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CHAPTER 1 BACKGROUND, INTRODUCTION AND SAHPM OVERVIEW
1.1 Purpose of Briefing Paper
The purpose of this briefing paper is to provide a report of the work carried out by the Office of Chief Researcher ( OCR) Scottish Executive Health Department ( SEHD) Scottish Academy for Health Policy and Management ( SAHPM) team testing the theory and practice of Knowledge Management, Knowledge Transfer and Knowledge Brokerage at a corporate and departmental level in Scottish Executive.
The paper provides a brief record of the pilot project described within the theoretical framework of Knowledge Management ( KM), Knowledge Transfer ( KT) and Knowledge Brokerage ( KB). The paper primarily reports on the processes and behaviours which comprised the KT and KB elements of the SAHPM initiative, and provides supporting commentary on the opportunity costs of KT/ KB work and the resource implications of adopting this approach to evidence provision to inform policy development and policy delivery. The paper focuses primarily on the work of the team on SEHD priorities; however, the process described has the potential to be applied across a range of policy areas, and several of the issues raised in the report are now being considered by the SE Knowledge Transfer Team, recently established in Office of Chief Researcher.
Drawing on the practical experience of the SAHPM knowledge brokers working within the Scottish Executive and with external communities of practice, the paper identifies implications for future KM/ KT& KB initiatives in policy, practice and academic worlds. The paper draws a distinction between the particular skills and expertise of government 'system aware' 'brokercrats' (civil service 'bureaucrats' working within Scottish Executive ( SE) as knowledge brokers-primarily social researchers); and the need for the creation of a new breed of external knowledge brokers operating as go-betweens who would link the policy, public sector practice, industry, and academic communities. Again, the implications of these outcomes are now being discussed by the KT team with relevant partners and internal and external stakeholders.
Other elements of the SAHPM initiative work programme have been reported through the production of a feasibility study Scottish Academy for Health Policy and Management Feasibility Study and Supporting Business Case written by Firn Crichton Roberts Ltd; a business plan Scottish Academy for Health Policy and Management Business Plan and two SAHPM Bulletins (web links provided in Annex A).
1.2 Overview of SAHPM Project
The SEHDSAHPM project commenced in January 2003 and concluded in March 2005. SEHD used the SAHPM project to adopt and develop current practice in the field of knowledge management and transfer; and to explore the best means of providing a forum that would bring together SEHD, the NHSS and partners, and the academic community to support health policy development and implementation in Scotland. The SAHPM team explored the potential of:
- a collaborative network to identify and co-ordinate clearly defined research and evidence to support policy, strategy and service development in SEHD, NHSS and other partner organisations
- dedicated resources to support policy implementation, service development and management practice
- management education and skills development to support implementation and improved service delivery
- a 'knowledge exchange' facility to store and disseminate knowledge and learning
The SAHPM Team was based in St Andrew's House, Edinburgh and comprised of a Director, a Principal Research Officer on loan to SEHD from Office of Chief Researcher, and an SEHD administrative officer. The project was overseen by joint SEHD/ NHSS Steering, Reference, and Delivery Groups, and the Head of Health Department/Chief Executive of NHSS.
'System awareness' of the civil service and a working knowledge (based on practical experience) of NHSS, pure and applied research practice in academia, and wider European and International networks were important competencies underpinning the successful KT and KB delivered by the SAHPM Team.
1.3 Knowledge Management, Knowledge Transfer, Knowledge Brokerage: Definitions and SAHPM Objectives
1.31 Definitions
The theory and practice of KM, KT, and KB is an emerging field, and useful definitions include:
Knowledge Management
" Knowledge Management caters to the critical issues of organizational adaptation, survival, and competence in face of increasingly discontinuous environmental change.... Essentially, it embodies organizational processes that seek synergistic combination of data and information processing capacity of information technologies, and the creative and innovative capacity of human beings."
( WWW Virtual Library on Knowledge Management quoted on http://www.mywiseowl.com/articles/Knowledge_management ( http://www.kmnetwork.com/))
"In simpler terms, Knowledge Management seeks to make the best use of the knowledge that is available to an organization, creating new knowledge in the process.
It is helpful to make a clear distinction between knowledge on the one hand, and information and data on the other.
Information can be considered as a message. It typically has a sender and a receiver. Information is the sort of stuff that can, at least potentially, be saved onto a computer. Data is a type of information that is structured, but has not been interpreted.
Knowledge might be described as information that has a use or purpose. Whereas information can be placed onto a computer, knowledge exists in the heads of people. Knowledge is information to which an intent has been attached."
( http://www.mywiseowl.com/articles/Knowledge_management)
Knowledge Transfer
"Knowledge exchange (formerly knowledge transfer): Knowledge exchange is collaborative problem-solving between researchers and decision makers that happens through linkage and exchange. Effective knowledge exchange involves interaction between decision makers and researchers and results in mutual learning through the process of planning, producing, disseminating, and applying existing or new research in decision-making."
(Canadian Health Services Research Foundation)
"Knowledge transfer is a two-way, continuous process where research information is exchanged between the research community and the community of potential users. The two-way exchange of information informs decision-making at all levels of the health care system through interactive engagement and participation."
(Nova Scotia Health Research Foundation)
"Knowledge Transfer has been defined by the Social Research Knowledge Management working group as 'the interactive delivery of external social research knowledge and expertise to Ministers, and policy and analytical colleagues'. This definition embraces both knowledge-'know-how' and 'know-who'-and evidence- 'know-what'"
(Scottish Executive Social Research Knowledge Management Group)
Knowledge Brokerage
"Knowledge brokering links researchers and decision makers together, facilitating their interaction so that they are able to better understand each other's goals and professional culture, influence each other's work, forge new partnerships, and use research-based evidence. Brokering is ultimately about supporting evidence-based decision-making in the organization, management, and delivery of health services.
The study and organization of knowledge brokering is an emerging activity in the field of knowledge exchange, intended to encourage and facilitate knowledge exchange and embed it into the operational culture of the health services field.
Knowledge brokering brings people-health services researchers, decision makers, practitioners, and policy makers-together to build relationships among them. Individuals working as brokers have broad skills that include a thorough understanding of Canada's healthcare system and knowledge of marketing and communications, as well as the ability to:
- link people together and facilitate their interaction;
- find academic research and other evidence to shape decisions;
- assess evidence, interpret it, and adapt it to circumstances;
- identify emerging management and policy issues which research could help solve; and
- create knowledge networks.
To find a Knowledge Broker, look for someone who has a network of contacts in various professions throughout the health services system, who can link people and facilitate their interaction." (Canadian Health Services Research Foundation: http://www.chsrf.ca/)
Community of Practice
"The organizational development ( OD) concept of a community of practice (often abbreviated as CoP) refers to the process of social learning that occurs when people who have a common interest in some subject or problem, collaborate to share ideas, find solutions, and build innovations.
The term was first used in 1991 by Jean Lave and Etienne Wenger who used it in relation to situated learning. In 1998, the theorist Etienne Wenger ( http://www.ewenger.com/) extended the concept and applied it to a commercial setting. More recently Communities of Practice have become associated with knowledge management as people have begun to see them as ways of cultivating or nurturing new knowledge or sharing existing tacit knowledge within an organisation."
( http://www.mywiseowl.com/articles/Community_of_practice)
Organisations who explicitly refer to their work using KM, KT, and KB definitions include:
Canadian Health Services Research Foundation
http://www.chsrf.ca/
AcademyHealth
http://www.academyhealth.org/
United States Department of Health and Human Resources [Federal]
Agency for Healthcare Research and Quality
http://www.ahrq.gov/
Center for Health Management Research
http://depts.washington.edu/chmr/
1.32 SAHPMKM/ KT/ KB Definitions and SAHPMKM/ KT/ KB Objectives
The SAHPM Team KT/ KB Objectives were to bring together people to achieve KM, KT and KB which would inform SEHD and OCR. Specific KM/ KT/ KB objectives included action to:
- foster research activity which would have a direct impact on policy development and implementation, and practitioner and organisational practice
- link with, and build on, the experiences of existing education and research providers
- be informed by the work of existing centres of expertise in Scotland
- provide a connective medium to create synergies between policy makers, practitioners and researchers in Scotland, Europe and further afield
- provide linkages between individuals and communities of practice on specific policy relevant topics, themes and issues
- improve SEHD policy administrators' understanding of the potential for using evidence in the policy cycle
Overall, it was anticipated that in the course of the project these processes would increase the use of evidence in the SEHD policy cycle and NHSS practice and service delivery. The work of the SAHPM team also emphasised:
- obtaining the best available range of knowledge and information which would both support, and in some cases challenge, policy development and implementation
- prioritising knowledge generation arising from dynamic human interaction created through face to face encounters above traditional transactional models of research/policy knowledge exchange
- embedding working processes and outcomes into departments in the course of the SAHPM project
- tailoring brokerage activity to suit different partners ranging from Ministers, NHSS Chief Executives, the Senior Civil Service and Scottish Universities; through the different layers of the academic community, NHSS front line staff, and diverse public and private sector evidence providers; to grass roots community groups and social enterprises across Scotland with an interest in engaging in the policy process.
The theory of KM, KT and KB has been practically applied within the UK private sector and in the United States and Canada, however, the SAHPM team appears to be the first to formally identify and apply KM, KT and KB techniques as civil servants in a Scottish government department. In doing so, the team aimed to implement a wide ranging programme of work and to offer academics the opportunity to put in to action long-standing requests for a greater degree of engagement and collaboration with civil servants on particular policy issues.
1.4 Final Pilot Project Outcomes and Direction of Travel for Knowledge Transfer
Over recent years each Analytical Service Division ( ASD)-whether implicitly or explicitly at the portfolio level-has taken forward knowledge management, knowledge transfer and knowledge brokerage activity in partnership with colleagues in relevant policy, academic and practice communities across a range of social and economic public policy issues.
In parallel to this activity Office of Chief Researcher developed a strategic dialogue on knowledge transfer with the academic sector, and other relevant partners, which resulted in the establishment of an OCR Knowledge Transfer Team in Spring 2005. The team now (Autumn 2005) provides a dedicated resource which leads on Scottish Executive social research knowledge transfer issues; provides advice and support on knowledge transfer and knowledge brokerage to colleagues in Analytical Service Divisions; and when appropriate collaborates with the Science and Research Group ( SRG) on multi-disciplinary elements of the SRG research programmes. Current key external partners the work of the team are Economic and Social Research Council, Scottish Higher Education Funding Council, and European Science Foundation.
The Knowledge Transfer team takes a strategic Executive-wide approach to Knowledge Transfer, however the health-focused SAHPM Pilot informed the current work programme of the Knowledge Transfer team, in particular their work on testing the theory and practice of knowledge transfer within and between the civil service and academic community; and locating evidence for policy in Scotland within a wider UK, European and international context.
The outcomes of the SAHPM project also informed the recent changes to SEHD infrastructure, and made an important contribution to a wider understanding of how development and research resources are currently identified, accessed, shared, stored and disseminated in SEHD.
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