Sharing the right information

An after action review is a tool used following the completion of an activity and shows whether anything could have or should have been done differently.

Also known as a post project appraisal, this is a process developed by the United States (US) Army to help teams to learn quickly from their successes and failures and share their learning with other teams.

It involves conducting a structured and facilitated discussion after a task or project has been completed to review what should have happened, what actually happened and why it happened; this allows participants to learn how to sustain strengths and improve on weaknesses in subsequent tasks or projects.

Definition from Department of Health Knowledge Management Framework.

Reference: Knowledge management at WHO C Bailey 2005, World Health Organization.

More information

This postcard describes the After action review tool in words and pictures.

View the NHS Knowledge Mobilisation Framework elearning module on after action reviews.

A before action review is a tool which can help a team state their intention (task, purpose and end-state) just before commencing a piece of work.

It also adds the discipline of predicting challenges and risks and, most important, drawing on lessons learned from past experiences.

More information

This postcard described the Before action review tool in words and pictures.

View the NHS Knowledge Mobilisation Framework elearning module on before action review.

A community of practice (CoP) is a method of sharing knowledge and helping colleagues share ideas, question and learn.

Definitions

”Communities of practice are groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise in this area by interacting on an ongoing basis.”

From page 4 of Cultivating communities of practice by Etienne Wenger, Richard McDermott and William M Snyder and published in 2002 by Harvard Business School Press.

A CoP shares a specific interest that becomes a source of identification. This identity creates a sense of commitment to the community as a whole, not merely connections to a few linking nodes.

A CoP is about creating a ‘doing and learning environment’ for a network of individuals with common problems or interests who get together to:

• explore ways of working
• identify common solutions
• share good practice and ideas
• learn

"Typically they pool resources related to a specific area of knowledge to support more efficient and more effective practices." From Communities of Practice on NHS Scotland's Quality Improvement Hub.

More information

This postcard described the Communities of practice tool in words and pictures.

See the NHS Knowledge Mobilisation Framework elearning module on communities of practice.

Enabling change through communities of practice - a learning paper by National Voices for more information on CoPs and practical advice.

Knowledge Cafes encourage productive conversations to help people learn from each other. They can help people to solve problems, break down silos, drive innovation and build a community.

The value of the Cafe is in the conversation itself and the learning that each individual takes away.

More information

This postcard describes the Knowledge Cafe tool in words and pictures.

View the NHS Knowledge Mobilisation Framework elearning module on Knowledge Cafes.

World Café

The World Café was established in 1995 as “a powerful social technology for engaging people in conversations that matter, offering an effective antidote to the fast-paced fragmentation and lack of connection in today’s world.” 

The website describes the 7 design principles and links to research, impact, resources and a community.

Visit the World Café website.

Action plan

Follow the format below to create an action plan for your own knowledge café.

• Is there a current issue that I want to explore via a knowledge café?
• Who will I invite to take part? (16-32 people works best)
• Who will I ask to facilitate? Speak to your local Library and Knowledge Service representative who will be happy to help
• Where will I hold the café? Will the room be large enough?
• How will I create a relaxed environment? Think about groups of tables and chairs, as well as refreshments
• When will I hold the café?
• Will I record the session in some way? This could be through illustration, film or photographs
• Will I ask someone to introduce the them? If you do, ensure you ask them to keep it short
• What powerful question will I use?

Knowledge exchange is a tool used to establish the level of knowledge being exchanged with different people with whom you have relationships.

Taking place when someone is moving on from their current position, it aims to recover unique and valuable information from them before they leave.

The knowledge exchange occurs between a knowledge holder and a facilitator. The knowledge holder is the person who is departing.

The facilitator is typically a line manager or trusted team member, who is close to the leaver and can ensure the questioning is of sufficient depth and relevance.

Ideally, the knowledge exchange will also involve the person replacing the knowledge holder or carrying out the tasks they leave behind. They will benefit from any useful tips and knowledge and from asking their own questions.

For more information see Knowledge management tools and techniques: helping you access the right knowledge at the right time

What are the benefits?

When staff leave an organisation they take with them the vital knowledge, experience and contacts they have built during their time there.

The organisation suffers if this information is not passed on before they leave.

Estimates suggest it takes at least 6 months before a new recruit contributes effectively to the organisation. Including checks of handover notes through the appraisal process protects organisational memory.

If a local authority adopted this approach, time and money saved per year would equate to between 10 and 100 posts.

Many organisations will already have some informal process in place to capture the knowledge of leavers. However, the best efficiency gains come from a formalised, structured knowledge exchange process.

How do I go about it?

Use a quick and dirty process

You will need you and the team, in a room, for an hour. The team draft ‘top 10 things we want to know about X’. You simultaneously draft ‘Top 10 things you need to know about X’. 

Bring lists together, work through and answer questions there and then. This ensures the crucial knowledge is exchanged in a short space of time, no lengthy documenting. 

The team are responsible for capturing their own notes.

Use a facilitated process

This methodology is based on work developed in the public and private sectors by knowledge management experts. It has 5 steps.

1. Two days prior to the knowledge exchange, the knowledge holder receives a copy of the knowledge exchange questions
2. The facilitator follows these questions as a guideline, but they are best used as a means to focus on the 4 key areas of work: general, key operational information, people and people skills, and lessons learned and 'pattern recognition'
3. Relationship mapping (see below) provides an overview of the relationships the knowledge holder has with key contacts in the organisation
4. The facilitator must then decide the best way to package this knowledge for the organisation. This may include: drawing up instructional guidelines, mapping business processes, producing a list of useful contact information and relationships, and recording as audio or film some of the knowledge holder’s information
5. The facilitator may then choose to upload this information onto the team intranet, team shared drive, or save as a standalone file for future reference

This process should be included in the performance appraisal process to eliminate risk of loss of knowledge to the organisation when staff leave.

Relationship Mapping Guide

To create a relationship map, please use an A4 plain piece of paper.

1. In the centre of the paper draw a small circle or oval and write your name in the centre
2. Start mapping from the centre to the people, teams and organisations that you have relationships with in your working life. Please use full names and team titles
3. The closer to the centre of the page, the closer the relationship is
4. By drawing lines with different thickness you can demonstrate the amount of dialogue between the relationships

Solid lines with no arrows show a general contact. A dotted line with no arrows show an occasional but relevant contact. One-way arrows show a one way flow of information. Two-way arrows show a 2-way flow of information. A squiggle line shows a difficult relationship.

The thickness of the line shows the volume of information being exchanged. The thicker, the more information. The length of the line indicates the frequency of the contact. The shorter the line the more frequency of interaction with the contact.

Lessons learned can help you to communicate how to avoid mistakes and improve processes.

They are concise descriptions of knowledge derived from experiences, that can be communicated through mechanisms such as storytelling, debriefing, or summarised in databases.

These lessons often reflect on “what we did right,” “what we would do differently,” and “how we could improve our process and product to be more effective in the future" - definition from Knowledge Management Specialist Library.

More information

Read more about Lessons Learned Logs on the NHS Scotland Quality Improvement Hub.

Read an article on Lessons Learned in Efficacy Research and Challenges to Blending Research and Practice on the National Center of Biotechnology Information website.

Peer assist is a tool where people from other business units or other businesses share their experience, insights and knowledge to a team who have requested help.

What are the benefits?

Peer assists are part of a process of what British Petroleum (BP) calls “learning before doing”, in other words gathering knowledge before embarking on a project or piece of work, or when facing a specific problem or challenge within a piece of work.

The benefits of peer assists are therefore quickly realised: learning is directly focused on a specific task or problem, and so it can be applied immediately.

A peer assist allows the team involved to gain input and insights from people outside the team, and to identify possible new lines of enquiry or approach – in short, reusing existing knowledge and experience rather than having to reinvent the wheel.

They also have wider benefits including promoting the sharing of learning between teams, and developing strong networks among people.

Peer assists are relatively simple and inexpensive to do as they do not require any special resources or any new, unfamiliar processes.

It is worth using a peer assist when a team is facing a challenge, where the knowledge and experience of others will really help, and when the potential benefits outweigh the costs of travel.

How do I go about it?

There is no single right way to hold a peer assist. The following is a method that has worked well for BP.

1. Clarify your purpose. Peer assists work well when the purpose is clear and you communicate that purpose to participants. Define the specific problem you are seeking help with, and be sure that your aim in calling a peer assist is to learn something (rather than seeking endorsement for a decision you have already made)
2. Has the problem already been solved? – Do some research to find out who else has already solved or tackled a similar problem. Also, share your peer assist plans with others, as there may be other teams who are currently tackling a similar problem who could also benefit from participating in the peer assist
3. Get a facilitator. You will need a facilitator from outside the team, to make sure the meeting participants reach their desired outcome. The facilitator also may or may not record the event. You must ensure you agree on that before the meeting
4. Timing is important. Ensure that you plan a date for the peer assist that is early enough in your project to make use of the input you receive and to do something different on the basis of what you have learned. A frequent mistake is to hold the meeting too close to the decision date to make a real impact. Consider that you might get a different response to the one you expect. Will you have time to do anything about it?
5. The length of a peer assist depends on the complexity of the problem and tends to be somewhere between half a day and 2 days long

Next steps

Select the participants

• Once you are clear on your purpose, select participants who have the diversity of knowledge, skills and experiences needed for the peer assist. 6 to 8 people is a good number
• Look “across” the organisation rather than “up” it. Hierarchies can hamper the free exchange of knowledge whereas peers tend to be much more open with each other and can challenge without feeling threatened
• Avoid the temptation to select “the usual suspects”. If the same experts are selected for peer assists again and again, you may be limiting the number of fresh ideas and perspectives available to you
• Similarly, seek to select people who will challenge your ways of thinking and working and perhaps offer a different angle, rather than looking for people who will validate your current approach. You might consider inviting people from outside your organisation

Get clear about the deliverables

• Be clear about what you hope to achieve during the peer assist and then plan the time to achieve that
• The deliverables should comprise options and insights rather than providing an answer. It is up to the person or team who called the peer assist to then make the relevant decisions, based on what is learned
• Provide the participants with any briefing materials in advance so that they have adequate time to prepare
• Allow time for socialising. Allow time in your agenda for the teams to get to know one another; this might be a dinner the night before or time for coffee at the start of the day. It is important to build rapport so that the group can work openly together

Define the purpose and set the ground rules

• At the start of the meeting, ensure that everyone is clear about the purpose of the peer assist and their roles within it
• The role of the host team is to listen in order to understand and learn. The role of the visiting team is to share knowledge and experience to help resolve the challenge without adding to the workload
• Agree that where there are areas of contention, you will focus on the activity rather than the individual people involved

Start by sharing information and context

• Divide the meeting time roughly into four equal parts. During the first quarter, the host team will present the context, history and their future plans regarding the problem or challenge in question. Keep this part short and sharp – you only want to say enough to get the visiting team started in the right direction. Remember that the purpose of the peer assist is to learn rather than tell
• When communicating the problem or challenge about which you are seeking input, be prepared for it to be redefined as part of the peer assist process. It may be that the problem you have identified is in fact the symptom of a further problem and the peer assist will help you identify the root cause

Encourage the vistors to ask questions and give feedback

• In the second quarter, the visitors consider what they have heard, and then begin by discussing what they have heard that has surprised them, and what they expected to hear but haven’t
• The host team should take a back seat at this stage and simply listen; in some cases they may even opt to leave the room. The visitors then consider what else they need to know to address the problem and where might they find that knowledge
• It may be that they want to make some telephone calls and talk to some other people, or request some data or reports. Remember, they are not seeking to solve the problem but to offer some options and insights based on their own knowledge and experience

Analyse what you have heard

• The third quarter of the meeting is for the visiting team to then analyse and reflect on what they have learned and to examine options
• Again, the home team remains largely in the back seat; it might be appropriate to involve one or two of them, provided that they continue to listen and learn rather than closing off options or seeking to draw conclusions too early

Present the feedback and agree actions

• In the fourth and final quarter of the meeting, the visiting team presents their feedback to the host team and answers any questions
• The presentation will be along the lines of “what we have learned, what options we see, and what has worked elsewhere”. As with all feedback, this should start with the positive – what has been done well, and then what options there are to do things differently
• When presenting what has worked elsewhere, presenters should simply tell the story rather than prescribing “you should…”
• The person who called the peer assist should acknowledge the contribution of the visiting team, and also commit to when he or she will get back with an action list of what the team are going to do differently
• Finally, invite the visiting team to reflect on what they have learned and what they will take away and apply. Learning is never one-way

Are there any other points I should be aware of?

• In the context of the NHS, an important consideration is that of evidence-based practice. When conducting peer assists, you will need to ensure that lessons learned are based on a combination of both on-the-job experience and sound research evidence
• You might wish to carry out an After Action Review following your peer assist to look at whether the process went according to plan, what was different and why, and what can you learn from that for the next time
• While the peer assist process is designed to provide input for a specific purpose or project, consider who else might benefit from the lessons learned. Always look out for opportunities to share and re-use knowledge and learning

More information

This postcard described the Peer Assist tool in words and pictures.

View the NHS Knowledge Mobilisation Framework elearning module on Peer Assists.

Randomised coffee trials are a tool which enables individuals who are paired at random talk to each other and exchange knowledge.

They give people the opportunity to meet and connect with each other at random, giving them time to talk about whatever they wish, perhaps over a cup of coffee.

They can:

• build relationships
• improve communication
• encourage collaboration
• help share knowledge and ideas

More information

This postcard describes the Randomised Coffee Trial tool in words and pictures.

View the NHS Knowledge Mobilisation Framework e-learning module on Randomised Coffee Trials.

Read a blog post by the National Endowment for Science, Technology and the Arts (Nesta) about institutionalising serendipity and productive coffee breaks. 

Plan your own randomised coffee trial

• What is the purpose of my coffee trial? For example, icebreaker, support integration of new staff, improving cross organisational communication or themed topic
• Who is your target audience? For example, one site, multiple sites, do you include patients or external audiences, meeting attendees
• Which senior leaders/teams will I contact to support the randomised coffee trial?
• Who will I contact to help organise this? Speak to your local Knowledge and Library Services representative will be happy to help
• How will I market the event? For example Twitter, newsletters and postcards
• When will I promote and re-promote?
• When will I randomise pairs?
• When will I notify pairs?
• Length of time needed for the randomised coffee trial?
• When will I send a reminder?
• When will I send feedback?
• How will I evaluated?
• How and when will I share the success stories and feedback?

This list was adapted from: Smith, S (2016) Making Time for a Coffee Trial Handout shared at Knowledge Management Study Day, York Accessed online 20 April 2018.

Questions to help get a conversation started

Here are some prompts to help you to identify knowledge at risk.

1. What do you think is the most important knowledge in your current role, which is not commonly known by team members?
2. Which activities require specific skills that other, less experienced individuals may not have?
3. Are there specific, software, tools, techniques you frequently use that others may not be familiar with?
4. Are there pressing issues (decisions, threats, opportunities, events) specific to your role, which need to be resolved urgently?
5. Are there any dormant issues that need to be dealt with in the long term?
6. Are there any specific people skills you bring to bear which help you get the job done/resolve problems?
7. Who are your key contacts (internal or external) for expert advice, decisions, permissions? Are these known to other members within the
8. Team?
9. What is most likely to go wrong and how do you usually respond?
10. What is the key documentation in your role? Is this readily available to the Team through a shared drive or intranet?
11. Are there any unexploited ideas or potential improvements/innovations you want to mention?
12. Is there anything else in relation to this role that we haven’t covered and we should be aware? For example, lessons learned, particular challenges.

These questions were prepared by Susan Smith and adapted with permission from a tool originally created by the NHS Institute for Innovation and Improvement Knowledge Management Team.

Rapid onboarding is the process of engaging with your new starters/users, bringing them up to speed quickly and easily.

It ensures they acquire the necessary knowledge, skills and behaviours to become effective organisational members.

This could also include, where applicable, utilisation of knowledge captured from departing staff members in the knowledge retention and transfer interview.

Tools

Rachel Cooke at Surrey and Sussex Healthcare NHS Trust has developed a Leavers toolkit which aims to “reduce the time and expense lost through the lack of continuity in critical, team, departmental and corporate  knowledge. For example, to prevent the loss of knowledge that occurs when someone moves to a new role or leaves the organisation altogether”.

A retrospective is a tool which captures the knowledge before the project team disbands.

The technique is also known as baton passing. It comprises a structured facilitated meeting at the end of a project (or major project stage), to capture the learning from it.

More information

This postcard describes the Retrospect tool in words and pictures.

View the NHS Knowledge Mobilisation Framework elearning module on retrospects.

Social network analysis is a tool which analyses how people work together to solve problems and come up with new ideas.

What are the benefits?

In the context of knowledge mobilisation, social network analysis (SNA) enables relationships between people to be mapped in order to identify knowledge flows.

• Who do people seek information and knowledge from?
• Who do they share their information and knowledge with?

In contrast to an organisation chart which shows formal relationships - who works where and who reports to whom, a social network analysis chart shows informal relationships. It looks at who knows who and who shares information and knowledge with whom.

It allows managers to visualise and understand the many relationships that can either facilitate or impede knowledge creation and sharing. As these relationships are normally invisible, SNA is sometimes referred to as an “organisational x-ray” as it shows the real networks that operate underneath the surface of an organisation's structure.

Once social relationships and knowledge flows can be seen, they can be evaluated and measured. The results of social network analyses can be used at the level of individuals, departments or organisations to:

• identify teams and individuals playing central roles - thought leaders, key knowledge brokers and experts
• identify isolated teams or individuals
• detect information bottlenecks
• spot opportunities for knowledge flow improvements
• accelerate the flow of knowledge and information across functional and organisational boundaries
• improve the effectiveness of formal communication channels
• target opportunities where increased knowledge flow will have the most impact
• raise awareness of the importance of informal networks

How do I go about it?

The process of social network analysis typically involves the use of questionnaires and/or interviews to gather information about the relationships between a defined group or network of people.

The responses gathered are then mapped using a software tool specifically designed for the purpose.

This data gathering and analysis process provides a baseline against which you can then plan and prioritise the appropriate changes and interventions to improve the social connections and knowledge flows within the group or network.

Key stages of the process will typically include:

• identifying the network of people to be analysed (for example, team, work group, department)
• gathering background information - interviewing managers and key staff to understand the specific needs and problems
• clarifying objectives, defining the scope of the analysis and agreeing the level of reporting required
• formulating hypotheses and questions
• developing the survey methodology and designing the questionnaire
• surveying the individuals in the network to identify the relationships and knowledge flows between them
• use a software mapping tool to visually map out the network
• reviewing the map and the problems and opportunities highlighted using interviews and/or workshops
• designing and implementing actions to bring about desired changes
• mapping the network again after a suitable period of time

Are there any other points I should be aware of?

In order for SNA maps to be meaningful, it is important to know what information you need to gather in order to build a relevant picture of your group or network. Good survey design and questionnaire design are therefore key considerations.

Questions will be typically based on factors such the following.

• Who knows who and how well?
• How well do people know each other’s knowledge and skills?
• Who or what gives people information about xyz?
• What resources do people use to find information/feedback/ideas/advice about xyz?
• What resources do people use to share information about xyz?

From NHS Knowledge Management Specialist Library ABC of Knowledge Mobilisation.

Reference: Scott J and others (2005) Social network analysis as an analytic tool for interaction patterns in primary care practices, Volume 3, Issue 5, pages 443 to 448.

Social media is a generic term used to describe a range of online applications that enable and encourage interactive communication between users. Millions of people around the world use social media to ask questions, network, learn and share their interests.

The social media ethos is all about engagement, participation and relationship building. Every platform encourages its users to take part, by commenting on what they see and getting involved in conversations with others. This makes it a particularly useful vehicle both for informing patients and for gaining their feedback. Used well, social media can be part of collaborative working and co-production. 

As well as having conversations and giving their opinions, visitors to social media sites also like to share information. This can have a powerful amplification effect (known as going viral), where articles, videos or images are shared between thousands or even millions of people.

Examples of social media platforms include Facebook, Twitter and MumsNet.

Stories can be very powerful communication tools, and may be used to describe complicated issues, explain events, communicate lessons learned, or bring about cultural change.

More information

More information about storytelling and how it can be used can be found on the below resources:

• Narrative-based librarianship by Peter Brophy
• 10 benefits of community through story - Huffington Post
• The art of purposeful storytelling - Harvard Business Review
• The Irresistible Power of Storytelling as a Strategic Business Tool - Harvard Business Review
• Using stories to persuade - Harvard Business Review
• How to tell a great story - Harvard Business Review