Gather insights
Collating evidence-based practice and emergent learning. 
Review of published literature
Use published literature to collate what is known and understood about the topic. Use the information to promote evidence based practice and highlight opportunities for learning. There are many internet resources to support literature reviews. Depending on the complexity of information consider engaging experts to analyse it. Expertise is available across many organisations.
Work with librarians or Knowledge Information Specialists to support staff and decision making.
Consider the following questions:
- what is the focus of the learning system and what is known and understood about the particular subject matter?
- what expertise is available to support collation and analysis of published literature? How does the review of literature inform next steps about evidence-based practice or action to address any gaps?; and
- what additional methods or tools will enable effective gathering of information: surveys, observation, benchmarking, personal interviews?
Capturing emerging practice
We want people to notice and identify emerging practice and share it where it may be useful elsewhere. This may include all or some of the following: new interventions, change ideas, results from tests of change, trends in data.
A network approach is at the centre of the Learning System Knot. This will help with sharing practice. Test how best to capture and share information for your learning system. It may involve some or all of the following:
- after action review
- case studies
- conferences (virtual or face-to-face)
- events (virtual or face-to-face)
- meetings
- 1:1 conversations
- small group discussions
- blogs; and
- online forums
Consider the following questions:
- what are the most effective and efficient methods for capturing and sharing emerging practice?
- how might those methods be tested?; and
- how might the capturing and sharing of emerging practice be evaluated and shared?
Formal and informal conversations
Formal conversations provide the opportunity for focussed, content-specific discussion. Informal conversations can lead to more diverse thinking and new relationships. The purpose of the learning system will determine whether formal or informal conversations are required.
Learn from others (about what is and isn't working well)
Knowing what has worked elsewhere will help decisions about ideas that can be spread more widely to increase the pace and scale of change. Creating opportunities such as site visits, shadowing or buddy systems may support wider learning and spread of ideas.
This is likely to involve a multi-faceted approach with some testing to determine the most effective and efficient method(s).
Consider the following questions:
- what processes might you test and develop to gather and share intelligence about successes and challenges?
- what information/data has been collated from other learning systems about what is working for them?
- how might you maximise access to knowledge and information (gleaned through evaluation, event feedback, after action review) for all participants?; and
- what information is available locally, nationally and internationally that will support learning?
Data to support learning
Our health and care system has access to a variety of data to support effective decisions from a local to a national level. Unfortunately, poorly presented data leads to inappropriate responses. Determine the right measures for your learning system, alongside existing programme measures.
Data and measurement have various uses:
Measurement for accountability – judge how a system is performing, usually against a stated standard
Measurement for research – data used to develop new generalizable knowledge
Measurement for improvement – using specific system related data to support decisions about where to focus improvement work and/or to measure whether the changes introduced are resulting in improvement
Effective analysis, evaluation and decision making should use both qualitative and quantitative data. Making sense of the data is an important next step to support decisions about what to do next.
Consider the following questions:
- what is the purpose of the learning system?
- what types of data are required to support learning?
- how can the data be used to promote effective decision-making?; and
- how can we use the data to understand what needs to be improved, understand variation, support PDSA testing, monitor progress, tell our story?
A culture where people "notice" and reflect
A culture where people share their reflections and insights takes time, effort and commitment. There are a variety of approaches to support effective reflection. Values Based Reflective Practice (VBRP) is one approach to make "taking notice" and critical thinking intentional. VBRP aims to support continuous learning and improvement. It is a method of reflection to improve future practice.
An overview of VBRP from the Knowledge Network:
“VBRP® promotes person-centred care, engages in dialogue between personal and organisational values, attitudes and behaviours, enhances staff fulfilment and turns history (what we have done) into learning. It supports staff members to better manage their own wellbeing, resilience and helps them to develop increased reflexivity in their practice.
Ultimately, its goal is to improve the care provided to patients and service users.”