the nation.” Institute of Medicine (IOM) Report, Leadership by Example: Coordinating Government Roles in Improving Health Care Quality (2002)

43. Drivers for health • Maximize the health & abilities of all persons, incl. 26M veterans & esp. 4+M needing care • Maximize satisfaction • Maximize quality of health care • Maximize accessibility & portability of care • Maximize affordability to key stakeholders • Maximize patient safety & minimize system “defects” (defects/errors to zero) • Minimize time between disability & illness and maximized function & health (time to zero) • Minimize inconvenience (inconvenience to zero) • Maximize security & privacy

44. CHI Benefits & Measurable Outcomes • Increase in the # of supported KC’s • From 3 pilot KC’s to 40 KC’s • 19 Potential KC’s • eLearning impact • 98% of MBOs utilizing LMS for compliance education • Cost savings from utilizing on-line learning for mandatory education • Cost Savings • Pharmacy Therapeutic Initiatives program: $17M • Pharmacy Community & Xigris Cost Avoidance • Decreased travel and labor costs from increased use of web-conferencing tools: 10:1

45. CHI Knowledge Community Evaluations • KC Satisfaction examples • Pharmacy • 75% agree the program has increased communication & sharing • Cost Accounting • 68% agree has helped to do job better • 66% agree improved relevant knowledge sharing • Healthy Communities Course • 100% agree that what they learned through the course will improve their daily work

46. It works! ↑system wide safety ↑system wide access ↑ customer centric service design ↑ time with the patient ↑ ability to retain and recruit ↑ revenue, ↑ margin, ↑ market share,↑ capital resources ↓ duplication, ↓ waste, ↓operating costs Patient Physician Ministry Sponsor Partner Satisfaction

47. Barriers to Effective Knowledge Transfer Differ by Stage of Transfer Process Legend: **p<.01 *p<.05 +p<.10 Source: Sticky Knowledge – Barriers to Knowing in the Firm, Gabriel Szulanski, Sage Publications, 2003

48. Exchange and Support Center 1. Technology infrastructure, applications and user interface 2. Support systems and staffing for operations, evolution and results reporting 3. Knowledge and resource library/database levels 4. Alignment and integration with Intranet and eLearning Systems

49. Expertise Locator Document Repository People with Known Expertise & Know-how Collaboration Areas Keywords, Concepts & Phrases Learning Mgmt System Threaded discussions, email, etc. SCORM (Learning Objects) Hierarchical Site Map All Documents Related to the Node (Explicit) External Links related to the Node (Explicit) Education & Training Topics Relevant to the Node (Explicit) Communities and Affinity Groups within the Node (Tacit) People with Experience & Know-how Concerning the Node (Tacit) Collaboration Concerning the Node’s Business (Tacit) Enterprise Taxonomy Knowledge Junction AFMS Knowledge ExchangeExecution Strategy Knowledge Junction TM Concept

50. How do I make my knowledge workers more productive? • How do I bring new employees up to speed more effectively? • How can I support geographically distributed cross-functional teams? • How can I increase team productivity and decrease cycle times? Knowledge Portals Collaborative Workspaces • How can I leverage the expertise resident in the organization? • How do I minimize costly rework? • How can I ensure that everyone knows what we know and where to find it? Expertise Location Communities of Interestand Practice • How can I form more effective teams with the appropriate skill sets? • How do I capture the tacit knowledge of my retirees? Adapted from Newell, 2002