Why is knowledge sharing now a mainstay of improvement?

M. Rashad Massoud

Director, USAID ASSIST Project/URC

Sharing knowledge and exchanging information is critical to improving health care more so now than ever before. Knowledge management (KM) is a key strategy for fostering “evidence-based quality improvement” in the USAID ASSIST Project.  When working deliberately to improve health care, health care professionals gain insights worth sharing with others and can benefit from the insight of others. Scaling up improvement efforts across large portions of a country’s health system – ASSIST’s mandate – requires that we have systems for capturing learning and transferring that learning across multiple sites and improvement teams.  

Put simply, KM is about people working together with colleagues from other places to share what they know and achieve results that are far beyond whatanyone can accomplish alone.  KM provides a way for health care improvement professionals to draw on all levels of experience to take performance and output to new levels.  

A quality improvement team develops a process map on enrollment in HIV treatment at Tandahimba District Hospital, Mtwara, Tanzania

A quality improvement team develops a process map on enrollment in HIV treatment at Tandahimba District Hospital, Mtwara, Tanzania. 

Photo by Yohane Mkiramweni, URC.

As taught by Nancy Dixon, our mentor on knowledge management who has been guiding our work in this field, there are two different types of knowledge – explicit and tacit – that are transferred in different ways.  Through ASSIST we capitalize on both of these types of knowledge.  We of course spend a great deal of time generating and disseminating expert or explicit knowledge (i.e., readily available information, often in written form) such as guidelines, checklists, job aids, reports, etc. which are very important to improving health care.  But another major part of ASSIST’s knowledge agenda is to give health workers the opportunity to share in small groups the tacit knowledge of the processes they have used to assure the know-how that life-saving interventions reach every patient every time in his or her particular setting.  

Now, imagine multiplying this shared learning on a greater scale: multiple teams all learning from each other about what they have done to try to improve the same thing and allowing everyone to go home and work with each other’s ideas.  ASSIST is trying to harness this incredible power of peer-to-peer learning:  You have a lot more changes being tested, a lot of people are energized as a result of that, and the scale up of change can be much faster.

Even though collective knowledge produces better solutions to complex problems than does individual expertise, health care delivery is a particularly complex endeavour, affected by many factors and subsystems.  It is therefore important to note that one shoe doesn’t fit all: every country, every health system is different. The secret of success is to adapt interventions to fit different contexts of each system.  When experiences are shared and interventions known to work are practiced, maximum utilization of best practices and successful interventions will ensure safe, effective, patient-centered, timely, efficient and equitable health care for every patient.

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