Preparing
for Conversations
with Józefa Fawcett
On the Operational
Level of Knowledge Management
Józefa
Fawcett, Chartered MICPD, MIHM, MinstLM
Independent
Knowledge Development Consultant
Co-founder, KnowledgeWorx Ltd., Beconsfield, Great Britain
 Biography
Józefa
Fawcett's commitment to Knowledge Management (akin to PKM) comes
from over 28 years of practical experience of working as a make-up
artist, national promotions, sales, recruitment, healthcare,
training and management roles across a range of well known UK-based
organisations in the public and private sector. She has a deep
interest in the interrelationship between individuals and teams
and in enabling managers to understand how to value this wealth
of knowledge within the organization - which she sees as fundamental
to performance management systems and Organisational Development
(OD) success.
She has written a number of articles on Knowledge Management
(KM) and is an enthusiastic and experienced speaker across the
subjects of Knowledge Management, Knowledge Development, eLearning
and Shared Services, not only at conferences but also in her
capacity as visiting lecturer for the University of Westminster,
London. Józefa is a member of the UK-based Institute of
Healthcare Management (IHM) and sits on their Regional Council
(London) and National Education Committee. She is also set to
join the Brussels-based Board of the European Consortium for
the Learning Organisation (ECLO) in October 2004.
She works at mainly operational level with middle managers and
teams on ways to explore knowledge-sharing and utilization of
workforce expertise. She is currently working on a variety of
projects which have knowledge-sharing, knowledge-creation and
knowledge-development implications, these include:
- Creating
an online Knowledge-sharing space for a UK-wide Professional
Healthcare Institute
- Establishing
a knowledge-development and job-creation scheme across West London's
unemployed community
- Implementing
eLearning programmes to support new healthcare workers in two
major hospitals in London
Keeping
up to date professionally is of paramount importance to her,
and over the last 12 years she has attained no less than six
different professional qualifications, finally being awarded
a Post Graduate Master of Arts (MA) degree in Strategic Human
Resource Management.
As
a result of her rigorous program of Continuing Professional Development,
she is eligible to hold full professional membership of:
- The
Chartered Institute of Personnel and Development (currently upgrading
to Fellow)
- The
Institute of Training & Organisational Learning (Fellow application
pending)
- The
Institute of Healthcare Management
- The
Institute of Leadership and Management
Józefa
is an enthusiastic contributor to at least four online communities/discussion
forums and has just started experimenting with weblogs, maintaining
two separate sites to support her professional work and personal
learning journey.
She
comes to AOK with a personal and pragmatic view of KM (PKM) and
is interested in sharing her views of practical applications
with those who wish to share theirs.
Click here for larger image
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Opening
Remarks and an Invitation
Why do I want to
converse with other AOKers?
Well,
I work at an operational level with regards KM (personal knowledge
management PKM, knowledge-sharing KS, knowledge-creation KC,
knowledge development KD) and am interested in other examples
of successful implementation and outcomes from such initiatives.
I
make no apology for my pragmatic approach, nor my use of somewhat
simple language and invite entertaining dialogue and hopefully
personal enlightenment with a view to offering others the same.
So
that you can position me and the context in which I work, some
facts..
- I
hold no position of power.
- I
have never worked in a large multi-national organisation.
- I
have never been fortunate enough to have my ideas listened to
by organisational strategists within the organisations I have
worked in.
- I
have never written a book (though I did have some small articles
published in journals).
My
most recent experiences are with the UK Public Healthcare sector,
but I can draw upon over 15 years private sector experience during
the 70's and 80's.
Does
the above mean that my knowledge and expertise is worthless?
I
would say perhaps not, but my experiences tell me different.
In
the public sector, hierarchies can often deny innovation, rather
than welcome it, and I have the scars to prove it. For me knowing
what the recipe is, understanding it will come out different
every time because of subtle changes in the ingredients and adapting/applying
this is knowledge management and mobilisation.
I
would like, during these two weeks, to invite examples of case
studies (both failures and successes) of where KM has been applied
and how this is being measured; to revisit old-fashioned words
like 'synergy' and equally old-fashioned concepts like 'quality
circles' and 'action learning sets'; look at how KM is part of
a wider Organisational Development and Changes agenda, just the
sort of areas that brought me into KM in the first place.
Here
is a little nugget often cited in training team building sessions,
maybe our starter for 10?
Coming
together is a beginning
Working together is progress
Keeping together is a success
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Listening
to Learn
Abstract
"The
NHS in the UK is constantly going through change. In this case
study, Józefa Fawcett highlights how Knowledge Management
principles were applied within the Public Health Sector during
2000-2003 as a mechanism to help support individuals manage the
change process. Using an organic KM infrastructure she describes
how a county-wide project in the UK laid the foundations upon
which the health economy could build better cross-organisational
working by listening their own workforce and in so doing, lead
the way towards improved communication, understanding and developments
in service provision and care for patients."
Key
words/ themes
- Knowledge
Management approaches
- Interprofessional
and cross boundary learning
- Change
management
- eLearning
- Signposting
and connections
Listening
to Learn
The Berkshire Healthcare Knowledge Management experience
Let
me briefly introduce you to the National Health Service in the
UK, summarise some of the changes impacting on healthcare provision,
clinical development & training and present a case study
of how a Knowledge Management Centre(nhs) Network across on English
county was developed to encourage a new way of organisational
learning, collaborative working and knowledge-sharing across
professional, organisational and sector boundaries.
The
UK National Health Service became a reality on 5th July 1948,
and over the last 56 years there have been constant changes in
Health Care provision, some of which have caused major organisational
headaches and ongoing Human Resource problems. Financial constraints
over the years have made it impossible to accurately predict
the day-to-day costs of running the NHS as more expensive and
more frequently used drugs are constantly being developed and
public expectations grow. These tensions continue to challenge
senior management and indeed successive governments. The current
government's answer to this was in its White Papers in 19971 and
19982
making clear the aim to build a modern and dependable health
service that provides a fast responsive and high quality service
across all parts of the country. The NHS Plan3 further
outlined a five-stage improvement programme, which included breaking
down barriers between different parts of health and social care
and investing in staff, buildings, equipment and information.
The restructure of the NHS started on 1st April 1999 with the
creation of 481 Primary Care Groups each responsible for the
co-ordination of healthcare provision. After only five months,
two fifths of these were aiming to become Primary Care Trusts
with further responsibilities for developing partnerships in
commissioning and provision. This case study area is made up
of six Primary Care Trusts, one Mental Health and Learning Disabilities
Trust, one Ambulance Trust and two General Hospitals.
- Changes
in the provision of healthcare
The
whole of the NHS is working towards an 'Interface' model of health
care, a fundamental principle of which is to encourage and enable
different relationships between the patient, the clinician and
other clinical professionals. This new relationship - based upon
consensus teams, integrated practice, blended roles, management
integration, mutual acceptance and support for the good of the
whole patient/client - also means a change in leadership and
management styles. Many writers have focused on the strategic
issues around consensus building, integration and collaboration,
Rosabeth Moss-Kanter (1999)4
highlighted that to create world class 21st Century organisations,
what is needed are a range of skills that allow the organisation
to operate either with a 'collaborative advantage' or as a 'collaborative
ambassador', these skills are categorised within three important
elements: Concepts, Competence and Connections
(see figure 1 below).
Click for larger image
To
those in the NHS, this model of collaborative and consensus working
between the professions might seem like an impossible dream,
but it is from this starting point that the idea for the Berkshire
Knowledge Management Centre(nhs) Network originated.
- Various
KM approaches in the NHS
One
definition often quoted is from the Swedish writer Karl-Erik
Sveiby (1999), he says:
Knowledge
Management is an organisation's capacity to influence and create
value from its intangible assets.
While
others have described KM as managing both explicit and tacit
knowledge, what is clear is that few activities depend on knowledge
as much as healthcare management, clinical practice and patient
choice. To date the NHS has spent more energy managing buildings
and money than managing its knowledge. This is now changing,
and there is a major shift to embrace both strands of Knowledge
Management. The traditional strand offering a scientific approach
where the emphasis is on the management of information and the
speed and accuracy of data storage, retrieval and dissemination
and the increasingly popular European strand, concentrating on
a more organic approach and the management and mobilisation of
people and their knowledge utilising this for creativity and
innovation within an organisation. There is however, growing
confusion between Information, which is embedded in tools for
processing data quickly and Knowledge, which is embedded in the
minds of the workforce and depends on a variety of social interactions
to encourage "knowledge harvesting/creation". The key
to any successful KM strategy is to apply a blended KM approach
adopting the best fit for the organisation and its context -
no longer does "one size fit all".
Over
the last few years the NHS in the UK has attempted four distinct
KM approaches (see figure 2) with varying degrees of success.
Click for larger image
- The
HR/OD approach
(most likened to the organic model)
Regular forums were held to raise awareness of how to support
change initiatives through the Human Resource and Organisational
Development professionals. These now are no longer being rolled
out and many HR departments have taken their eye of the KM agenda.
- The
Informatics approach (most
likened to the scientific model)
A considerable amount of work has been undertaken with NHS librarians
across the UK in how to adapt and influence this new environment,
there is also an online National Electronic Library for Health
providing a wonderfully rich resource library, some would say
though that this is now reaching overpopulation and questions
where next.
- The
Research & Development approach (a mix of the scientific
and organic)
A national tool5
was designed to identify ways to increase individual and organisational
research and development capacity and promote systematic take
up of research evidence. This ran for four waves and now has
gone into decline.
- The
Learning Network approach (a
mix of the scientific and organic models)
Regional Learning Networks offered leadership and management
development programmes for non-executive directors and clinical
leaders, learning centres, learning partnerships and beacon sites
for sharing intelligence. This now appears to have been disbanded.
- The
County-wide KM project case study
The
Berkshire Knowledge Management Centre(nhs) Network (KMC) was
established in May 2000 and its origins were from an initial
UK-wide research project undertaken to establish how influential
Organisational Development was in changing health economies.
Arising from the results and analysis, the KMC concept was developed
with its main purpose to: encourage the sharing of knowledge
in a single health economy (some six different healthcare organisations);
to provide signposting across professional, organisational and
sector boundaries; to build up working partnerships for the future
across health and social care and offer a wide range of information
regarding traditional and eLearning opportunities.
The
project's key deliverables between March 2000 and March 2003,
were to:
- Set
up KM Centres around across the county creating local 'Communities
of Practice' each with a 'learndirect' eLearning access point
- Create
an infrastructure (see figure 3) that aligned the KMC Network
with other development going on around the County thus creating
local internal working partnerships
- Market
the provision of eLearning facilities to all health and social
care staff in Berkshire
- Support
eLearning study through the establishment of an eLearning Advisory
Team
- Act
as a 'signposting' service connecting people to other people
so as to fully utilise the vast array of explicit and tacit knowledge
held within Berkshire
- Facilitate
cross boundary working relationships so as to underpin the next
phase of health and social care changes post 2003.
Click for larger image
The
'parachute' analogy was used to represent the way which staff
on the ground could access national and other high level directives
and information (guidelines, learning provision etc..), share
expertise across joined up initiatives and find collaborative
partnerships via their own local supportive framework. Through
'human portals' (the KM intermediaries, who run the Knowledge
Management Centres) staff get advice on how to find information
(electronic and paper), discover what county-wide initiatives
are going on and encourage them to share their local learning
(tacit knowledge). The role of these KM co-ordinators was to
mobilise this knowledge, rather than manage it, and ensure that
those responsible for future decision-making and problem solving
have access to their own talented workforce.
The
health economy already had well established Post-Graduate libraries,
a Corporate Intranet and various organisational and clinically
specific websites. This organic KM approach aimed to build upon
these systems by providing equity of access to all of this information
to healthcare staff particularly those who had limited time or,
in many cases, no access to computers in their day to day work.
It also was to provide a vehicle through which the organisations
themselves could listen to the ideas from their workforce.
In
July 2000, the KMC Network was invited by the health care regional
office to promote a new UK-wide eLearning initiative - a partnership
between the NHS and University for Industry (Ufi) - this led
to the KM Centres becoming licensed 'learndirect' sites for enrolment
onto any of the 700+ products available. This brought much needed
funding to progress the KM side of the project as well.
The
plan was simple, to establish a network of KM Centres in at least
four healthcare organisations across the county during the period
2000 - 2003. Local Implementation Teams (made up of partners
from health, social, independent and voluntary care sectors and
Borough councils) were brought together to oversee the introduction
of each Centre for their own geographical area. An eLearning
Advisory Team was established to address cultural issues associated
with the development of the new learning technologies, and a
Project Advisory Board that reported progress to the Department
of Health via a National eLearning Action Group. As one of 16
eLearning pilot NHS sites across the UK, this particular health
economy was unique in that it was attempting to introduce eLearning
and knowledge-sharing across many sectors on behalf of a whole
health economy that was itself embarking upon major organisational
and structural change. Part funding came from the Department
of Health, the regional office, the local Workforce Development
Consortium and the local organisations themselves.
- Lifelong
Organisational Learning & KM
Each
KM Centre was organised into KMzones, providing:
- A
Reflection Zone with dedicated 'learndirect' computers for eLearning
- An
Information Zone with Internet connections, books and journals
and completed assignments, dissertations and general information
donated by staff
- A
Networking Zone for neutral-space for meetings and protected
learning time
- The
Interprofessional Learning Exchange - place to bring different
professionals together
This
last KMzone was the most exciting because put in place ways to
further promote and encourage collaboration and cross boundary
sharing, including ideas like:
- A
Post-Graduate Advanced Certificate in Change Management (designed,
delivered and accredited in-house using external awarding body)
- KM
SHAREMATCH scheme - offering staff an opportunity to workshadow
any profession they like across sector boundaries
- KM
database capturing information about the talented workforce in
each geographical area
- Development
for Trainers Forum - a supportive network through which members
could reflect upon the latest learning practices and share professional
knowledge
- The
KM Collaborative - For those who are leading KM initiatives whether
it be from a technological, management or social perspective.
This new network wanted to look at how to apply KM principles
to other organisational learning initiatives.
- Challenges
and Constraints
Working
on a project of this scale, that was based upon collaboration
and networking, during a period of such major multi-organisational
restructuring, meant both exciting challenges and very practical
constraints. There was the need to regularly energise some of
the original project champions who, as part of the boundary changes,
found themselves with other more immediate priorities, or in
many cases losing their jobs.
There
was also the need to constantly identify new champions in the
system to support the project -- this was not always easy and
often meant that there was NO local support for this work.
Of
all the constraints, the most significant was attempting to defy
the more traditional approach to cultural change which
was usually top down and in total contrast to this bottom-up
project that wished to inform some of the key decision making
from a purely operational level.
Local
resourcing of the project faltered towards the end of 2003 and,
as a result, many of the innovative ideas were scrapped or fell
into decline. The monitoring groups fell apart and the network
administration and co-ordinating role disappeared with the lack
of funds. The eLearning provision was retained, mainly because
of the interest of staff representative groups who refused to
see this facility disappear. The KM side, however, has all but
gone, and with it the learning from within that could have benefited
the organisations in their improvement and modernisation plans.
Finally,
there was always a danger that as interest in KM grew in the
NHS, the emphasis on classifying and codifying information and
creating online 'library junk yards' would become more important
than developing networking capability. This sadly has been the
case, resulting in huge repositories of information that are
kept for just-in-time (JIT) use, which is both costly and a huge
strain on already creaking IT infrastructures and servers.
For
readers of this case study there will be many questions: Can
you buck the cultural trend of an organisation from within --
should you even try? How do you demonstrate the benefits of learning
in real monetary terms, so that the organisation takes notice?
Should you be looking to develop opportunities for innovative
practice when there is little chance for staff to use this at
their workplace? And what happens to the motivation of the workforce
when their ideas and views are not valued or even known about?
I
leave you to make up your own mind, but here are some of my concluding
thoughts.
This
project focused less upon the mechanics of managing knowledge
and more on the challenge of how to mobilise and effectively
share this knowledge across organisations. Innovations that enable
the workforce to learn and share are hard to maintain, and if
organisational learning is to be successful then the end result
must be a change of cultural fit at all levels. It is not enough
to introduce a website or database, but also to have in place
a plan as to how an organisation can learn to listen so that
they can in turn learn how to change and build the skills needed
to use the knowledge that is being created. This health economy
took a first and important step in crossing what were once traditional
NHS boundaries in learning, knowledge sharing and utilisation
of local intellectual capital - and in so doing might still have
a chance of creating opportunities for the workforce to influence
and inform the future provision of health and social care services
for patients.
Footnote:
Since
writing up this article, renewed interest in realising the potential
in the KMC Network from one of the originating organisations
gives hope that with the support of this newly enthusiastic CEO,
they might still pick up the pieces and build upon what has been
achieved so far, rather than re-invent the wheel. An encouraging
end to the beginning of this story.
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- Article
references, useful websites and background research
1
'Modern & Dependable', Department of Health; 1997
2
A First Class Service', Department of Health; 1998
3
'NHS Plan', Department of Health, 2000
4
Moss-Kanter, R.; Change is everyone's job; Organisational
Dynamics Journal; Summer 1999, pp7-22
5
The 'Knowledge Work Contributions' tool was developed specially
for the Knowledge Management Centre(nhs) Network, by David Simmonds,
author of 'The Evaluation Tool Kit', Fenman Publishing
www.knowledgebusiness.com
www.sveiby.com
www.stevedenning.com
www.trainingvillage.gr
www.knowledgeboard.com
- Allee.
V. 2003, The Future of Knowledge, Butterworth Heinemann
Books
- Argyris.
C. 1993, Knowledge for Action: a guide to overcoming barriers
to organisational change, Jossey-Bass Publications
- Bünz.A.P
& Kirch-Verfuss. G.; "Mapping the value of KM,"
Knowledge Management Journal, Jan 2001 www.ark-group.com
- Iske.
P & Boekhoff. T., "The Value of Knowledge doesn't exist,"
Knowledge Management Journal, Oct 2001 www.ark-group.com
- Lewin.
R, & Birute. R, 1999, The Soul at Work, Orion Business
Books
Stewart. T.A. 2002, The Wealth of Knowledge, Brealey Publications
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