Designing social media impact; a challenge for healthcare improvers

Social media is the in thing in healthcare organisations - Twitter, Facebook, LinkedIn etc. These systems have been around for 5 years or more but are now catching on in healthcare as they are seen as a method for sharing messages quickly and a way to bring diverse and segregated communities together. And this works well.

The challenge is to integrate the use of social media into the mindset of the quality improver.  The Improvement Model asks three questions - all of which are relevant for social media use:

1. What are we trying to accomplish?
2. How will we know its an improvement?
3. What changes can we make that will result in an improvement?

If you're starting out using, say Twitter, and you're in a healthcare quality improvement role the have a think about:

• What do you want to achieve? What is your purpose in using Twitter? Do you want to discover new info from others, link to others, use the media as a broadcast system, raise awareness, raise your own profile... etc? You need to have a purpose.
• How will you know it's an improvement? In the Twitter case, how will you know whether you are reaching your purpose / objectives and in a way that's better than what you do now? It really helps to think about this.  How will you measure your progress? How will you learn? Will you be using an analytics system to learn about what works (classic PDSA processes work very well for understanding how Twitter can work for you).
• Linked to the measures above, how will you maintain your learning and continue to get better and better at using Twitter?

In my experience it's best to thing through purpose and practice as part of starting on the social media road. An online social media account where nothing happens tends not to be a good strategy.

Knowledge management has lost its bark

I'm reminded of the old saying "It's not what you know but who you know". This struck me when reviewing a large and beautifully presented collection of "good practices" collated onto a website by an organisation. This is one of many I see and the teams involved assure me this is part of their knowledge management strategy and one of the mechanisms they are using to share the good practices amongst their constituents.

So I've been wondering for whom these databases have been designed. The measures applied are mostly about counting the number of entries and the number of "hits". This no doubt gives the owner of the system some satistfaction that the extracted knowledge (and I use that term cautiously) is being tapped into. Personally, I am a great deal more sceptical about the whole business.

There is an industry of "knowledge management" and a quick search through the academic publishing databases through up some interesting omissions. I could find little researched and/or published about how individuals or teams successfully used databases and turned them into practical changes that delivered improved results in their organisations - as this is the expressed intent of those who are creating these systems. It is as though the databases have become their own self-sustaining life form, with a purpose now disconnected from their original objective. At what cost?

The databases hold the "what" of information. Some individuals may remember the database exists, find the time to search it, reach the case study, work out how it fits in their circumstance etc. In my experience, most people will either start to solve the problem they have on their own or at best, will find someone in their personal network who can give them some advice. So, how can we find ways to help people extend their personal networks so they can connect to people who can help them answer the questions they want?

Part of the answer to this is a technology literacy - being able to access and use some of the Web 2.0 function including networking sites like LinkedIn http://www.linkedin.com/, chatrooms, wikizines, collaborative documenting etc. Part is an emotional literacy - having the conversational and interpersonal skills to connect with others.

By over-emphasising the "what" are organisations deskilling the "who"?




For an example of a wikizine go to
http://www.zimbio.com/Quality+Improvement+for+Healthcare+Services
and please post some content!

(c) 2008, Sarah Fraser