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Knowledge Sharing and Learning for Health

Olivier Serrat

The views expressed in this presentation are the views of the author/s and do not necessarily reflect the views or policies of the Asian Development Bank, or its Board of Governors, or the governments they represent. ADB does not guarantee the accuracy of the data included in this presentation and accepts no responsibility for any consequence of their use. The countries listed in this presentation do not imply any view on ADB's part as to sovereignty or independent status or necessarily conform to ADB's terminology.

Eternal Problems in Healthcare

Errors and mistakes
Poor quality healthcare Variations between policy and practice Poor patient experience Overenthusiastic adoption of interventions of low value Failure to incorporate new evidence into practice Failure to manage uncertainty Failure to close inequality gaps
Knowledge is the enemy of disease. The application of what we know will have a bigger impact on health and disease than any drug or technology likely to be introduced in the next decade. William Gibson, National Health Service, United Kingdom

Types of Knowledge in Healthcare

Generalizable Knowledge
Evidence - Knowledge from research. Statistics Knowledge from measurement of healthcare performance.

Of Patients and Technicians Knowledge from experience.

Particular Knowledge

Knowledge about this patient.

Knowledge about this service.
Ignorance is like cholera; it cannot be controlled by the individual alone. It requires the organized efforts of society.

Professionals and patients need clear knowledge for decision making just as they need clean water for hand washing.
William Gibson, National Health Service, United Kingdom

The Health Sector in ADB

Health plays an important role in human development and inclusive growth.
ADB's health sector operations aim to support and strengthen efforts to improve the health of the poor, women, children, and indigenous peoples in the region. Strategy 2020 emphasizes the well-defined role ADB can play in improving health through its core activities, relying on its institutional skills and comparative advantages to complement other partners in supporting developing member countries.

Tools of the Health Community of Practice

Meetings Brown Bag sessions Announcements in ADB Today Web presence on Knowledge products

The Value of Communities of Practice

CoPs are groups of people who share a passion for something they know how to do and who interact regularly to learn how to do it better. They enhance learning and empower people in their work. They have become an accepted part of organizational development. Short-Term Value help with challenges access to expertise confidence fun with colleagues meaningful work problem solving time saving Long-Term Value personal development reputation professional identity collaborative advantage marketability
One of the challenges of One of the challenges of development is how to access development to access and share tacit knowledge. Tacit and share tacit knowledge. Tacit knowledge needs must be knowledge needs must be transmitted by special methods. transmitted by special methods.


Learning organizations build Learning organizations build CoPs, leverage CoPs, leverage them with effect, and link them them with effect, and link them to networks of practice. to networks of practice.

knowledge sharing synergies across units reuse of resources

strategic capabilities keeping abreast innovation retention of talents new strategies


The simple act of joining and being regularly involved in organized groups has a very significant impact on individual health and well-being.

Roles of Communities of Practice in ADB

ADB's numerous and diverse CoPs are the heart and soul of knowledge generation and sharing in ADB. This owes to the social and organizational capital (experiences, insights, and perspectives) their members offer. They can play a role in helping ADB lend smarter. They can influence development outcomes by promoting greater and better informed dialogue. They can promote innovative approaches to address specific development challenges. They can develop, capture, and transfer best practices on specific topics by stimulating the active sharing of knowledge. They can link a diverse groups of practitioners from different disciplines and are thus intertwined with ADB's organizational structure. CoPs serve as an ongoing learning venue for staff members (and outside practitioners) who share similar goals, interests, problems, and approaches. They can respond rapidly to individual inquiries from members and ADB audiences, clients, and partners with specific answers.

Critical Success Factors

An organization is ready to host a CoP (and allocate resources to it) if: The domain is of strategic importance to the host. The host recognizes knowledge management and learning as important. The CoP and its host share common values. The results are relevant and beneficial for the host and its staff members.

A domain that energizes the core group and inner circle Skillful and reputable managers and facilitators Involvement of members The details of practice are addressed Right rhythm and mix of activities

Strategic relevance of the domain Management sponsorship (without micro-management) Judicious mix of formal and informal structures Adequate resources Consistent attitude

Clearly delineated function(s) Capacities, skills, resources, and systems match function(s)

A successful CoP is able to cope with the organizational culture (and pragmatism) of its host.

Functions of Communities of Practice

Filtering Amplifying Organizing and managing information that is worth paying attention to Taking new, little-known, or little-understood ideas, giving them weight, and making them more widely understood Offering a means to give members the resources they need to carry out their main activities Bringing together different, distinct people or groups of people Promoting and sustaining the values and standards of individuals or organizations

Investing & Providing Convening

Community Building

Learning & Facilitating

Helping members carry out their activities more efficiently and effectively

CoPs can carry out several functions simultaneously. But, there are trade-offs. Each function requires specific capacities, skills, resources, and systems. Overlooking trade-offs can drive CoPs away from their original role.

Areas of Competence
Strategy Development Management Techniques

Collaboration Mechanisms

Knowledge Sharing and Learning

Knowledge Capture and Storage

Areas of Competence
Strategy DevelopmentA strategy is a long-term plan of action designed to achieve a particular goal.

Management Techniques Leadership is the process of working out the right things to do. Management is the process of doing things right. Collaboration MechanismsWhen working with others, efforts sometimes turn out to be less than the sum of the parts. Too often, not enough attention is paid to facilitating effective collaborative practices. Knowledge Sharing and LearningTwo-way communications that take place simply and effectively build knowledge. Knowledge Capture and StorageKnowledge leaks in various ways at various times.

Knowledge Sharing and Learning in Communities of Practice

Every Single One of Us Working in Teams As a Community


I ask questions. Inquiring minds are welcome here.

We check first to see what already exists.

We question accepted wisdom.


I contextualize learning to make it real.

We connect and take opportunities to learn. We share experience, evidence, and feedback.

We review lessons as we go and apply our learning. We share achievements, outcomes, and pride.


I share personal details, roles, and skills.

Disseminating Knowledge Products

Dissemination is The delivery and receipt of a message. The engagement of one or more individuals in the effort. The transfer of a product or process.
Successful dissemination Must be planned before the onset of the agenda. Should elicit a response from targeted audienceshow will they use the findings? Must be formulated in light of the distinct stages of awareness, understanding, and action.

Effective dissemination is constrained by Poor planning. The absence of a dissemination policy, strategy, plan, and tactics.

Disseminating Knowledge Products

Key Steps
1. Adopt a strategic approach to dissemination. 2. Know the target audience. 3. Formulate generic, viable dissemination strategies that can be modified according to primary purpose. 4. Monitor and evaluate accomplishments.


Dissemination and Use of Knowledge




Disseminating Knowledge Products

Key Questions 1. What do we want to disseminate? Effective dissemination hangs on having a shared vision and common understanding of what one wishes to disseminate.
2. What is the target audience? What are we offering it? Identify the target audience and map for awareness, understanding, and action. Successful dissemination strategies actively engage a target audience and deliver what it needs. Examine the knowledge product and present it as a benefit and solution to the target audiences.

Disseminating Knowledge Products

3. When do we disseminate? Make the dissemination plan realistic. Identify and set the milestones of the dissemination plan. 4. What are the most effective ways of disseminating? Explore and evaluate what methods meet the needs of the target audience most effectively and appropriately. Vary the methods to increase the chances of success.
5. Who might facilitate dissemination? Work through existing channels to have a greater chance of success. Collaborate with others to improve the impact of dissemination and reduce costs.

Disseminating Knowledge Products

6. How do we prepare dissemination strategies?
Strategy covers Dissemination

The knowledge products for dissemination

Target audiences The benefits to users

Dissemination methods and related activities

Timescale and responsibilities Targets

Monitoring and evaluation and criteria for success

Disseminating Knowledge Products

7. How do we turn our strategy into a dissemination plan?
Clearly set the objective, target audience, methods, timing, and responsibilities.

8. How do we cost our dissemination activities?

Estimate individual costs for dissemination activities. 9. How will we know if we have been successful? A dissemination strategy will only be effective if it is viewed as an evolving process.

Establish clear targets at the onset by linking them to the three broad purposes of disseminationawareness, understanding, and action.

Developing a Dissemination Policy

An agenda requires
A dissemination policy A dissemination strategy

A dissemination plan
Dissemination tactics A dissemination policy Establishes the network's vision and values, and measures these to engage. Explains how efforts at disseminating knowledge products results link to their utilization. Ties knowledge products to practice through dissemination strategies, dissemination plans, and the application of dissemination tactics.

Developing a Dissemination Strategy

A dissemination strategy is about
The overall effect an individual or institution wishes to create. How an individual or institution addresses particular issues to ensure that dissemination of knowledge products leads to their utilization.

Key Considerations
1. Users Is the readiness of the users to change limited? Are there needs for widely divergent formats and levels of information content? Is the number of trusted information sources limited?

Developing a Dissemination Strategy

2. Source
Is the credibility of an individual or institution's experience limited? Is the level of perceived competence low? Is the motive suspect? 3. Medium Is the information content clear and attractive? Are the dissemination methods flexible and reliable?

Are the dissemination methods cost-effective?

Are the timeframes required to access the information content lengthy?

Developing a Dissemination Strategy

4. Information Content Is confidence in the quality of knowledge products and its methodology low? Is the utility and relevance of the information content unclear? Is the credibility of outcomes limited? Is the format of the information content user-friendly? Are there cost implications to access to information content?
5. Context Are there competing knowledge products? Do the general climate or circumstances favor adoption of knowledge? Can the knowledge products find practical application?

Developing a Dissemination Plan

A dissemination plan outlines basic elements that must be implemented. Dissemination should produce a response, viz., utilization of the knowledge products, on the part of the users.
Key Elements 1. Impact and Outcome What is the desired impact of dissemination? What outcome does the dissemination plan aim to accomplish? In what ways will users benefit?
2. Users Which users will be most affected by the knowledge product? Which users will be most interested in learning? What are their scope and characteristics?

Developing a Dissemination Plan

3. Information Content
Does the information content match the users' expected information needs? Is the information content reviewed through a quality control mechanism to ensure accuracy and relevance? Does the comprehension level required to understand the information content match the characteristics of the users? 4. Medium What resources does each group typically access? What capabilities does each group have? What are the most effective dissemination methods to reach each user group?

Developing a Dissemination Plan

5. Execution When should each aspect of the dissemination plan occur? Who should be responsible for specific dissemination activities?
6. Obstacles What potential obstacles may slow access to or utilization of the knowledge products by each user group? What actions could be developed to overcome these obstacles? 7. Accomplishment How will accomplishment be described and measured? If data is to be gathered, who will gather it?

Developing a Dissemination Plan

An effective dissemination plan
1. 2. 3. Is oriented to the needs of users. Relies on appropriate form, language, and information content levels. Incorporates various dissemination methods (i.e., written, graphical, electronic, and verbal media) to include both active and reactive communication channels. Draws on existing (and planned) resources, relationships, and networks.



Establishes linkages to the resources required to implement the information content (e.g., technical assistance).

Applying Dissemination Tactics


The Report

Dissemination Tactics

Desk Launch Press Conference



Professional Conference Verbal Feedback to Contributors Verbal Briefings

Dissemination Magazine Verbal Feedback

Journal, Magazine

Press Release

Consortium and Network

Meetings First Qualification

Referencing Material Website Database CD-ROM Basic Dissemination Tactics

Integration into Training

Post-Qualifying Courses Other Courses

Advanced Dissemination Tactics

Source: Adapted from Barnardo's. 2000. What Works? Making Connections: Linking Research to Practice.

Some Dissemination Methods

Identifying and Sharing Good Practices

Good practice is a process or methodology that has been shown to be effective in one part of the organization and might be effective in another too.
Three possible levels of good practice flow from: Promising practices Demonstrated practices Replicated practices Since knowledge is both explicit and tacit, good practice programs should comprise two elements: good practices databases the connect people with information, and collaboration or knowledge sharing and learning mechanisms (i.e., CoPs or peer assists) that connect people with people.

Identifying and Sharing Good Practices

The benefits from identifying and sharing good practices are that doing so will
Identify and replace poor practices.

Raise the performance of poor performers closer to that of the best.

Decrease the learning curve of new employees. Reduce rework and prevent "reinvention of the wheel." Cut costs through better productivity and efficiency.

Improve services.
Minimize organizational knowledge (both tacit and explicit) loss.

Identifying and Sharing Good Practices

The six-step approach to identifying and sharing good practice:
1. Identify user's requirements Who will benefit most from better knowledge and understanding of good practices? How will they access and use these? 2. Discover good practices Who are likely using good practices? What parts of their overall approach or methodology represents good practice? 3. Document good practices What standard format can be used? Can the information be kept in a database?

Identifying and Sharing Good Practices

4. Validate good practices
Is there a demonstrable link between what is practiced and the end result? Are there mechanisms in place that seek input and feedback from clients? 5. Disseminate and apply Is there added value in the process? Do the mechanisms generate benefits? 6. Develop a supporting infrastructure Is there a supporting technical infrastructure to successfully implement a good practice program (e.g., document sharing, databases, content management system, etc.)? Does the technical infrastructure consider the people who will facilitate and drive the process?

Identifying and Sharing Good Practices

Do's and Don'ts
Good practices are not a quick-fix solution and setting up the required processes and infrastructure can be resource intensive. Good practice evolves constantly.

Do not underestimate the importance of organizational culture.

Resist the temptation to focus on explicit knowledge: it is through people that deep knowledge is transferred. Do not be too prescriptive about good practices and focus instead on encouraging people to identify and share them voluntarily. Tie good practices to business drivers, focus on those that add value, demonstrate benefits, and give evidence.

Recognize the individuals and groups who submit good practices.

Promote the good practice resource actively. Monitor usage of the good practice resource. Make contact to the provider of the good practice easy.

Value Cycles for Development

Projects (and programs) and knowledge are mutually dependent: to deliver development outcomes, projects must be enriched by knowledge; and new knowledge (that should be captured and leveraged) must in turn be generated by projects. The value cycle is a conceptual framework:
depicting how organizations can build a continuous momentum for creating value. integrating internal (comparative advantage, competitive advantage, and measures of organizational performance) and external perspectives (value proposition, customer perceived value, and market-based measures of performance). A consistent value cycle: needs to be occurring throughout all stages of the project cycle. should generate and communicate benefits while remaining aligned with the projected impact of the project.

The Five-C Value Cycle

Communicate 1 5 Connect 2

4 Capitalize

3 Collaborate

Source: Arthur Shelley. 2009. Being a Successful Knowledge Leader: What Knowledge Practitioners Need to Know to Make a Difference. Ark Group.

The Five-C Value Cycle

The Five-C Value Cycle offers an effective way to enhance development outcomes.
Communicating at the beginning of the cycle targets at engaging stakeholders and resources. Once engaged, they are encouraged to connect and build relationships to ensure a high level of collaboration. As desired outputs are accomplished, the project team needs to ensure that they are capitalizedthe promised benefits are delivered to the intended beneficiaries. Successes (including shortcomings and failures) are shared by communicating widely to derive lessons, highlight possible solutions, mitigate potential risks, and reduce future errors.

The Five-C Value Cycle

Source: Adapted from Arthur Shelley. 2009. Being a Successful Knowledge Leader: What Knowledge Practitioners Need to Know to Make a Difference. Ark Group.

Posting Online
The internet Is now a primary vehicle for disseminating knowledge products. Makes it possible for anyone to capture, store, and share knowledge products so that it may be invoked by peers, educators, students, journalists, customers for expertise, and the general public.

Advantages of Posting Knowledge Products Online 1. Outlay Once material is online, hundreds of thousands of people can access it at no cost to the initiating party.
2. Speed and Flexibility The internet is very fast compared to print media, and enables hypertext-specific and interactive actions. Posting online takes minutes: this facilitates opportune and fresh updates.

Posting Online
3. Synergies Posting knowledge products enhances and sponsors other dissemination methods. Posting knowledge products can entice users to draw on other's work.
4. Audiences The internet exposes work to new audiences. More people can find and access materials that are available online as well as in print. 5. Monitoring and Evaluation Web pages, nowadays, invite feedback and therefore facilitate online impact assessment.

Posting Online
6. Fund-raising Internet publication is a common requirement of individuals and institutions. Dissemination of knowledge products raises the profile and enhance the capacity of individuals and institutions. Donors are likely to be attracted to individuals and institutions that are committed to disseminating knowledge products to users.

Better Writing on the Web

Successful online communications actively encourage users to read and absorb material.

Operating Principles 1. Reading Online Users are impatient. Users make on-the-spot judgments about the value of the knowledge and information presented.
2. Disseminating Successfully Online Websites must be scannable. Users do not read but scan websites. Websites must be concise. Users do not scroll. Websites must be objective. Users do not like selfserving publicity.

Better Writing on the Web

Communicating in Web-Friendly Ways
1. Help users find the knowledge products Display prominent links to website materials.

Advertise knowledge products through short yet informative descriptions.

Make the work searchable by using page and section headings, page descriptions, and meta tags. Undertake e-marketing to inform users that knowledge products are available on the internet.

Better Writing on the Web

2. Organize links to documents Think outside the box. Categorize materials by type (e.g., working paper, discussion paper, etc.) and provide a menu for direct access. Specify if the document is downloadable. Develop a customized search engine if numerous documents are hosted on the website. 3. Select a digital format Make the documents available in a format that can be easily opened and printed. Avoid zipping or splitting online documents.

Real-Life Examples from ADB

Real-Life Examples from ADB

Real-Life Examples from ADB

Real-Life Examples from ADB

Real-Life Examples from ADB

Real-Life Examples from Department of Health, Philippines

DOH Call CenterHelpdesk

DOH History BookDocuments DOH initiatives for the past 100 years.
Digitization of ArchivesConversion of library collections, gray materials, and permanent records to digital formats. Knowledge TranslationTranslation of policies and dissemination to local health departments, hospitals, etc. for implementation. Knowledge HubRepository of health information as databases. e-Jobs Health Facilities Atlas Web-based Document Tracking System for DOH

Real-Life Examples from Department of Health, Philippines

Real-Life Examples from National Health Service, United Kingdom

Real-Life Examples from National Health Service, United Kingdom

Real-Life Examples from National Health Service, United Kingdom

Further Reading
ADB. 2008. Posting Research Online. Available: ADB. 2008. Using Plain English. Available: ADB. 2008. Identifying and Sharing Good Practices. Available: ADB. 2009. Conducting Effective Presentations. Available: ADB. 2009. Disseminating Knowledge Products. Available: ADB. 2009. Value Cycles for Development Outcomes. Available; ADB. 2010. Showcasing Knowledge. Available: ADB. 2010. Harvesting Knowledge. Available:

Knowledge Management Center

Olivier Serrat
Principal Knowledge Management Specialist Knowledge Management Center Regional and Sustainable Development Department Asian Development Bank