Self-organizing knowledge management might improve the quality of person-centered dementia care: A qualitative study.

BACKGROUND: In institutional dementia care, person-centered care improves care processes and the quality of life of residents. However, communication gaps impede the implementation of person-centered care in favor of routinized care. OBJECTIVE: We evaluated whether self-organizing knowledge management reduces communication gaps and improves the quality of person-centered dementia care. METHOD: We implemented a self-organizing knowledge management system. Eight significant others of residents with severe dementia and six professional caregivers used a mobile application for six months. We conducted qualitative interviews and focus groups afterward. MAIN FINDINGS: Participants reported that the system increased the quality of person-centered care, reduced communication gaps, increased the task satisfaction of caregivers and the wellbeing of significant others. CONCLUSIONS: Based on our findings, we develop the following hypotheses: self-organizing knowledge management might provide a promising tool to improve the quality of person-centered care. It might reduce communication barriers that impede person-centered care. It might allow transferring content-maintaining tasks from caregivers to significant others. Such distribution of tasks, in turn, might be beneficial for both parties. Furthermore, shared knowledge about situational features might guide person-centered interventions.

Factors influencing the success of knowledge management process in health care organisations: a literature review.

INTRODUCTION: Knowledge is a strategic resource in health care organisations and knowledge management (KM) is applied as an effective solution to overcome challenges, such as rising health care cost and increasing demands for improving quality of care. The aim of this review was to identify factors influencing the success of KM process in health care organisations of developed and developing countries. METHODS: This review was conducted in 2018. The sources used for searching relevant papers were PubMed, Scopus, Science Direct, Web of Knowledge, EMBASE and Google Scholar, and the time frame was between 1980 and 2017. The search terms were KM, health care services administration, health care organisation, hospital and clinic which were combined by using AND/OR Boolean operators. RESULTS: In this review, 13 papers were included. The main success factors influencing KM implementation in health care organisations were organisational culture, information technology, organisational structure, and performance evaluation and measurement. In developed countries, organisational culture was the most frequent factor, while in developing countries, organisational culture and information technology were the most frequent ones. CONCLUSION: It seems that in developed and developing countries, organisational factors are the most frequent factors influencing successful KM in health care organisations.

Implementation assessment in confidential enquiry programmes: A scoping review.

BACKGROUND: Response should be a key part of maternal death surveillance and response (MDSR) programmes, which include confidential enquiries into maternal deaths. The programmes investigate avoidable factors in maternal deaths and make recommendations for improving maternity care. There is a gap in information on how these recommendations are transformed into practice. OBJECTIVE: To explore the methods used to assess the implementation status of recommendations made in confidential enquiries into maternal deaths and other health outcomes. DATA SOURCES: We searched PubMed, Web of Science, CINAHL, and Google Scholar databases and general web for grey literature using the "Arksey and O'Malley framework" in all major scientific databases and search engines. STUDY SELECTION AND DATA EXTRACTION: An initial screening was followed by extraction of information using a data chart. Variables in the chart were based on the response component of maternal death and surveillance systems. SYNTHESIS: Information collected was summarised using content analysis method. RESULTS: We reviewed 13 confidential enquiry systems into maternal deaths. Many confidential enquiries into maternal deaths published reports with their recommendations and dissemination often involved national-level scientific presentations. Only five reports provided strategies for implementing the recommendations. Follow-up of previous recommendations was routinely published in only two reports. However, impact assessment of recommendations on other health outcomes was found only in the UK. CONCLUSION: There is a gap in monitoring the response generated by confidential enquiries into maternal deaths. Actions to develop this are therefore needed.

Produção e disseminação de informação em um centro de pesquisa de referência na América Latina / Producción y diseminación de información en un centro de investigación de referencia en América Latina / Production and dissemination of information in a reference research center in Latin America

Objetivo: aprofundar a compreensão sobre o processo de produção e disseminação de informação no âmbito organizacional, recorrendo à análise de uma organização intensiva em conhecimento. Métodos: a organização escolhida foi um Centro de Pesquisa e Desenvolvimento na área de Tecnologias da Informação e Comunicação. Tal organização é referência em seu segmento, por possuir um dos maiores programas de Pesquisa e Desenvolvimento da América Latina em sua área de atuação, sendo seus processos de produção e disseminação de informação passíveis de serem aplicados em outras organizações intensivas em conhecimento, como instituições de pesquisa no campo das ciências da saúde. Para tanto, foi realizada uma pesquisa qualitativa de campo, empregando a técnica de entrevistas. Foram entrevistados três profissionais de unidades organizacionais cujas atividades-fim relacionavam-se diretamente com a produção e a disseminação de informação organizacional. Resultados: apenas uma das unidades organizacionais possuía as atividades de produção e disseminação de informação descritas como um processo formal da organização. Conclusão: os resultados apontaram que as maiores dificuldades das unidades organizacionais foram a definição do público-alvo e, principalmente, a avaliação do uso da informação. Também indicaram a adoção de boas práticas na organização, como definição clara das necessidades informacionais e adequação do uso das Tecnologias da Informação e Comunicação no processo de produção e disseminação de informação(AU)

Objetivo: profundizar en la comprensión sobre el proceso de producción y diseminación de información en el ámbito organizacional, mediante el análisis de una organización intensiva en conocimiento. Métodos: la organización elegida fue un Centro de Investigación y Desarrollo en el área de las Tecnologías de la Información y la Comunicación. Tal organización es referencia en su segmento, por poseer uno de los mayores programas de Investigación y Desarrollo de América Latina en su área de actuación. Sus procesos de producción y diseminación de información pueden ser aplicados en otras organizaciones intensivas en conocimiento, como instituciones de investigación en el campo de las ciencias de la salud. Se realizó una investigación cualitativa de campo, empleando la técnica de entrevistas. Se entrevistaron a tres profesionales de unidades organizativas cuyas actividades se relacionaban directamente con la producción y la diseminación de información organizacional. Resultados: solo una de las unidades organizativas poseía las actividades de producción y diseminación de información descritas como un proceso formal de la organización. Conclusión: los resultados apuntaron que las mayores dificultades de las unidades organizacionales fueron la definición del público objetivo y, principalmente, la evaluación del uso de la información. También indicaron la adopción de buenas prácticas en la organización, como definición clara de las necesidades informacionales y adecuación del uso de las tecnologías de la información y la comunicación en el proceso de producción y diseminación de información(AU)

Objective: the purpose of the study was to broaden understanding of the process of production and dissemination of information in the organizational environment by means of the analysis of a knowledge intensive organization. Methods: the organization chosen was a Research and Development Center from the field of information and communication technologies. This center is a reference organization in its sector, for it has one of the largest research and development programs for this field in Latin America. Its processes for production and dissemination of information may be applied in other knowledge intensive organizations, as may be the case of health sciences research institutions. To achieve this aim, a qualitative field study was conducted which was based on interviews. The interviewees were three professionals from organizational units whose work was directly related to production and dissemination of organizational information. Results: in only one of the organizational units activities related to the production and dissemination of information were described as a formal process of the organization. Conclusion: the results pointed out that the main difficulties in organizational units have to do with the definition of the target audience, and mainly the evaluation of the use of information. They also point to the adoption of best practices in the organization, such as a clear definition of the information needs, and the adequacy of the use of information and communication technologies in the process of production and dissemination of information(AU)

Diseño de una auditoría del conocimiento organizacional orientada hacia los procesos principales y el desarrollo profesional / Design of an organizational knowledge audit oriented towards principal processes and professional development

Objetivos: reflejar los principales elementos de una auditoría de conocimiento que combine los procesos principales con los indicadores de desarrollo profesional que podrían identificar aquellos componentes del capital humano que deberían ser favorecidos. Métodos: se analizaron los principales elementos sobre una auditoría de conocimiento que combina los procesos principales con los indicadores de desarrollo profesional. Se propone un enfoque que permite la identificación de los componentes del capital humano que deben ser potenciados. No se ha identificado ninguna otra metodología con esta orientación. Resultados: la imagen de las fortalezas y debilidades de las organizaciones, así como el conocimiento necesario en cada proceso, proporcionan la base para la regulación de los procesos organizacionales y los componentes humanos y tecnológicos necesarios. Contribuye a la identificación de vacíos de conocimiento así como de los elementos culturales que deben ser tratados. Es una orientación sólida para programar acciones de desarrollo profesional que podrían solidificar el diseño futuro de estos procesos y contribuir a las competencias profesionales de los miembros de estas comunidades de práctica. Conclusiones: esta es una guía sólida para la práctica de desarrollo profesional, orientada hacia el desarrollo futuro de procesos organizacionales y contribuye al crecimiento de las competencias profesionales de estas comunidades de práctica. La plataforma estratégica de la organización se ha enriquecido con la identificación de las fortalezas y debilidades de sus procesos desde diferentes puntos de vista. Este enfoque metodológico se aplicará en diferentes casos a posibles ajustes analizados en su diseño(AU)

Objectives: to reflect the principal elements of a knowledge audit that combines principal processes with professional development indicators that could identify those human capital components that should be favored. Methods: the main elements about a knowledge audit that combines principal processes with professional development indicators were analyzed. This approach allows the identification of those components of human capital that should be raised. No other methodology with this orientation has been identified. Results: the image of strengths and weaknesses of the organizations, as well as knowledge needed in each process gives the base for the regulation of organizational processes and necessary human and technological components. It contributes to the identification of knowledge gaps as well as cultural elements that should be treated. This is a solid orientation for programming professional development actions that could solidify the future design of these processes and contribute to professional competences of the members of these communities of practice. Conclusions: this is a solid guidance for executing professional development practice, oriented towards the future development of organizational processes and contribute to the growth of professional competences of these communities of practice. The strategic platform of the organization has been enriched with the identification of strengths and weaknesses of its processes from different views. This methodological approach will be applied in different cases to analyze possible adjustments in its design(AU)

Evaluación del estado del sistema CITMA para la gestión del conocimiento y la innovación en Pinar del Río / Evaluation of the status of the CITMA system for knowledge and innovation management in Pinar del Río

En un contexto actual, la información, el conocimiento y la innovación son factores indispensables para la sociedad, la economía y el desarrollo territorial y organizacional. Por tales razones, Cuba ha implementado desde el año 1995 un sistema de ciencia, tecnología e innovación con el propósito de lograr la vinculación entre la comunidad científica, la comunidad empresarial y el gobierno. Con la finalidad de identificar las capacidades y las limitaciones que tienen las estructuras del Ministerio de Ciencia, Tecnología y Medio Ambiente de Pinar del Río para gestionar el conocimiento, se realizó un diagnóstico utilizando el método científico histórico-lógico y el dialéctico para conocer los fundamentos históricos que existen sobre la gestión del conocimiento y su articulación en el sistema de ciencia, tecnología e innovación. Se aplicó un cuestionario para la recolección de los datos y el análisis documental que comprendió el estudio de textos de la especialidad y de las principales experiencias reportadas. Los principales resultados muestran que estas organizaciones no logran transferir con efectividad la información, el conocimiento y las innovaciones disponibles en la comunidad académica hacia la comunidad empresarial. Se propone un programa de acciones que contempla el diseño de un modelo de gestión del conocimiento, crear capacidades para el trabajo en red, renovar el conocimiento, articular la estrategia de comunicación social que permita una mayor visibilidad y fomentar el desarrollo del potencial científico en función de las prioridades del territorio(AU)

In the current context, information, knowledge and innovation are essential to society, the economy, and territorial and organizational development. It is for this reason that ever since the year 1995 Cuba has implemented a science, technology and innovation system to establish links between the scientific community, the business community and the government. A diagnostic study was conducted based on the scientific historical-logical and dialectical method with the purpose of becoming acquainted with the historical foundations of knowledge management and their relationship to the system of science, technology and innovation, as well as with the knowledge management capacities and limitations of structures from the Ministry of Science, Technology and the Environment in Pinar del Río. A questionnaire was applied to collect the data, and document analysis was performed which comprised the study of texts on the specialty and reports about the main lessons learned. Results show that these organizations do not manage to effectively transfer the information, knowledge and innovations available in the academic community to the business community. An action program is proposed which includes designing a knowledge management model, building networking capacities, renewing knowledge, articulating the social communication strategy so that it permits greater visibility, and fostering the development of the scientific potential in keeping with territorial priorities(AU)

Acciones estratégicas para la integración endógena de las funciones sustantivas universitarias desde la gestión del conocimiento / Strategic tasks for the endogenous integrality of the university substantive functions from the knowledge management

La integración de las funciones sustantivas de las universidades deviene un reto actualmente y la gestión del conocimiento constituye la misión social, la razón de ser de los diferentes centros de altos estudios, por medio de la cual logran difundir sus saberes y experiencias, así como contribuir al desarrollo socioproductivo y cultural de la colectividad. En el presente artículo se proponen acciones necesarias para endogenizar las funciones sustantivas universitarias desde ese tipo de gestión, a partir de la aplicación de métodos empíricos que permitieron conocer los criterios de educandos y docentes en relación con el problema objeto de esta investigación y revelaron a través de los resultados obtenidos,la fragmentación de los procesos sustantivos universitarios que ha estado limitando la producción del conocimiento científico en las instituciones de educación superior

The integration of the substantive functions of the universities becomes a challenge at present and the knowledge management constitutes the social mission, the reason of the different high studies institutions, by means of which they are able to diffuse their knowledge and experiences, as well as to contribute to the social, productive and cultural development of the collectivity. In this work, necessary tasks for endogenize the university substantive functions from that type of management are proposed, with the use of empiric methods that allowed to know the students and teaching staff criteria related to the object of this investigation, and they revealed through the results obtained, the fragmentation of the university substantive processes which have been limiting the production of the scientific knowledge in the higher education institutions

Identifying and prioritizing the tools/techniques of knowledge management based on the Asian Productivity Organization Model (APO) to use in hospitals.

INTRODUCTION: Appropriate knowledge, correct information, and relevant data are vital in medical diagnosis and treatment systems. Knowledge Management (KM) through its tools/techniques provides a pertinent framework for decision-making in healthcare systems. The objective of this study was to identify and prioritize the KM tools/techniques that apply to hospital setting. METHODS: This is a descriptive-survey study. Data were collected using a -researcher-made questionnaire that was developed based on experts' opinions to select the appropriate tools/techniques from 26 tools/techniques of the Asian Productivity Organization (APO) model. Questions were categorized into five steps of KM (identifying, creating, storing, sharing, and applying the knowledge) according to this model. The study population consisted of middle and senior managers of hospitals and managing directors of Vice-Chancellor for Curative Affairs in Kerman University of Medical Sciences in Kerman, Iran. The data were analyzed in SPSS v.19 using one-sample t-test. RESULTS: Twelve out of 26 tools/techniques of the APO model were identified as the tools applicable in hospitals. "Knowledge café" and "APO knowledge management assessment tool" with respective means of 4.23 and 3.7 were the most and the least applicable tools in the knowledge identification step. "Mentor-mentee scheme", as well as "voice and Voice over Internet Protocol (VOIP)" with respective means of 4.20 and 3.52 were the most and the least applicable tools/techniques in the knowledge creation step. "Knowledge café" and "voice and VOIP" with respective means of 3.85 and 3.42 were the most and the least applicable tools/techniques in the knowledge storage step. "Peer assist and 'voice and VOIP' with respective means of 4.14 and 3.38 were the most and the least applicable tools/techniques in the knowledge sharing step. Finally, "knowledge worker competency plan" and "knowledge portal" with respective means of 4.38 and 3.85 were the most and the least applicable tools/techniques in the knowledge application step. CONCLUSION: The results showed that 12 out of 26 tools in the APO model are appropriate for hospitals of which 11 are significantly applicable, and "storytelling" is marginally applicable. In this study, the preferred tools/techniques for implementation of each of the five KM steps in hospitals are introduced.

Data privacy management and data quality monitoring in the German Centre for Cardiovascular Research's multicentre TranslatiOnal Registry for CardiomyopatHies (DZHK-TORCH).

AIMS: The multicentric TranslatiOnal Registry for CardiomyopatHies (TORCH) of the German Centre for Cardiovascular Research aims to recruit 2300 patients with non-ischemic cardiomyopthies. METHODS AND RESULTS: The investigations were performed after standard operating procedures. The data are collected in standardized electronic case report forms provided by the data holding of the central data management of the German Centre for Cardiovascular Research using secuTrial (interActive Systems GmbH, Berlin, Germany). The personal-identifying data and informed consent are collected, stored, and quality-checked by the independent Trusted Third Party in Greifswald. The quality management of the medical data is performed by the data and quality centre Greifswald. In December 2014, the recruitment for TORCH has started. Currently, data and biomaterial from about 1397 patients and more than 74 500 biomaterial aliquots were collected. Regular study centre-specific quality reports address completeness and plausibility of data and provide detailed information about current missing or implausible data entries to improve the data quality by using a query management in addition. CONCLUSIONS: A regular quality control and reporting improve the data quality in TORCH and will support high-quality data analysis and the translation of research results into routine care.

A systematic review of factors influencing knowledge management and the nurse leaders' role.

AIM: To describe factors facilitating or inhibiting the development of registered nurses' competency and nurse leader's role in knowledge management. BACKGROUND: Nurses' competency directly influences patient safety and the quality and effectiveness of patient care. Challenges of nurse leaders in knowledge management include acquiring, assessing and utilising current knowledge and assessing and enhancing competency. EVALUATION: A systematic search was conducted in PubMed, CINAHL, SCOPUS and ERIC databases in April 2015. The search identified 18 relevant research articles published between 2009 and 2015. The quality of the studies was appraised in accordance with study designs. KEY ISSUE: Knowledge management is facilitated by an organisation culture that supports learning, sharing of information and learning together. Leader commitment and competency were factors related to leadership facilitating knowledge management. CONCLUSION: Nurse leaders need evidence-based interventions to support shared learning and to create infrastructures that facilitate competence development. Future research is especially needed to evaluate connections between knowledge management and patient outcomes. IMPLICATIONS FOR NURSING MANAGEMENT AND LEADERSHIP: The results of this review can be utilised in enhancing factors to facilitate knowledge management in clinical practice and identifying nurse leaders' role in strengthening nurses' competency.

Evidence-Based Decision Making in Youth Mental Health Prevention.

Given the impressive amount of knowledge relevant to prevention efforts, this paper articulates strategies to capitalize on such knowledge through evidence-based decision making. Knowledge, or "evidence," is understood here as coming from multiple sources, including research, individual people, group history, and relevant theory. The presented strategies to facilitate evidence-based decision making are: (1) intervention knowledge management; (2) collaborative design; (3) knowledge resources for intervention; and (4) developmentally sensitive training and supervision. Examples and benefits are outlined for each strategy. It is ultimately argued that evidence-based decision making embodies the scientific approach, and is worth consideration within primary prevention, given its early success in secondary intervention of youth mental health.

[The IMSS and the CONRICyT]. / El IMSS y el CONRICyT.

In this editorial we make a review of the way the Instituto Mexicano del Seguro Social (IMSS) has established a relation between knowledge and its healthworkers to improve patient care. We also mention the agreement that IMSS and CONRICyT (National Consortium of Scientific and Technological Information Resources, according to its initials in Spanish) signed in 2013 to keep promoting knowledge among its workers.

En el presente editorial se hace un repaso de la manera como el Instituto Mexicano del Seguro Social (IMSS) ha establecido un nexo entre el conocimiento y sus trabajadores de la salud, a fin de que estos atiendan de una mejor manera a los derechohabientes del Instituto. También se menciona el convenio que el IMSS y el CONRICyT firmaron en 2013 para seguir promoviendo el conocimiento entre los trabajadores.

Formative evaluation of a patient-specific clinical knowledge summarization tool.

OBJECTIVE: To iteratively design a prototype of a computerized clinical knowledge summarization (CKS) tool aimed at helping clinicians finding answers to their clinical questions; and to conduct a formative assessment of the usability, usefulness, efficiency, and impact of the CKS prototype on physicians' perceived decision quality compared with standard search of UpToDate and PubMed. MATERIALS AND METHODS: Mixed-methods observations of the interactions of 10 physicians with the CKS prototype vs. standard search in an effort to solve clinical problems posed as case vignettes. RESULTS: The CKS tool automatically summarizes patient-specific and actionable clinical recommendations from PubMed (high quality randomized controlled trials and systematic reviews) and UpToDate. Two thirds of the study participants completed 15 out of 17 usability tasks. The median time to task completion was less than 10s for 12 of the 17 tasks. The difference in search time between the CKS and standard search was not significant (median=4.9 vs. 4.5m in). Physician's perceived decision quality was significantly higher with the CKS than with manual search (mean=16.6 vs. 14.4; p=0.036). CONCLUSIONS: The CKS prototype was well-accepted by physicians both in terms of usability and usefulness. Physicians perceived better decision quality with the CKS prototype compared to standard search of PubMed and UpToDate within a similar search time. Due to the formative nature of this study and a small sample size, conclusions regarding efficiency and efficacy are exploratory.

Clinical and Pharmaceutical Solutions through Analysis (CPSA BRASIL 2015): on the way to innovation - pharmaceutical/analytical technology, regulation and knowledge management.

Clinical and Pharmaceutical Solutions through Analysis, São Paulo, Brazil, 3-5 August 2015 The 2nd Annual Symposium on Clinical and Pharmaceutical Solutions through Analysis was held on 3-5 August 2015 at Club Transatlântico, São Paulo, Brazil. This annual meeting began in 2014 and was the first industry-led event in Brazil to focus on the specific needs of industry researchers while bringing together technology and regulators. The goal of CPSA is to provide an in-depth review of innovative technology and industry practices through open discussion of industry-related issues and needs. Education and specialized training are the foundation of all CPSA events. As the industry has evolved so has CPSA. The CPSA annual meeting thrived with high quality scientific content, open interaction from industry opinion leaders and a collegial environment.

El trabajo independiente en el proceso de enseñanza-aprendizaje / The independent study in the teaching-learning process

El trabajo independiente forma parte del proceso de enseñanza aprendizaje y ejerce una importante influencia en la formación del estudiante en cualquier nivel de enseñanza. Una buena planificación del trabajo independiente por parte del profesor contribuye a elevar la calidad del proceso docente. En este trabajo se discute el beneficio de la utilización del formato web como soporte para la propuesta de cursos interactivos y dinámicos confeccionados por los profesores, como apoyo al trabajo independiente de los estudiantes de postgrado de nuestras universidades médicas. A punto de partida de una revisión bibliográfica sobre el tema se analiza el criterio de diversos autores sobre el papel de la actividad independiente y sus beneficios para la formación de los estudiantes. Se sustenta, también partiendo de un estudio del estado del arte sobre soportes informáticos apropiados para estos fines, la propuesta del formato web como enfoque de elección, para cumplir los objetivos formativos tanto en lo instructivo como en lo educativo(AU)

The individual activity is an important part of the learning teaching process and exerts a significant importance in the student´s training in any educational level. A good planning of student's independent work by professors contribute to improve the academic process quality itself. This paper aims at discuss the benefits of the web format to support interactive and dynamic courses prepared by professors to improve the results of the individual activity in post graduate students in our medical universities. The author takes into account a bibliographical research about the topic and analyzes the criteria of different authors about the role of the individual activity and its benefits for students´ training. The paper is also based on a study about the state of the art of proper computer applications to these ends and the benefits of web format as election platform to submit the educational and formative objectives of individual activity(AU)

Mitigating Knowledge Loss: A Strategic Imperative for Nurse Leaders.

With the aging of the nursing workforce and expected retirement of large numbers of experienced nurses in the next decade, mitigating the impact that lost knowledge will have on organizational performance and patient outcomes is critical. The authors raise awareness of the problem, summarize observations procured from hospital nurse executive regarding approaches for knowledge transfer through workforce development, and pose proactive strategies for nurse leaders who can provide direction to offset the issue before it becomes a crisis.

Ethical considerations on the value of patient knowledge in long-term care: a qualitative study of patients suffering from Korsakoff 's syndrome.

AIM: This study explores experiences of patients suffering from Korsakoff's syndrome. It contributes to improved reflection on the value of patient knowledge. BACKGROUND: An ethics of care perspective states the importance of moving to patients in their vulnerable state of being, and to figure out patients' individual needs necessary to provide good care. The information given by patients suffering from Korsakoff's syndrome might be mistaken, invented and even not true. The value of these patients' experiences and knowledge had not been researched to date. METHOD: Data from six in-depth interviews were analysed concurrently through the constant comparative method. ETHICAL CONSIDERATIONS: The principles of voluntariness, confidentiality and anonymity were respected during the research process. FINDINGS: Four important themes within patients' knowledge emerged: health condition, involuntary admission into the nursing home, the daily routine and interpretation of the caring abilities of healthcare professionals. The findings show that our respondents were able to provide a window into their inner perspective. CONCLUSION: This study deepens our understanding of the value of patient knowledge in situations where patients see the world in a different manner as do healthcare professionals. The conversations revealed personal subjective knowledge which our respondents create and live by. Healthcare professionals are encouraged to discover and affirm the understandings of these patients, and not be prepossessed due to the diagnosis or general nursing home rules. Understanding patients' unique knowledge through appreciation of the complexity and richness of different views on the situation can assist to give a more humane response to individual needs and pain. Health staff in healthcare institutions are encouraged to evaluate the - unintended - effect of rigidly applied nursing home rules, and the government is challenged to rethink its policy about care, and provide more resources permitting relational care that nurtures the dignity of patients suffering from Korsakoff's syndrome.