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Pugh & Prusak’s 8 Design Dimensions and the RELACSIS Network

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A Framework for Knowledge Network Effectiveness

A Framework for Knowledge Network Effectiveness by Katrina Pugh and Larry Prusak

Designing Effective Knowledge Networks by Katrina Pugh and Larry Prusak is both relevant and timely for me and the work I am doing with public health-related knowledge networks. (Pugh, K., Prusak, L. Designing effective knowledge networks. MIT Sloan management review 55.1 2013: 79-88. MIT Press. 18 Dec 2013.) I work to build and nurture sustainable knowledge networks and communities of practice that are focused on strengthening health systems in various regions and countries. Over the past five years of working with these groups, I am drawn to how planning and design facilitate desired behaviors and outcomes. While plans serve as a blueprint for constructing a knowledge network, these eight design dimensions by Pugh and Prusak inform its architecture:

The Eight Design Dimensions of Knowledge Networks

  1. Leaders’ shared theory of change
  2. Objectives/outcomes/purpose
  3. Role of expertise and experimental learning (a.k.a. “the expert-learner duality”)
  4. Inclusion and participation
  5. Operating model
  6. Convening structures and infrastructures
  7. Facilitation and social norm development
  8. Measurement, feedback and incentives

I choose to examine RELACSIS, a network that joins health information system professionals based in Latin American and Caribbean countries. The purpose of RELACSIS is to “generate a mechanism to articulate the regional efforts that contribute to the improvement of the HIS among the participants in the Network.” While members share their health system strengthening efforts via discussion boards and annual meetings, knowledge sharing activities and collaboratively developed products, such as guidelines and courses, are key outputs. After understanding practices that strengthen the health system, the network mobilizes human and financial resources to member countries to fill knowledge gaps. According to Pugh and Prusak’s types of knowledge network goals, RELACSIS works towards coordination.

According to Pugh and Prusak, a goal with a coordination outcome “leverages members’ existing knowledge activities through its structures, incentives and norms.” For example, RELACSIS leverages knowledge activities through working groups, member recognition and constant communication. Members submit questions and insight in working groups. They are recognized for their best practices and achievements at annual meetings. Members stay in constant communication through email, Skype and discussion boards between annual meetings.

As a result of coordinating activities, RELACSIS has influenced measurable change in member country health systems. For example, Mexico adopted an electronic system to assist coding causes of death developed by the United States. After Mexico implemented the system, health officials shared their experiences with Argentina, Chile, Costa Rica, Ecuador, Guatemala, Uruguay and Venezuela. Through RELACSIS, the countries developed work plans to implement the system with assistance from the Mexican health officials. Technical assistance delivered to Chile resulted in a centralized, electronic coding process and changes to encoders’ job functions through integration of data analysis and assessment activities.

Behaviors are “those that are conducive to outcomes: cohesion, demonstration of trust, connection sharing, using a common technology platform and making investments in collaboration.” Members of RELACSIS connect through discussion boards on the RELACSIS website and conduct Skype calls to discuss and implement their annual work plans. In conversations I have had with the Network leaders, they have emphasized the importance the discussion boards play: they keep all questions and answers in a central location and link members to knowledge sources. Trust is not established virtually. According to Pugh’s Trusting in Us, member of display collaboration in a way that sacrifices individual goals for the common good. This behavior is one of five in a functioning network. RELACSIS members invest time to collaboratively develop training materials, coding systems, and provide technical assistance.

Following annual meetings, members of RELACSIS apply concepts and methods they learned. Working groups discuss key implementation challenges and solutions via the website’s discussion boards. This is a systematic feedback loop that sustains collaboration, and peer-support. According to Pugh and Prusak, members who voluntarily use a working platform (such as discussion boards) have a distinct behavior of a functioning network.

In my observation, much of RELACSIS’ success can be attributed to commitment displayed by the network’s leaders. The leaders listen to member’s greatest collective challenges and work to make connections to technical know-how that exists in the regions. I also commend the leadership for continuously identifying and inviting practitioners into the network who can not only contribute, but also gain new knowledge. These conditions, established by leadership, trigger the networks dynamics, and set behaviors into motion.

In conclusion, RELACSIS’ facilitates behaviors and lead to desirable knowledge network outcomes such as coordination, learning, local adaptation, and support of individual members. Consistent strategy, structure, and tactics should perpetuate the network’s effectiveness.

Strategic
  1. Leaders’ shared theory of change
The core team of network leaders model desired behavior by using the online discussion boards and make regular contact with members.
  1. Objectives/outcomes/purpose
The networks purpose, desired outcomes and objectives were initially defined at a launch meeting in Lima, Peru in 2010. These are documented and displayed on the website.
Structural
  1. Role of expertise and experimental learning (a.k.a. “the expert-learner duality”
Leaders are clear about establishing a safe environment for even experts to express knowledge needs and for the learners to share bold possibilities. After each presentation in the face-to-face meeting, the floor is open for discussion and deliberation.
  1. Inclusion and participation
To my knowledge, different profiles for different levels of participation do not exist. Participants are invited based on their involvement in strengthening their country’s health information system.
  1. Operating model
Working groups work toward solutions between annual face-to-face meetings. Decisions are made in country teams, regional teams and among core leadership.
  1. Convening structures and infrastructures
The network utilizes annual face-to-face meetings, Skype, and web conferencing software to convene.
Tactical
  1. Facilitation and social norm development
I am not aware of specific facilitation approaches that are used. Per my understanding there is a strong collaborative and knowledge sharing tone that begins with core leadership and echoed throughout the network.
  1. Measurement, feedback and incentives
A newer network member, representative from Trinidad and Tobago, won a prize at the annual meeting for his presentation about the country’s electronic health management information system. The award was an incentive for his contribution. Every quarter, the following statistics are collected: cumulative number of listserv registrants, number of threads, number of posts, and number of contributors. These help measure interest in the network and discussion topics.
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