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Sumathi Sundram - UEA 1 Defining and measuring Knowledge Capital in Health Care Presenter: Sumathi Sundram University Of East Anglia - Health Economics.

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Presentation on theme: "Sumathi Sundram - UEA 1 Defining and measuring Knowledge Capital in Health Care Presenter: Sumathi Sundram University Of East Anglia - Health Economics."— Presentation transcript:

1 Sumathi Sundram - UEA 1 Defining and measuring Knowledge Capital in Health Care Presenter: Sumathi Sundram University Of East Anglia - Health Economics Group / Norwich Business School Co – Author: Dr Pinar Guven- Uslu University of East Anglia – Norwich Business School

2 Sumathi Sundram - UEA 2 Context Purpose of Research Concept ;Theoretical Frameworks Methods Some Results Conclusion Knowledge Capital in Health Care

3 Sumathi Sundram - UEA 3 Primary Care Trusts - HMOs Policy- Centralised, national Funding- Top down to PCTs Care Providers- Public Sector, mainly Private Sector, limited Private Sector, limited UK context of Health Care

4 Sumathi Sundram - UEA 4 Maximise Investment in Health Define and measure Knowledge Capital in health care organisation Stock of embedded knowledge generating capacity Stock of embedded knowledge generating capacity Method to define and measure knowledge capital in monetary and non monetary terms Method to define and measure knowledge capital in monetary and non monetary terms Purpose of Research

5 Sumathi Sundram - UEA 5 Knowledge Capital Edvinsson & Sullivan define : Intellectual/ Knowledge Capital as the knowledge that is constantly being developed in organisations together with its ability to convert these assets into revenue

6 Sumathi Sundram - UEA 6 Theory of Knowledge creating organisations Meritum Project categorisation Theoretical Frameworks

7 Sumathi Sundram - UEA 7 Research/ Knowledge Creation in Health Public Good certain outputs non- rival, non excludable Public Good certain outputs non- rival, non excludable Research & Development key driver for Health Improvement Research & Development key driver for Health Improvement Economic potential of public sector research establishments Economic potential of public sector research establishments Research key resource in healthcare services Research key resource in healthcare services

8 Sumathi Sundram - UEA 8 Why Knowledge Capital in Health Theoretical basis for management of knowledge creation or research in health Difficulty in agreeing resource allocation basis Lack explicit recognition of phenomena R&D capacity part of knowledge capital base Optimal path of investment in health to maximise all benefits (inc) knowledge generation/ research capacity

9 Sumathi Sundram - UEA 9 Methodology Literature Review Mixed Methods - Bottom up costing & Qualitative methods Semi Structured Interviews- 2 Stages Operational and Financial reports analysis

10 Sumathi Sundram - UEA 10 Adapted from Nonaka, Nomura and Kametsu, & Umemoto (1999) Experiential Knowledge Conceptual Knowledge Routine Knowledge Interacting & Capturing Identifying & Sharing Selecting & Adapting Tacit Knowledge Explicit Knowledge Tacit Knowledge Explicit Knowledge Systemic Knowledge Organising & Formalising Research & Health and Social Care delivery Primary Knowledge Secondary Knowledge Application Knowledge Practical Knowledge socialisation Externalisation Combination Internalisation Knowledge Creation Cycle – Health

11 Sumathi Sundram - UEA 11 Emerging Condition Pulmonary Hypertension –Cusp of Research – Clinical Care –Provision in care pathway, specialist tertiary/ specialist community services support –Defined as a National Specialist service

12 Sumathi Sundram - UEA 12 Case Study Hospital Specialist Cardio Thoracic Hospital One of 5 National Centres for 1 Pulmonary Hypertension (PH) Heart & Lung Transplant, Sleep Studies International & National Center for Pulmonary Thromboendartecomy (PTE) Patients from England, Wales and Scotland 1.Department of Health National specialist commissioning group Service specification for the national pulmonary hypertension services (NPHS) January 2003 http://www.dh.gov.uk/assetRoot/04/13/08/99/04130899.pdf

13 Sumathi Sundram - UEA 13 Patient pathways –Pulmonary Hypertension services Identify and cost resources - services & research Cost the resources for Pulmonary Hypertension Cost vs reimbursement per NHS (HRGs) Purpose – Bottom Up Costing

14 Sumathi Sundram - UEA 14 Pulmonary Hypertension Activity Profile: 2005/06 Assessments: FCEs ( Finished consultant Episodes) Thoracic Day ward 62 Inpatient 66 Total Assessments127 Follow–ups: FCEs & Attendances Inpatient FCEs 186 Thoracic Day ward attendances291 Outpatient attendances303

15 Sumathi Sundram - UEA 15 Pulmonary Hypertension – Multi- Disciplinary Team

16 Sumathi Sundram - UEA 16 Pulmonary Hypertension Resource Profile Assessments Inpatient or Day ward Establish PH cause and stabilise Establish severity Between 3 to 5 days stay Suitability for surgical intervention Emergency inpatient Transfer Patient Education Follow ups Outpatient, Day ward or Inpatient Monitor progression of symptoms Monitor and adjust drugs up to 7 day stay if inpatient Emergency inpatient Transfer Readiness for surgical intervention Patient Education

17 Sumathi Sundram - UEA 17 Pulmonary Hypertension - Tariff Payment by Result Tariff – Reimbursement HRGs D06 - minor thoracic conditions requiring <2days stay), D07 – Fibre optic Bronchoscopy (requiring <2 days stay) E14 – Cardiac Cath and angiography without complications and co-morbities) E37- other Cardiac Diagnoses (ranging from viral carditis to haemorrhage, not elsewhere captured) E38 – Electrophysiology and other Percutaneous Cardiac Procedures>18 E39 – Electrophysiology and other Percutaneous Cardiac Procedures>19 E40 – Other Cardiothoracic or Circulatory procedures >18 E41 – Other Cardiothoracic or Circulatory procedures >19 E99 – Complex Elderly with a Cardiac Primary Diagnosis P25 – Cardiac Conditions (includes Aortic Stenosis, multiple valve disease, Primary Pulmonary Hypertension etc) Q12 – Therapeutic Endovascular Procedures Q19 – Vascular access for renal replacement therapy

18 Sumathi Sundram - UEA 18 Costed Profile vs Reimbursed

19 Sumathi Sundram - UEA 19 7 years Annualised Donations & Interest £103.7k £14.8k Research £544.1k £77.7k Total £647.7k £92.5k Other Funding Generated PH Team

20 Sumathi Sundram - UEA 20 Dimensions of Knowledge Capital Meritum project Adapted from Meritum project Staff time, specialist training posts, research staff Relational Capital & Public Goods in Health Capital Human Resources Capital Tangible Capital Knowledge Capital National Capacity in Health National protocols, leadership of professional body, national patient pool, specialist training materials, Patient education and material, Patient Support groups Equipment, databases, computers, Specialist Medical equipment External research funding, Patient Donors, National, Global Leadership in field

21 Sumathi Sundram - UEA 21 Healthcare service Funding not reflective of resources used Targets not accommodating complexity Additional outputs not recognised Culturally seen as lower status Challenges (1)- National Policy

22 Sumathi Sundram - UEA 22 Challenges (2)- National Policy Knowledge creation Lack of Commissioner understanding Interdependency not explicitly recognised Research outputs not part of main performance management NHS Funding not for joint outputs

23 Sumathi Sundram - UEA 23 Conclusion Knowledge Creation & healthcare delivery interdependent Policy and management needs to be integrated Bottom up costing process useful for resource recognition Services funding not enough for knowledge generation Tool for planning better utilisation of knowledge capital

24 Sumathi Sundram - UEA 24 Knowledge Capital Defining and Measuring Thank You For Defining and measuring Knowledge Capital bottom up costing useful tool


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