Presentation to Brighton and Sussex Medical School Institute of Postgraduate Medicine May 20 2010

1. Delivered by Anne Caborn www.cdacontentlab.com www.webwordsworking.co.uk Making sense of Knowledge ManagementInstitute of Postgraduate Medicine

2. Some of the things we’ll explore Knowledge as a personal tool and resource Flexing messages for different audiences Knowledge handling as part of your working practice But most importantly...

3. Turning management into husbandry and creating an environment where knowledge thrives, grows, transforms and nurtures both individuals and organisations

4. It all starts with you The survey

5. Key out takes Self-scoring your own current understanding of Knowledge Management - where 0 was no understanding and 5 a deep understanding. 2 was typical. A few of you gave yourselves 3. None higher. You expect the amount of information you have to deal with in your job to at least double. A significant number of you said it would triple or more than triple. Nearly all of you ticked: “too many and changing local and national government initiatives that I need to know about”. Staff cuts ticked the least. But most importantly...

6. What do you think is your biggest knowledge management challenge? Sharing of knowledge around an organisation. “few opportunities to share knowledge widely, which I believe often leads to duplication of work” “a lot of the information that comes across my desk is 'restricted' for reasons of national security” Perhaps passing on the right information to the right person, knowledge of the roles of others is vital for this. Prioritising, analysing and making sense of the information in a limited amount of time We need to understand how we can best use information that is already out there to prevent duplication. “challenging the culture - elements of control which hinder, elements of fragmentation which disempower people” “very little 'knowledge management' and a lot of 'knowledge' invested in people, which means at the moment the system is extremely vulnerable to the loss of individuals”

7. Here’s one you made earlier The activity

8. Organise an event for fellow professionals focusing on how looked after children are disproportionately represented within the criminal justice system. Attendees will represent the police and court systems, local education, and other agencies as well as your own organisation. Event will be used to kick start a working group which will then go on to evolve a strategy (for wider buy-in and adoption) aimed at increasing life chances and community involvement for these children and minimising offending / reoffending. At this stage, you want to encourage interest and gauge likely participants. Consider the following questions...

9. Your take on how to handle this What you might say? What response do you need and why? eg do they need to commit in some way to attendance – and how would you go about encouraging / measuring that? How might your message and the language you use differ for the different audiences? What methods (post, email, posters etc) might you use and why? Okay, let’s hear from you...

11. After coffee Language used within organisations, between organisations and by / to client groups Your personal knowledge handling and communication profile – understanding the way you think about knowledge. Changing the way you and others feel about & view an issue through using and communicating knowledge dynamically.

13. Language,organisations & groups

14. You’re all legal eagles Ways in which looked after children are to be accommodated and maintained (1) This section applies where a local authority are looking after a child (“C”). (2) The local authority must make arrangements for C to live with a person who falls within subsection (3) (but subject to subsection (4)). (3) A person (“P”) falls within this subsection if— (a) P is a parent of C; (b) P is not a parent of C but has parental responsibility for C; or (c) in a case where C is in the care of the local authority and there was a residence order in force with respect to C immediately before the care order was made, P was a person in whose favour the residence order was made.

15. diversity 5 clients, service users and colleagues 6 only colleagues empowerment multi-disciplinary

16. Hey you! Pass me the pointy, jabby thing

18. Same or different? Too much stuff to deal with To much rubbish to deal with Too much information to deal with Too much paperwork to deal with 1/11

19. Knowledge metaphors “In the West, dominant metaphors of knowledge are based on the idea of knowledge as stuff” Daniel Andriessen 2008 Knowledge as Energy: a metaphorical analysis

20. Stuff or love? How metaphors direct our efforts to manage knowledge in organisations Andriessen 2008

21. Tip – record and playback

22. Understanding the way you think about knowledge

23. Cognitive bias “cognitive biases affect the most important strategic decisions made by the smartest managers in the best companies” Dan Lovallo and Olivier Sibony March 2010 McKinsey Quarterly Dan Lovallo, professor at the University of Sydney, senior research fellow at the Institute for Business Innovation, University of California, Berkeley. Olivier Sibony, director, McKinsey, Brussels.

24. Human nature “biases are pervasive because they are a product of human nature—hardwired and highly resistant to feedback, however brutal. For example, drivers laid up in hospitals for traffic accidents they themselves caused overestimate their driving abilities just as much as the rest of us do” Dan Lovallo and Olivier Sibony March 2010 McKinsey Quarterly

25. PATTERNS ACTION STABILITY

26. Tip – recognising bias Pattern-recognition eg overweighting recent or highly memorable events, ignoring evidence that would disprove a hypothesis Counter with site visits, meeting management techniques such as role reversal Action orientated bias - often prompted by excessive optimism about the future and especially about our own ability to influence it Counter by making clear and explicit distinctions between ‘we’re still deciding’ meetings (embrace uncertainty, encourage dissent) and implementation meetings (time to move forward together). Other valuable tools - decision trees, and the “premortem” I’ve uploaded a useful PDF about this to the bottom of the online reading list

27. “If a project goes poorly, there will be a lessons-learned session that looks at what went wrong and why the project failed - like a medical postmortem. Why don’t we do that up front? Before a project starts, we should say, ‘We’re looking in a crystal ball, and this project has failed; it’s a fiasco. Now, everybody, take two minutes and write down all the reasons why you think the project failed.’.” Gary Klein Senior scientist, MacroCognition

31. “by far the most frequently used drug in general practice was the doctor himself, ie it was not only the bottle of medicine or the box of pills that mattered, but the way the doctor gave them to his patient” The doctor, his patient and the illness Michael Balint,1957 Acouple’s therapist who carried out groundbreaking work into the doctor-patient relationship

33. Schema Theory - most simply described as the organisation of knowledge into units, or schemata. We develop these schemata long before we engage in formal education and they are the basic building blocks we employ for understanding the world. Our personal schema help us discern information which is relevant to us. Piaget, Anderson, et al

34. Schema – 4 main concepts Early Maladaptive – core themes or patterns that we keep repeating Schema Domains – how our emotional needs were met in childhood eg rejection, overprotection, overindulgence (impaired limits)... Coping Styles - a child adapts to damaging childhood experiences such as bullying eg surrender, avoidance, overcompensation Modes - moment-to-moment emotional states and coping responses often triggered by life situations that we are oversensitive to, making us angry, feel isolated, feel happy...

35. Communicating knowledge dynamically

37. How the content landscape transforms

38. Tip – cut email strings Distil the action or observation from an email string. You’re ccing people not conversations.

40. Tip - the 4 As Assess For example, do you currently trade data, information or knowledge? Do you communicate too much / too often or too little / too infrequently? Is what is being communicated a distillation or is data / information / information simply being ‘shortened’? How to you feel post-comm – how do recipients feel post-comm?

41. The 4 As Adjust Don’t throw the baby out with the bath water Identify lightening rods within your team and get their help Make small / incremental changes – fizz not biz

42. The 4 As Apply Tell people what you intend to do before you do it Make sure they know feedback is welcome Listen out for what’s not being said

43. The 4 As Assess Is it working? If not, adjust, apply...

44. Experiential learning circle David A. Kolb 1975

46. After lunch Feedback on lunchtime activity Academic systems and processes v. practical needs Processes you might evolve for dynamic knowledge usage and sharing

47. Take another look at your activity outline Have you created something for you – or for your recipients? What’s the worst case scenario (pre-mortem)? Tell us how well the event went and why. Feedback after lunch...

49. Academic systems and processes v. practical needs

50. Experiential learning circle David A. Kolb 1975

51. Communication does not depend on syntax, or eloquence, or rhetoric, or articulation but on the emotional context in which the message is being heard. People can only hear you when they are moving toward you, and they are not likely to when your words are pursuing them. Even the choicest words lose their power when they are used to overpower. Attitudes are the real figures of speech. Edwin H. Freedman, founding rabbi of the Bethesda Jewish Congregation and a family therapist who exposed the connections between emotional process at home and at work in religious, educational, therapeutic, and business systems

53. From replicate

54. & preserve

55. To share & grow

56. Knowledge within your organisation Tacit or explicit Location Access

57. Tacit, implicit and explicit knowledge Tacit – harder to transmit / articulate. eg ‘ndfgy’ is not a word. Implicit – known but not verbalised. Explicit – written down, recorded, getatable.

58. Tip – knowledge harvesting

59. Thoughts on the processes for dynamic knowledge usage and sharing

60. Organisations - funnel or flow?

61. Key out takes 2 5 of you likened knowledge and how it ‘acts’ within your organisation to electricity – illuminates but not always thing you want to see 4 needed to know exactly what was being referred to

62. usefulness 64

63. The importance of process “contrary to what one might assume, good analysis in the hands of managers who have good judgment won’t naturally yield good decisions. The third ingredient—the process—is also crucial” Dan Lovallo and Olivier Sibony March 2010 McKinsey Quarterly

64. Tip – take the bias out of meetings Make sure the right people are involved - diversity of backgrounds, roles, risk aversion profiles, and interests. Cultivate critics within the top team. Invite contributions based on expertise, not rank. At the point where a decision is going to be made, keep attendance to a minimum, preferably with a team that has experience making decisions together. This loads the dice in favour of depersonalized debate. Assign homework – competing fact gathering teams. Dan Lovallo and Olivier Sibony April 2010 McKinsey Quarterly

65. Tip - Using the familiar Talking about tools – triage & create your personal tool kit.

66. Who, what, where, when, why, how... What? What? SUI Who? patients staff During evidence gathering When? Publication of report