Knowledge Pit Stops

Back in 2009, I blogged about some heart-warming examples of cross-industry peer assists,  involving Great Ormond Street Hospital and the Ferrari Formula 1 pit team.  Geoff and I wrote the story up fully in our second book, "No more Consultants". The specific example related to the operating theatre team improving their handover processes during an operation called the "arterial switch" - and the insights of Professor Martin Elliott and his colleagues who had the curiosity and the passion to approach Ferrari and ask for help.

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It reminded me of Thomas Friedman's book "The World is Flat" where he wrote:

“I have concluded that in a flat world, IQ- Intelligence Quotient – still matters, but CQ and PQ – Curioity Quotient and Passion Quotient – matter even more. I live by the equation CQ+PQ>IQ. Give me a kid with a passion to learn and a curiosity to discover and I will take him or her over a less passionate kid with a high IQ every day of the week.”

I was interested to see that Formula One was in the news again this week with another example of curiosity-driven cross-sector knowledge sharing - this time with public transport.  Train manufacturer Alstom, who say that the knowledge they gained has enabled them reduce a 2-day repair job to just 4 hours.

We need more of these "I wonder" moments to bring knowledge together, where curiosity triumphs over the "but we're different" default reaction of not-invented-here cultures which drives those connections and overlaps apart.

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Halfway down the stairs, where good is the enemy of great.

I've been reflecting on the dangers of “staying with the herd” when it comes to knowledge sharing.  It’s easy for our organisations to reinforce this mentality, and lead to people feeling exposed as “tall poppies” is they step out and share a good practice – or professionally incompetent if they are seen to be asking for help.  I think this leads people to cluster in the middle ground of mediocrity, or to put it more kindly, a place where good is the enemy of great.

This leads me to the words of AA Milne, in his poem, “Halfway down the stairs”.

Halfway down the stairs is a stair where I sit. there isn't any other stair quite like it. I'm not at the bottom, I'm not at the top; so this is the stair where I always stop.

Halfway up the stairs Isn't up And it isn't down. It isn't in the nursery, It isn't in town. And all sorts of funny thoughts Run round my head. It isn't really Anywhere! It's somewhere else Instead!

There’s a charming version sung by Robin the Frog from the Muppet's Show on YouTube, which takes me back to my childhood!  (I'll post it at the end as a treat for you)

The River Diagram is has now become a fairly well established tool, combining the principles of positive deviance with knowledge sharing.  However, less people are familiar with its companion tool, the Stairs Diagram.

The Stairs diagram shows levels of capability (often derived from a common self-assessment tool or maturity model) plotted against the size of the improvement goal.  The example below (fictitious) shows the results of a number of healthcare-related networks who have all used a common self-assessment tool to discuss and agree their levels of networking capability against a number of practices.  They have also identified a number of targets for improvement. One of the practices in the self-assessment was "Network Leadership & Facilitation".  This is the Stairs Diagram for that practice.

Stairs Diagram
Stairs Diagram
  • The Diabetes Network is at level 5, and clearly has something to share.
  • The Quality Improvement Fellows network is at level 1, but has a desire to improve by two levels.
  • The Cardio-community is at level 2, and hasn't chosen this practice as a priority for improvement.
  • There is a cluster of networks at level 3 with no aspiration to improve, including the Health Informatics network.
  • Finally, the TB Network is at level 3, but still seeking to improve by two level.

The power of the stairs diagram is that it maps out the potential connections of highest value - connecting those who have something to share with those who have something to learn.  This is shown in the green and red areas respectively.

Having a common measure (in this case, a self-assessment tool) enabled this group of networks to identify not only the positive deviants, but also the networks with the greatest aspiration to improve.  For each "staircase", the group can be coached to use an appropriate knowledge management tool to help those in the nursery to improve, and those in the town to share. That might be a Peer Assist, offers and requests, a knowledge cafe, knowledge fair, storytelling approach, or the capture and sharing of a distinctive or excellent practice.

So with the right motivation, the right leadership and the right methods, you can help people avoid the stair where they always stop.

You thought I'd forgotten?

Knowledge retention - a game of two halves.

36brokenHeartNecklaceBack in the '80s, the oil company Shell ran a promotional campaign from their petrol (gas) stations in the UK which would never work today.  With every petrol purchase, you were given a scratch-card, which would reveal the left or right half of a banknote, with a value of up to £5000.  The half-note had no value in itself  - but if you could discover both halves of the banknote, then you would receive the cash.  As a child, I can remember it made those boring garage stops much more exciting! Shell's promotion relied on a good geographic separation of left and right halves of the high value banknotes. It worked well... until someone had the bright idea of asking for the missing half-notes on national radio (we're pre-internet here folks!), at which point I think Shell cried "foul" and cancelled the promotion.

I've been working on a KM/OL strategy for a company with a large number of major construction projects.  I had the privilege of interviewing a very perceptive senior manager who was reflecting for the first time on the challenges of managing knowledge in a project  team environment. She made an interesting observation about the power of stories as a source of shared knowledge, and the true cost of breaking up project teams to reallocate resources to new tasks.

It's easy to assume that when a team dissolves, each of the members  take the knowledge, lessons and stories with them. Completely.  Within this assumption, every team member is a  repository and can be managed and reallocated as a lossless, portable knowledge transfer approach, plugged into the next project just like a lego brick.

This manager's insight was that many of the stories don't reside wholly with an individual - they only surface when two former team members come together and spark each other's memories to release the value - just like our £5000 Shell scratchcard halves.  Without the other half, the knowledge value of that shared story is volatile, and at risk of dispersing into the ether.

Image In this world there is a real loss of knowledge when a team is disbanded and reallocated - it's not all carried by the individuals. The sum of the separated parts is now less than the sum of the parts when they were together.

As I write this, it seems obvious, but I have a feeling that our approaches to managing and sharing experience and expertise - and even our interpretation and use of network analysis - is often built on the assumption that we can make and break bonds and still retain all the knowledge in the nodes.

I think it's a lot messier than that - as Joe Cocker and the Beatles both sang - we only get by with a little help from our friends.