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PubMed2001

Benefits of collaborative learning for environmental management: applying the integrated systems for knowledge management approach to support animal pest control.

Resource management issues continually change over time in response to coevolving social, economic, and ecological systems. Under these conditions adaptive management, or "learning by doing," offers an opportunity for more proactive and collaborative approaches to resolving environmental problems. In turn, this will require the implementation of learning-based extension approaches alongside more traditional linear technology transfer approaches within the area of environmental extension. In this paper the Integrated Systems for Knowledge Management (ISKM) approach is presented to illustrate how such learning-based approaches can be used to help communities develop, apply, and refine technical information within a larger context of shared understanding. To outline how this works in practice, we use a case study involving pest management. Particular attention is paid to the issues that emerge as a result of multiple stakeholder involvement within environmental problem situations. Finally, the potential role of the Internet in supporting and disseminating the experience gained through ongoing adaptive management processes is examined.

Animals↗
PubMed2001

Knowledge management: white knight or white elephant?

Knowledge management (KM) is a new management theory embraced by hundreds of writers in multiple countries and industries. Although a single fixed methodology does not exist, several methodological elements are common to most KM writtings. KM has a number of similarities to and differences from quality improvement and reengineering. It can be applied to at least two universes in health care organizations. Applying KM to a case study in health information management (HIM) departments yielded much useful information but also proved unable ultimately to resolve the problem being studied. HIM professionals can embrace elements about KM that are good and useful, while ignoring elements that do not work.

Delivery of Health Care↗
PubMed2002

Intelligent healthcare information assistant: towards agent-based healthcare knowledge management.

Initiatives in healthcare knowledge management have provided some interesting solutions for the implementation of large-scale information repositories vis-à-vis the implementation of Healthcare Enterprise Memories (HEM). In this paper, we present an agent-based Intelligent Healthcare Information Assistant (IHIA) for dynamic information gathering, filtering and adaptation from a HEM comprising an amalgamation of (i) databases storing empirical knowledge, (ii) case-bases storing experiential knowledge, (iii) scenario-bases storing tacit knowledge and (iv) document-bases storing explicit knowledge. The featured work leverages intelligent agents and medical ontologies for autonomous HEM-wide navigation, approximate content matching, inter- and intra-repositories content correlation and information adaptation to meet the user's information request. We anticipate that the use of IHIA will empower healthcare stakeholders to actively communicate with an 'information/knowledge-rich' HEM and will be able to retrieve with ease 'useful' task-specific information via the presentation of cognitively intuitive queries.

Internet↗
PubMed2003

Embedding knowledge management in the NHS south-west: pragmatic first steps for a practical concept.

Knowledge management, like clinical governance, is a practical science. Clinical governance, with its emphasis on creating an environment where clinical quality is monitored and acted upon, is one of the foundation stones of the new National Health Service (NHS). Both knowledge management and clinical governance need to share the same criteria in order to operate. Using these two pragmatic concepts and the premise of a practical approach, this article seeks to identify the drivers for knowledge management in the NHS, highlight national initiatives and focus on the steps libraries in the south-west of England have taken to make knowledge management a reality. In so doing, the central role of the library and information service has been reinforced and embedded and librarians have been recognized for their real worth to their organizations.

Evidence-Based Medicine↗
PubMedDate not supplied

Things to come: postmodern digital knowledge management and medical informatics.

The overarching informatics grand challenge facing society is the creation of knowledge management systems that can acquire, conserve, organize, retrieve, display, and distribute what is known today in a manner that informs and educates, facilitates the discovery and creation of new knowledge, and contributes to the health and welfare of the planet. At one time the private, national, and university libraries of the world collectively constituted the memory of society's intellectual history. In the future, these new digital knowledge management systems will constitute human memory in its entirety. The current model of multiple local collections of duplicated resources will give way to specialized sole-source servers. In this new environment all scholarly scientific knowledge should be public domain knowledge: managed by scientists, organized for the advancement of knowledge, and readily available to all. Over the next decade, the challenge for the field of medical informatics and for the libraries that serve as the continuous memory for the biomedical sciences will be to come together to form a new organization that will lead to the development of postmodern digital knowledge management systems for medicine. These systems will form a portion of the evolving world brain of the 21st century.

Artificial Intelligence↗
PubMedDate not supplied

Nurses' personal pain experiences and their pain management knowledge.

BACKGROUND: This study examined nurses' personal experiences with pain and whether nurses' personal pain experiences were associated with initial pain management knowledge and ability to learn more about pain management. METHOD: This descriptive correlational study was a secondary analysis of a study that used a one-group pretest-posttest design to examine the effect of a pain management education program on nurses' pain management knowledge. The sample consisted of 177 nurses who answered yes to having had a personal pain experience requiring treatment. RESULTS: Nurses reported 13 types of pain, with pharmacological interventions comprising 94.4% of the pain treatments. Nurses' previous personal pain experiences were negatively related to their initial pain management knowledge (r = -.23, p < .01). CONCLUSION: Nurses' personal pain experience may impact their learning of pain management knowledge and should be considered when designing pain management education.

Adult↗
PubMed2001

Operationalizing knowledge management in health care.

Being able to leverage the collective clinical knowledge that a health system acquires on a daily basis and then apply that knowledge to elevate productivity and maintain clinical quality would be nirvana for health system executives. Although it is difficult to bring knowledge management to health care, it is not impossible. Architects of knowledge management solutions in health care will need to balance what an organization hopes to achieve in its market (business strategy); how they hope to achieve it (operating strategy); and where information technology is needed to enable what they hope to achieve and how they hope to achieve it (information strategy).

Decision Support Systems, Clinical↗
PubMed2003

Knowledge management in healthcare: what does it involve? How is it measured?

While knowledge exists in all healthcare organizations, it often remains in silos or on the sidelines, neither used to its maximum potential nor purposefully focused on strategic results. In order to facilitate the development of strategically valuable knowledge, this article outlines seven knowledge-building dimensions that create a solid knowledge-management lever within the organization. Additionally, the article helps readers to come to grips with accountability by suggesting strategic outcomes for knowledge management. A particular focus is on lead or forward-looking indicators that track the progress and success of knowledge management.

Canada↗
PubMed2002

Knowledge management to support performance-based medicine.

OBJECTIVES: To discuss research issues for medical informatics in order to support the further development of health information systems, exploiting knowledge management and information and communication technology to increase the performance of Health Care Organizations (HCOs). METHODS: Analyze the potential of exploiting knowledge management technology in medicine. RESULTS AND CONCLUSIONS: The increasing pressure on HCOs to ensure efficiency and cost-effectiveness, balance the quality of care, and contain costs will drive them towards more effective management of medical knowledge derived from biomedical research. Knowledge management technology may provide effective methods and tools in speeding up the diffusion of innovative medical procedures. Reviews of the effectiveness of various methods of best practice dissemination show that the greatest impact is achieved when such knowledge is made accessible through the health information system at the moment it is required by care providers at their work sites. There is a need to take a more clinical process view of health care delivery and to identify the appropriate organizational and information infrastructures to support medical work. Thus, the great challenge for medical informatics is represented by the effective exploitation of the astonishing capabilities of new technologies to assure the conditions of knowledge management and organizational learning within HCOs.

Decision Making, Computer-Assisted↗
PubMed2003

[Randomized controlled trial on effectiveness of the community re-entry program to inpatients with schizophrenia spectrum disorder, centering around acquisition of illness self-management knowledge].

OBJECTIVE: The objective of this study was to examine by randomized controlled trial the effectiveness and safety of the Japanese version of the Community Re-Entry Program, a manualized psycho-educational program with cognitive-behavioral therapy techniques, in discharge preparation for inpatients with schizophrenia. Our hypotheses are that firstly the program is effective for patients in acquiring illness self-management knowledge, that secondly the program shows positive effects on objective behavior and symptoms, and that thirdly the program has no adverse effects on subjective quality of life (QOL). METHOD: The subjects were 32 psychiatric inpatients, 24 male and 8 female, hospitalized in psychiatric rehabilitation wards, who gave written informed consent to participate in this study. The Community Re-Entry Program consists of 16 small-group sessions of one hour each that teach illness self-management knowledge and related skills to prepare patients for discharge from hospital and re-entry to the community with cognitive-behavioral techniques such as demonstration, roleplay, feedback, behavioral modeling and homework assignments. A specialized trainer's manual, demonstration videotape and patient workbook are utilized in the program. The program content includes defining discharge readiness, identifying symptoms and medication effects, assisting with discharge planning, connecting with community care, medication self-management, monitoring relapse warning signs, and preparing for emergencies. Except for considerations of the sex ratio in both groups, subjects were randomly allocated to the program (the program group) or ordinary occupational therapy (the control group). Of 32 patients, 31 were diagnosed with schizophrenia and 1 with schizotypal disorder. For the patients in the program group, we administered the program of 16 sessions as well as introductory and closing sessions, twice a week for 9 successive weeks. Nursing staffs in the wards took the roles of trainers with careful fidelity to the manual and supervision by psychiatrists with extensive experience in cognitive-behavioral therapy. The subjects were assessed concerning psychopathology with PANSS by psychiatrists, objective behavior with REHAB by nurses, subjective QOL with subjects' self-reports on WHO/QOL-26 and illness self-management knowledge also by self-report questionnaire attached to the trainers' manual of the program, before and after the whole program. RESULTS: Before the program, no significant differences were observed between groups concerning age, illness duration, education, length of current hospitalization, amount of antipsychotic medication, psychopathology, objective behavior, subjective QOL and illness self-management knowledge. One patient dropped out of the program because of transient ischemic attack. After the program, the patients in the program group significantly improved in illness self-management knowledge, as well as in speech skills and social activity score, factors of REHAB concerned with objective behavior evaluation, compared with those in the control group. Positive symptoms thus seemed to improve in the patients in the program group compared with those in the control group. No significant changes were observed in other items, including subjective QOL, in the patients of both groups. No patients experienced psychotic relapse in the observation term. DISCUSSION: We consider that the results supported most of our hypotheses, as they showed positive effects of the program in learning illness self-management knowledge, objective behavior and possible positive effect on positive symptoms, and no adverse effects were observed in psychopathology, behavior or subjective QOL. Further study is necessary on illness self-management behavior acquisition and the effects on long-term clinical outcomes. Study on whether the program is effective for younger patients with shorter hospitalization are expected, because the subjects in this study were rather older (45.9 +/- 11.5 years in the program group) and hospitalized longer (37.8 +/- 36.7 months in the program group). CONCLUSION: The Japanese version of the program was effective and relatively safe for schizophrenia spectrum disorder inpatients for learning illness self-management knowledge in preparation for discharge and planning community re-entry.

Adult↗
PubMed2005

Knowledge management in health care.

It is a long-term, sustainable commitment to changing the culture of health care to become more collaborative, more transparent, and more proactive. Knowledge management, implemented well, will transform the health care delivery system over the next few decades, into a more cost-effective, error-averse, and accountable public resource. For the sake of simplicity, this article will limit the application of knowledge management principles to the context of hospitals, hospital systems or associations, or other groupings of hospitals based on a common interest or focus. The field of knowledge management has tremendous application and value to the health care industry, particularly for hospitals and hospital systems. For many who have invested in a knowledge management infrastructure, it has become the measure of value of belonging to a hospital system or membership organization.

Cooperative Behavior↗
PubMed2001

An informatics system to support knowledge management in the health sector--the South African National Health Knowledge Network.

This paper discusses the planning and development of a South African national health knowledge network. The methodology is in essence based on the principles of knowledge management and the drivers of a system of innovation. The knowledge network, SA HealthInfo, aims to provide a one-stop interactive forum/resource, for quality-controlled and evidence-based health research information, to a wide spectrum of users, at various levels of aggregation, with the necessary security arrangements and facilities for interaction among users to promote explicit (codified) and tacit knowledge flow. It will therefore stimulate the process of innovation within the South African health system.

Computer Security↗
PubMedDate not supplied

[Knowledge management in medicine: in search of lost information].

This paper offers a brief review of the application of knowledge management in the field of the health sciences. This new current, which emerged in the business sphere, is seeking to win itself a space in disciplines characterised by their intensive use of information and which had traditionally assumed many of the proposals presented as novelties by these currents. The challenges and problems that knowledge management poses in the health sciences are discussed and, focusing on explicit knowledge management, solutions that are currently being developed are described.

English Abstract↗
PubMed2006

Knowledge management: a core skill for surgeons who manage.

The yawning gap between what we know and what we do has major implications for patients. By putting into practice what we know now, we will have a bigger impact on the health of individuals and populations than any drug or technology discovered in the new decade. The assumption underlying this article is that the gap can be closed by thinking, planning, analyzing, mobilizing,managing, personalizing, and using knowledge. There is, however,a risk that the attempted solution may perpetuate or aggravate the problem, and surgeons must be aware of the dangers of substituting thought for action, when knowledge management becomes an industry of its own, remote from the core activities of the organization and those who deliver them.

Clinical Competence↗
PubMed2001

Online research to guide knowledge management planning.

The current paper describes the process and results of an effort to find a way to effectively manage and diffuse prevention knowledge. This study shows the role that today's communication technologies can play in ensuring collaboration and participation in both the design and use of a knowledge management system (KMS) for prevention research, practice and policy. In the context of this study, 'prevention research' includes primary through tertiary prevention efforts consistent with general applied public health research in the US. An online Delphi study was used to engage a set of prevention research constituencies in the design of a mechanism to enhance the potential for effective technology transfer. A three-round Delphi was conducted with 58 stakeholders and key informants involved in prevention: government-level policy makers, researchers and front-line practitioners. The study resulted in consensus on 34 functions and 32 output/content elements of a proposed web-based KMS called PreventionEffects.net. The paper also describes the implications of both the processes of development and the benefits of the proposed system for those interested in prevention.

Delphi Technique↗