How to score an 'A' in knowledge management
Communicating lessons learned is integral
By Patrice Spath, RHIT
Brown-Spath & Associates
Forest Grove, OR
A variety of improvement projects are going on throughout your organization. Some are aimed at improving the efficiency of services and some are undertaken in an effort to reduce adverse events. There are also customer satisfaction and documentation improvement projects. And the list goes on...
While many of these projects achieve the intended goals, what's often missing is a formal process for sharing lessons. Lessons typically are shared by word of mouth during hallway conversations.
Disseminating the lessons learned during each project is a principal component of your organization's commitment to knowledge management and continuous improvement. That's why it is important to share the knowledge gained during each improvement experience — both negative and positive experiences.
The sharing of lessons learned is a component of the organization's system of knowledge management. Effective knowledge sharing and organizational learning leads to ever better performance. Often people equate knowledge management with information technology tools; however, these tools are merely facilitators, not the essence of knowledge management. The goal of knowledge management is to deliver the intellectual capacity of the organization to the people who make day-to-day decisions.
The Institute for Health Care Improvement uses the term "spread" to describe the learning that takes place in other parts of the organization when improvement information is actively shared and acted upon. This includes not only those parts of the organization that are the same as the original improvement site but also other parts of the organization that have similar processes or face similar issues. For instance, ideas for improved patient flow developed in an outpatient department are spread to other units where patient flow is a problem.
To achieve spread, dissemination of lessons learned must be active — lessons must be "pushed" to potential users using various communication channels. If an organization relies solely on passive dissemination through word of mouth, the likelihood of spread is low. A formal method, coordinated through the quality department, is needed to capture and disseminate the knowledge or understanding gained in improvement initiatives.
To create a formal system for identifying, sharing, and using lessons learned, the first step is to define the infrastructure and communication mechanisms. Consider these questions:
- How will you identify applicable lessons, document the information, and distribute to appropriate areas?
- What actions are expected to be taken as a result of the lessons learned and how will completion of the actions be monitored?
- What resources, procedures, and personnel will be needed to support the system?
The overall scope of the lessons learned system should be broad, including lessons from the many projects within the organization — operations, clinical care, business, management, and more. Don't just focus on what is learned during investigations of adverse events or failures as you'll miss opportunities to improve all processes. Sharing a "good practice" or innovative approach to promote repeat application is just as valuable as sharing adverse experiences to avoid recurrence. Participation in sharing lessons learned needs to be continuously reinforced at all levels. At every performance improvement meeting the question should be asked,"What is the lesson learned?"
Create hard copy and electronic input mechanisms that people can use to submit lessons learned. An example is shown in Figure 1. Reporting should be as simple as possible, but sufficiently detailed to be useful to other people in the organization. Every documented lesson learned should contain at least these general elements:
- project information and contact information for additional detail;
- a clear statement of the lesson;
- a background summary of how the lesson was learned;
- benefits of using the lessons and suggestion how the lesson may be used in the future.
Encourage collection of lessons learned throughout the project cycle so that reporting isn't viewed as just another "add on" at the project end. This makes the reporting process less labor intensive. At any time during a project, the leader or team members may identify lessons that should be shared. By starting the report at the beginning of the project these lessons won't be forgotten. Lessons learned should be compiled throughout the project and then finalized during a debriefing when the project is complete.
The organization's culture can affect reporting of lessons learned. If the organization's culture does not encourage sharing of information — people want to get and hold and not give — lessons learned reporting may be difficult to implement. In some situations people may not want to show their weaknesses if an improvement project didn't go as planned. Leaders need to encourage and reward reporting of negative lessons as well as best practices and successes.
Lessons learned reports are forwarded to the quality department for organization-wide sharing. This involves more than copying the reports and distributing to appropriate departments. While reports often contain good information, people must be able to quickly find lessons without going through each document. The lessons must be summarized into concise statements. In addition, the quality department can see across multiple improvement projects and should identify and link related lessons for reporting purposes. A simple truism to remember when preparing reports — if people can quickly find what they want, they are more likely to use it.
Summaries of improvement project lessons learned should be regularly distributed throughout the organization. Some of the common tools for distribution are:
- electronic mail and bulletin boards;
- virtual communities in an Intranet environment;
- face-to-face discussions at management and staff meetings.
The quality department can help the organization achieve ever-better performance by facilitating the collection and distribution of improvement project lessons learned. Remember, two (or more) heads are always better than one and great benefits can be gained from sharing someone else's prior experience.
(Editor's note: We regret that Patrice Spath will no longer be writing The Quality-Cost Connection column. Spath, who will continue to serve as consulting editor, has written the column since 1985 and we thank her for all of her insight and support.)
A variety of improvement projects are going on throughout your organization. Some are aimed at improving the efficiency of services and some are undertaken in an effort to reduce adverse events. There are also customer satisfaction and documentation improvement projects. And the list goes on...You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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