Create knowledge products

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Making knowledge useable in your context is important to support decison making.

Think about:

This is also known as Actionable Knowledge which can be defined as 'a set of skills, tools and technology (or a combination of these) which enable the creation and use of an evidence base'. The information contained in the evidence base must be capable of being delivered to the right person, at the right time and in the right format so as to support patient and service-user care.

The format and delivery method should provide easy access and the facility to be integrated into everyday workflows at the point of care.

  • How can you make it easier for you and others to do the right thing everytime?
  • Are there ways to remind practitioners of the evidence?
  • How can you take into account the local context and processes to make it easier?
  • Who can help you do this?
Decision support

Decision support tools can range from a checklist on the wall to prompts on online record systems and mobile apps.

These digital knowledge tools recognise that busy practitioners rarely have time to read and evaluate full research papers during the pressures of day to day work. 

To address this challenge, these tools provide concise summaries of evidence and recommendations for practice in actionable formats that are easy for health and social care workers to use to make decisions in frontline care. For examples of point of care tools available to staff in Scotland see the Evidence Summaries section of this guidance.

Examples of tools to help people do the right thing everytime

A key aspect of using tools is that they support delivery of knowledge in actionable formats which can then be used easily in decisions at point of care. These can be simple checklists or sophisticated mobile apps or pathways.

The Right Decision Service provides access to mobile apps, guidance and tools

Protocols and pathways

Protocols and pathways are both methods of converting evidence and guidelines into actionable formats that individual clinicians and teams can use in frontline care.

Local protocols reflect local services and staffing arrangements. They identify who carries out key parts of the care or treatment and where they should be delivered.

A key aim of a clinical pathway is to focus on the patient’s overall journey, and to improve coherent continuity and coordination of care, rather than the contribution of each specialty or caring function independently. Pathways differ from practice guidelines and protocols as they are utilised by a multidisciplinary team and have a focus on the quality and co-ordination of care across disciplines and sectors. The pathway design tries to capture the foreseeable actions which will most commonly represent evidence-based practice for most patients most of the time. They are actionable knowledge products in that they include prompts for clinicians to take actions at the appropriate time in the pathway. 

Definition: Pathways

A clinical pathway (also known as a care pathway or integrated care pathway) is a multidisciplinary management tool based on evidence and guidance for a specific group of patients with a predictable clinical course, in which the different tasks (interventions) by the professionals involved in the patient care are defined, optimised and sequenced.

Definition: Protocol

Protocol-based care enables staff to put evidence into practice by addressing the key questions of what should be done, when, where and by whom at a local level. This standardisation of practice reduces variation in the treatment of patients and improves the quality of care.

Pathways can be viewed as algorithms in as much as they offer a flow chart format of the decisions to be made and the care to be provided for a given patient or patient group for a given condition in a step-wise sequence. It is important to note that pathways are generally not prescriptive; the patient’s journey is an individual one, and an important part of the purpose of the pathway documents is to capture information on “variances”, where due to circumstances or clinical judgment different actions have been taken, or different results unfolded.

Developing a pathway

1. Identify the topic – normally this should be a high volume issue with recognised impact on patient safety, quality of care, and cost.

2. Create the pathway team – with clear professional leadership and involvement of all disciplines.

3. Use guidelines and evidence summaries to identify current evidence-based practice.

4. Evaluate the current process of care and critical areas where it varies from evidence-based practice.

5. Work with clinicians or relevant practitioners to analyse the causes of this variation.

6. Define how to measure changes in practice in these areas of variation.

7. Define the format of the pathway, specifically how key processes and timings will be presented.

8. Measure variation from evidence-based practice in these target areas.

9. Make amendments to practice and to pathways to address this variation.

10. Re-measure variation after implementing the improvements.

The Clinical Knowledge Publisher Tool - this is a web-based system that allows users to design and publish clinical pathways and guidelines documents.

Visualisation tools

Knowledge visualisation is the transformation of large quantities of knowledge or information into a graph or picture. When done well these visual representations can make facts and knowledge more accessible to the end user.

There are many on-line tools available, a few are highlighted un the Knowledge Management Toolbox in the Sourcing and Structuring / Knowledge Visualisation section which will help you present your own data and information in picture form.