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Results for “Knowledge Management”

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PubMed1989

Why we need laboratories for applied research in academic information.

A common vision for an electronic management environment is emerging. Fundamental to this vision is a radical change in the way that knowledge is captured, stored, manipulated, visualized and accessed. To bring these visions to reality, partnerships need to be formed between authors, publishers, and libraries. Research and development in knowledge management is essential and universities must identify more clearly their roles as knowledge creators and distributors.

Baltimore↗

PubMed2003

An approach to enrich online medical Problem-Based Learning with tacit healthcare knowledge.

Existing Problem-Based Learning (PBL) problems, though suitable in their own right for teaching purposes, are limited in their potential to evolve by themselves and to create new knowledge. Presently, they are based on textbook examples of past cases and/or cases that have been transcribed by a clinician. In this paper, we present (a) a tacit healthcare knowledge representation formalism called Healthcare Scenarios, (b) the relevance of healthcare scenarios in PBL in healthcare and medicine, (c) a novel PBL-Scenario-based tacit knowledge explication strategy and (d) an online PBL Problem Composer and Presenter (PBL-Online) to facilitate the acquisition and utilisation of expert-quality tacit healthcare knowledge to enrich online PBL. We employ a confluence of healthcare knowledge management tools and Internet technologies to bring tacit healthcare knowledge-enriched PBL to a global and yet more accessible level.

Computer-Assisted Instruction↗

PubMed1998

Building patient workflow management systems by integrating medical and organizational knowledge.

Patient management is a distributed activity involving general practitioners, clinicians, analysts, nurses, etc. Thus an integrated Patient Workflow Management System (WfMS), based on a detailed model of both the organizational and medical knowledge, could heavily improve Health Care System's performance in terms of collaborative work and resource utilization. A set of tools was developed to improve 1) acquisition of medical knowledge represented through clinical practice Guideline, and 2) acquisition of organizational knowledge describing the work process.

Computer Simulation↗

PubMed1992

The dilemma of scientific knowledge versus clinical management of temporomandibular disorders.

The dilemma of scientific knowledge versus clinical management of TMD is discussed by focus on five questions; (1) What is scientific evidence and how is it transmitted? (2) What important evidence is lacking in the field of TMD? (3) What clinical concepts have been challenged by the scientific evidence? (4) Why is there adherence to concepts that appear to conflict with the evidence? (5) How does the clinician provide patient care in the face of uncertainty while retaining scientific integrity? It is concluded that no fundamental reason for a dilemma between scientific evidence and clinical practice need exist provided that (1) clinical investigators use appropriate research protocols and report results in refereed scientific journals and (2) dentists are familiar with the requirements of sound scientific evidence, interpret this evidence and its clinical implications, and apply it to the care of TMD patients.

Diffusion of Innovation↗

PubMed2004

A preliminary report of an educational intervention in practice management.

BACKGROUND: Practice management education continues to evolve, and little information exists regarding its curriculum design and effectiveness for resident education. We report the results of an exploratory study of a practice management curriculum for primary care residents. METHODS: After performing a needs assessment with a group of primary care residents at Wright State University, we designed a monthly seminar series covering twelve practice management topics. The curriculum consisted of interactive lectures and practice-based application, whenever possible. We descriptively evaluated two cognitive components (practice management knowledge and skills) and the residents' evaluation of the curriculum. RESULTS: The mean correct on the knowledge test for this group of residents was 74% (n = 12) and 91% (n = 12) before and after the curriculum, respectively. The mean scores for the practice management skill assessments were 2.62 before (n = 12), and 3.65 after (n = 12) the curriculum (modified Likert, 1 = strongly disagree, 5 = strongly agree). The residents rated the curriculum consistently high. CONCLUSIONS: This exploratory study suggests that this curriculum may be useful in developing knowledge and skills in practice management for primary care residents. This study suggests further research into evaluation of this curriculum may be informative for practice-based education.

Adult↗

PubMed2003

The healthcare manager as catalyst for evidence-based practice: changing the healthcare environment and changing experience.

This thoughtful essay conveys a logically ordered series of concepts that may help develop a process to more fully integrate evidence into healthcare management decisions. In responding to this article we have tried to think broadly about what might be discovered if the ideas of Browman, Snider and Ellis were put into practice. We have chosen to focus on factors that could confound the five-point plan suggested by the authors. Browman, Snider and Ellis provide an interesting overview and advocacy for evidence-based medicine and its application. The authors recognize that the area under investigation, oncology, may lend itself more readily than others to the facilitation of evidence-based practice. They introduce the concept of healthcare as a negotiating environment and the healthcare manager as a potential catalyst for change. In their conclusions the authors offer healthcare managers a five-point plan: 1. Express the value that knowledge is a core resource. 2. Structure decision-making to involve the stewards of knowledge and stimulate negotiation while encouraging the parties to express shared goals. 3. Invest in strategies that support knowledge management, including arbitration. 4. Demonstrate leadership and develop organizational metaphors to encourage participation. 5. Share the results and experiences of evidence-based decision-making.

Decision Making, Organizational↗

PubMed2000

A systematic review of the effects of physician specialty on the treatment of coronary disease and heart failure in the United States.

PURPOSE: To assess the effects of physician specialty on the knowledge, management, and outcomes of patients with coronary disease or heart failure. MATERIALS AND METHODS: We performed a systematic search of MEDLINE from 1980 to 1997, as well as bibliographic references to articles about the effects of physician specialty on the knowledge, treatment, and outcomes of patients with coronary disease or heart failure in the United States. RESULTS: Twenty-four articles met our criteria for inclusion (including eight that involved knowledge or self-reported practices, 14 that described actual practice patterns, and six that measured clinical outcomes). Cardiologists were more knowledgeable than generalist physicians about the optimal evaluation and management of coronary disease but not about the use of angiotensin-converting enzyme (ACE) inhibitors for heart failure. Patients with unstable angina or myocardial infarction were more likely to receive proven medical therapies, and possibly had improved outcomes, if they were treated by cardiologists. The use of lipid-lowering drugs after myocardial infarction was also more common among patients of cardiologists. ACE inhibitor use for heart failure was probably greater, and short-term readmission rates were lower, with cardiology care. CONCLUSIONS: Patients with coronary disease or heart failure in the United States who are treated by cardiologists appear more likely to receive evidence-based care and probably have better outcomes. Investigation of collaborative models of care and innovative efforts to improve the use of proven therapies by physicians are needed.

Cardiology↗

PubMed2001

Developing organizational learning in the NHS.

Learning has been identified as a central concern for a modernized NHS. Continuing professional development has an important role to play in improving learning but there is also a need to pay more attention to collective (organizational) learning. Such learning is concerned with the way organizations build and organize knowledge. Recent emphasis within the NHS has been on the codification of individual and collective knowledge - for example, guidelines and National Service Frameworks. This needs to be balanced by more personalized knowledge management strategies, especially when dealing with innovative services that rely on tacit knowledge to solve problems. Having robust systems for storing and communicating knowledge is only one part of the challenge. It is also important to consider how such knowledge gets used, and how routines become established within organizations that structure the way in which knowledge is deployed. In many organizations these routines favour the adaptive use of knowledge, which helps organizations to achieve incremental improvements to existing practices. However, the development of organizational learning in the NHS needs to move beyond adaptive (single loop) learning, to foster skills in generative (double loop) learning and meta-learning. Such learning leads to a redefinition of the organization's goals, norms, policies, procedures or even structures. This paper argues that moving the NHS in this direction will require attention to the cultural values and structural mechanisms that facilitate organizational learning.

Education, Medical↗

PubMed2005

Do we need a Unique Scientist ID for publications in biomedicine?

BACKGROUND: The PubMed database contains nearly 15 million references from more than 4,800 biomedical journals. In general, authors of scientific articles are addressed by their last name and forename initial. DISCUSSION: In general, names can be too common and not unique enough to be search criteria. Today, Ph.D. students, other researchers and women publish scientific work. A person may not only have one name but several names and publish under each name. A Unique Scientist ID could help to address people in peer-to-peer (P2P) networks. As a starting point, perhaps PubMed could generate and manage such a scientist ID. SUMMARY: A Unique Scientist ID would improve knowledge management in science. Unfortunately in some of the publications, and then within the online databases, only one letter abbreviates the author's forename. A common name with only one initial could retrieve pertinent citations, but include many false drops (retrieval matching searched criteria but indisputably irrelevant).

Journal Article↗

PubMed2002

Seedling Development and Field Performance of Prairiegrass, Grazing Bromegrass, and Orchardgrass.

Seedling establishment is a critical phase in pasture management. Knowledge of the seedling development of new forages is necessary to develop management practices and recommend species mixtures for pasture seedings. We compared seedling growth and development of prairiegrass (Bromus willdenowii Kunth = B. catharticus Vahl), grazing bromegrass (B. stamineus Desv.), and orchardgrass (Dactylis glomerata L.) in controlled environment and field studies. Seedlings were sampled weekly for 7 wk in the growth chamber and greenhouse beginning 8 to 10 d after planting (DAP). The number and mass of leaves and roots were recorded. In the field, leaf development was measured during spring and fall of 1997, and leaf and root development were measured during spring and fall of 1999. Forage dry matter (DM) yield was measured in clipped field plots during 1998 to 2000. Grazing bromegrass had more leaves, about twice the number of tillers per seedling, and a greater seedling mass than other grasses. Grazing bromegrass also had 50 to 100% more tillers m(-2) than other grasses in clipped field plots. The larger seedling size and greater tiller density, however, did not translate into greater yield in clipped plots. Grazing bromegrass yielded 10 to 15% less than orchardgrass or prairiegrass. Because of their large seedlings and rapid development, prairiegrass and grazing bromegrass probably should be used at a lower seeding rate or perhaps not used in seed mixtures with small-seeded grasses. Seedlings of these grasses should be fully established by 40 to 50 DAP under favorable moisture and temperatures in the spring and late summer.

Journal Article↗

PubMed2005

A knowledge creation info-structure to acquire and crystallize the tacit knowledge of health-care experts.

Tacit knowledge of health-care experts is an important source of experiential know-how, yet due to various operational and technical reasons, such health-care knowledge is not entirely harnessed and put into professional practice. Emerging knowledge-management (KM) solutions suggest strategies to acquire the seemingly intractable and nonarticulated tacit knowledge of health-care experts. This paper presents a KM methodology, together with its computational implementation, to 1) acquire the tacit knowledge possessed by health-care experts; 2) represent the acquired tacit health-care knowledge in a computational formalism--i.e., clinical scenarios--that allows the reuse of stored knowledge to acquire tacit knowledge; and 3) crystallize the acquired tacit knowledge so that it is validated for health-care decision-support and medical education systems.

Artificial Intelligence↗

PubMed2005

Diagnostic and prognostic tests for oral diseases: practical applications.

Dental caries and periodontitis are initiated by specific bacteria and modified by host and environmental factors. Individuals have great differences in their rates of disease progression, but a small set of risk factors, such as smoking and diabetes, can distinguish patients at high risk for more severe disease. The application of information about factors that influence disease can be used to improve disease prevention and management. Knowledge of when specific information may be valuable should lead to the optimal management of individual patients. The use of diagnostic and prognostic tests and their application to the assessment and management of dental caries and periodontitis are the focus of this review.

Dental Caries↗

PubMed2000

Pest management strategies in traditional agriculture: an African perspective.

African agriculture is largely traditional--characterized by a large number of smallholdings of no more than one ha per household. Crop production takes place under extremely variable agro-ecological conditions, with annual rainfall ranging from 250 to 750 mm in the Sahel in the northwest and in the semi-arid east and south, to 1500 to 4000 mm in the forest zones in the central west. Farmers often select well-adapted, stable crop varieties, and cropping systems are such that two or more crops are grown in the same field at the same time. These diverse traditional systems enhance natural enemy abundance and generally keep pest numbers at low levels. Pest management practice in traditional agriculture is a built-in process in the overall crop production system rather than a separate well-defined activity. Increased population pressure and the resulting demand for increased crop production in Africa have necessitated agricultural expansion with the concomitant decline in the overall biodiversity. Increases in plant material movement in turn facilitated the accidental introduction of foreign pests. At present about two dozen arthropod pests, both introduced and native, are recognized as one of the major constraints to agricultural production and productivity in Africa. Although yield losses of 0% to 100% have been observed on-station, the economic significance of the majority of pests under farmers' production conditions is not adequately understood. Economic and social constraints have kept pesticide use in Africa the lowest among all the world regions. The bulk of pesticides are applied mostly against pests of commercial crops such as cotton, vegetables, coffee, and cocoa, and to some extent for combating outbreaks of migratory pests such as the locusts. The majority of African farmers still rely on indigenous pest management approaches to manage pest problems, although many government extension programs encourage the use of pesticides. The current pest management research activities carried out by national or international agricultural research programs in Africa focus on classical biological control and host plant resistance breeding. With the exception of classical biological control of the cassava mealybug, research results have not been widely adopted. This could be due to African farmers facing heterogeneous conditions, not needing fixed prescriptions or one ideal variety but a number of options and genotypes to choose from. Indigenous pest management knowledge is site-specific and should be the basis for developing integrated pest management (IPM) techniques. Farmers often lack the biological and ecological information necessary to develop better pest management through experimentation. Formal research should be instrumental in providing the input necessary to facilitate participatory technology development such as that done by Farmer Field Schools, an approach now emerging in different parts of Africa.

Africa↗

PubMed1997

CIO of the Year. Thriving on the challenge of change.

To manage the change that confronts Harris Methodist Health System, Larry Blevins uses his technical knowledge, management and interpersonal skills, and business savvy. In 14 years with the Arlington, Texas-based health care system, Blevins has unified its information systems approach and given in the automation infrastructure to thrive. "If you're not changing, then you're either dead or stagnant," Blevins says. "While that is the challenge, that's part of the fun. Change should be fun."

Awards and Prizes↗

PubMed2005

Managing the alert process at NewYork-Presbyterian Hospital.

Clinical decision support can improve the quality of care, but requires substantial knowledge management activities. At NewYork-Presbyterian Hospital in New York City, we have implemented a formal alert management process whereby only hospital committees and departments can request alerts. An explicit requestor, who will help resolve the details of the alert logic and the alert message must be identified. Alerts must be requested in writing using a structured alert request form. Alert requests are reviewed by the Alert Committee and then forwarded to the Information Systems department for a software development estimate. The model required that clinical committees and departments become more actively involved in the development of alerts than had previously been necessary. In the 12 months following implementation, 10 alert requests were received. The model has been well received. A lot of the knowledge engineering work has been distributed and burden has been removed from scarce medical informatics resources.

Decision Support Systems, Clinical↗

PubMed2006

A new module for on-line manipulation and display of molecular information in the brain architecture management system.

A new "Molecules" module of the Brain Architecture Management System (BAMS; http://brancusi.usc.edu/bkms) is described. With this module, BAMS becomes the first online knowledge management system to handle central nervous system (CNS) region and celltype chemoarchitectonic data in the context of axonal connections between regions and cell types, in multiple species. The "Molecules" module implements a general knowledge representation schema for data and metadata collated from published and unpublished material, and allows insertion of complex reports about the presence of molecules collated from the literature. For different CNS neural regions and cell types, the module's database structure includes representation of molecule expression revealed by various techniques including in situ hybridization and immunohistochemistry, molecule coexpression and time-dependent level changes, and physiological state of subjects. The metadata representation allows online comparison and evaluation of inserted experiments, and "Molecules"structure allows rapid development of data transfer protocols enabling neuroinformatics visualization tools to display gene expression patterns residing in BAMS, in terms of levels of expressed molecules and in situ hybridization data. The module's web interface allows users to construct lists of CNS regions containing a molecule (depending on physiological state), retrieve further details about inserted records, compare time-dependent data within and across experiments, reconstruct gene expression patterns, and construct complex reports from individual experiments.

Animals↗

PubMed2005

Employee knowledge of a managed pharmacy benefit in a large corporation.

Knowledge about prescription drug benefits is necessary for consumers to choose appropriate health benefits plans in a consumer-directed health plan market. The objective of this study was to describe employees' knowledge of their prescription drug benefits. A one-group, cross-sectional survey of full-time university employees with a tiered pharmacy benefit was performed. Correct responses to knowledge questions were described individually and as an aggregate index score. Respondent understanding of pharmacy benefits was low to moderate. Specifically, knowledge of pharmacy benefits was most limited with respect to formulary management, cost sharing, and financial implications of out-of-network use and the selection of a branded or generic medication. Future research should refine methods for assessing knowledge of pharmacy benefits, explore knowledge of pharmacy benefits in diverse samples, and assess the consequences associated with variations in knowledge of prescription drug benefits.

Adult↗

PubMed2000

Health expert's tacit knowledge acquisition and representation using specialised healthcare scenarios.

The abundance and transient nature to healthcare knowledge has rendered it difficult to acquire with traditional knowledge acquisition methods. In this paper, we propose a Knowledge Management approach, through the use of scenarios, as a mean to acquire and represent tacit healthcare knowledge. This proposition is based on the premise that tacit knowledge is best manifested in atypical situations. We also provide an overview of the representational scheme and novel acquisition mechanism of scenarios.

Artificial Intelligence↗