共享关键信息,医疗保健行业(知识管理)概要

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5: Time and Experience
Challenges
• Cultural readiness for technology • Decision-making on key data sets • Dilemma of broad visions and small steps
Practices
Practices
• Acknowledgement of evidence-base and experience-base • Integration of CPOE and EMR; with institutions knowledge base e.g. Clinical pathwayve Culture
Challenges
• Isolated decision-making • “Voluntary” physician base in hospitals • Communication patterns • Mergers, mixed hospital models
• Managing expectations around time required • Taking small steps – exactly charting
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6: Integrated
Data-Management & Decision Support
Challenges
• Time for conclusive evidence to be broadly available • Importance of but associated burden of accreditation e.g. HIPAA • Lack of time to make decisions
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The Purpose of our Work
• To articulate what we heard from health industry leaders in terms of what works in sharing critical knowledge in terms of information technology and life-saving practices.
• Make time for practitioners to be part of the system design • Work out technology and process at the same time • Complex organizations can be dramatically improved with small changes
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3. Combined Clinical and IT Expertise
Challenges
• Separation of IT and practice • Credibility and knowledge of unique knowledge set
Practices
• Leadership has both IT and Clinical skills • Leadership practices both management and clinical skills
This research was funded by Babson College in MA, and conducted in collaboration with Tom Davenport, Chair in Information Technology and Management
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The Interviews*
Practices
• Multi-disciplinary team rounds • Communication protocols • Recruiting and performance management
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2: Process and Technology Together
Challenges
Sharing Critical Knowledge: Healthcare Lessons
Presented at KMWorld and Intranets 2005 November 17, 2005 Mary Lee Kennedy
The Triggers
• • • • • Increasing healthcare costs The aging population Patient safety IT application growth in healthcare Developments in the study of complexity
• As a result of a process change (putting the patient’s head up on 8” blocks) this post-operative pneumonia was dramatically reduced.
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Extrapolations
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Adoption Impact
Some Examples • A new technology solution led to lower mortality and fewer unplanned readmissions. • With the use of wireless technology, and the co-location of required equipment (a reclining chair) and an EKG technician reduced a critical care process by 70 minutes.
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4: Workplace Design
Challenges
• Research-oriented vs. community oriented hospitals • Staff and IT budgets • Decision-making protocols
Practices
• Clear decision hand-offs • Multi-disciplinary teams with immediate information access
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*Interviews took place during the summer and fall of 2004
What Works
The top six findings:
• A collaborative culture • Focusing on technology and process together • Combining clinical and IT expertise on the leadership team • Workplace design • Time and experience with IT • Integrated data-management & decision support
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Mary Lee Kennedy Email: marylee@ Website:
• • • • • • • • • • • • Cedars Sinai (Los Angeles) InterMountain Healthcare (Salt Lake City and Utah) OSF Healthcare (Illinois and Michigan) Partners HealthCare (Boston) Peace Health (Pacific Northwest) Tallahassee Medical Center (Florida) Kaiser Permanente (HMO) Vanderbilt University Medical Center CareGroup (Boston) Veterans Administration Hospitals Institute for Innovation in Healthcare (Boston) Plus Healthcare IT vendors
• IT or process driven • Information management huge • People move
Practices
• Electronic Medical Record • Learn from other industries and each other • Involve clinicians in IT system design