This piece is the fourth installment of a five-part series on the importance of knowledge management strategy titled, “The Missing Pieces: How Better Knowledge Management Practices Can Complete the Public Health Puzzle.”

“I know it’s here somewhere.”

This thought, expressed silently or out loud, is bound to happen a few times in any professional’s career when they are searching for a document, an article, or some other piece of data or information that, although they recognize that it might be useful at this particular moment, cannot quite remember where they stored it. Those who work in public health, however, will recognize this as a common – and frustrating – realization. The information that public health professionals need and use on a daily basis comes in a wide variety of forms and formats and is found in just as many places; from peer-reviewed journals, white papers, and official government documents to meeting minutes, internal documents, e-mails, and even notes scribbled into margins. This rich diversity of information that public health professionals contribute to their field is invaluable; however, that same diversity can make finding that critical quote, statistic, or document nearly impossible to locate if the content creator is not there to tell you where they put it.

The knowledge and experience of its professionals is public health’s greatest resource. The broad scope of public health carries the potential to collect and learn from the expertise of civil servants in various levels of government agencies, non-profit organizations, clinicians, healthcare administrators, and the public. Unfortunately, such wisdom can be elusive – if it is not stored somewhere, then it will be lost when workers leave the profession or their organization, and those who follow often find themselves reinventing the wheel.

Staff turnover happens for many reasons. People retire, accept promotions, or quit; positions are lost when funding is cut; or “brain drain” draws professionals to move on to greener pastures, whether from rural areas to urban or from developing countries to developed. Regardless of the reason, there is always the potential for knowledge to be lost when someone leaves, which is why good knowledge management practices are so critical. Unfortunately, most public health organizations do not have an information management plan that assures that formal knowledge and know-how is systematically acquired, organized and delivered where and when it is needed.

Fortunately, several organizations are utilizing knowledge management systems and practices to preserve institutional memory so that knowledge and contributions are not lost. In the introductory chapter to Knowledge Management in Public Health, Dr. Jay Liebowitz details how Harvard Medical School and Beth Israel Deaconess Hospital use knowledge management practices to collect and preserve their institutional expertise:

Among these [knowledge management tools] are: an automated faculty-activity report generator…an automated feature for department chairs to generate annual reports; 1600 online courses and 200 Flash simulations; problem-based learning using interactive simulations; learning portfolios in a wiki-like fashion; and the hosting of about 300 Harvard Med wikis.
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[A]ll clinicians at Beth Israel Deaconess must be documenting, e-prescribing, and using wikis for lessons learned and problem solving. Every Wednesday…the Change Control Board meets to discuss after-action reviews…Knowledge is being encoded as decision-support rules for patient safety, professional knowledge managers are being used to keep the decision-support rules up to date…wikis and blogs are actively being used, and knowledge is being codified as workflows.

Organizations in the human service sector have begun implementing knowledge management practices to preserve their own expertise as well. For example, one organization engaged Cadence Group to recruit a specialist to develop and direct its knowledge and information management program. This KM director described some of the organization’s recent successes:

• Process documentation: When a long-time manager was preparing to retire, the KM director worked closely with that person to make sure that all of the functions they oversaw were thoroughly documented in a way that was easy for others to access. This did a great deal to make it easier for other employees to ensure that those processes continued with minimal disruption.
• Knowledge scouting: A recent move that the staff found very exciting was the use of “knowledge scouts” at a recent conference hosted by the organization. During the conference, these knowledge scouts attended each session and took notes on what was presented, as well as some valuable discussions. This allowed the expertise and ideas shared at the conference to be retained and provided the organization with a resource that they could return to.
• Improved morale: As they have adjusted to an increasing emphasis on building good knowledge management practices into their regular work, the organizations’ staff has really blossomed as they have gained access to knowledge management tools. They are more confident in their work, more efficient, and are pleased to have better access to information and resources.

The Association of State and Territorial Health Officials (ASTHO) reflects the same key points in its assessment of knowledge management in public health, when it states that “Knowledge management helps to codify knowledge so all may access it, decreases redundant work practices and system development (because there is access to what has already been done), and helps an organization to retain knowledge when staff departs.” Without a sound knowledge management system, public health’s most valuable tool is rendered useless.