Proceedings of the 12th European Conference on Knowledge ...

Multipr<strong>of</strong>essional Communities <strong>of</strong> Practice in a Large-scale
Healthcare Collaboration: Formation, Identity Building and
Knowledge Sharing
Roman Kislov
Manchester Business School, The University <strong>of</strong> Manchester, UK
roman.kislov@postgrad.mbs.ac.uk
Abstract: While it is implicitly implied by policy-makers that healthcare pr<strong>of</strong>essionals and healthcare
organisations are able and willing to work toge<strong>the</strong>r in <strong>the</strong> improvement <strong>of</strong> healthcare services, <strong>the</strong>se assumptions
are not always grounded in sound scientific evidence. This study aims to address this issue by exploring <strong>the</strong>
reality <strong>of</strong> healthcare collaboration in <strong>the</strong> implementation strand <strong>of</strong> <strong>the</strong> Collaboration for Leadership in Applied
Health Research and Care (CLAHRC) for Greater Manchester. The study uses <strong>the</strong> <strong>the</strong>ory <strong>of</strong> communities <strong>of</strong>
practice (CoPs) to explore <strong>the</strong> process <strong>of</strong> joint working in primary care in <strong>the</strong> context <strong>of</strong> <strong>the</strong> English NHS and
reflect on how this process is influenced by <strong>the</strong> CLAHRC. It specifically focuses on <strong>the</strong> development <strong>of</strong>
multipr<strong>of</strong>essional and multi-organisational CoPs in healthcare organisations, reconciliation <strong>of</strong> pr<strong>of</strong>essional and
organisational identities in <strong>the</strong> process <strong>of</strong> collaborative working, and knowledge sharing across interpr<strong>of</strong>essional
and inter-organisational boundaries within and across CoPs. Underpinned by <strong>the</strong> critical realist approach, <strong>the</strong>
research uses a qualitative case study as an overarching research methodology, with specific methods
comprising documentary analysis, semi-structured interviews and participant observation. It adopts a purposeful
sampling strategy, with respondents including general practitioners, nurses, managers, hospital consultants,
knowledge transfer associates and management academics. The data is subjected to template analysis
facilitated by NVivo s<strong>of</strong>tware. Initial data analysis upon <strong>the</strong> completion <strong>of</strong> <strong>the</strong> first stage <strong>of</strong> fieldwork has led to <strong>the</strong>
formulation <strong>of</strong> <strong>the</strong> following <strong>the</strong>oretical propositions:
• The organisational landscape in <strong>the</strong> NHS primary care is represented by multiple co-existing and
overlapping CoPs, which are mainly centred around general practices, pr<strong>of</strong>essional groups and
geographical areas.
• Multipr<strong>of</strong>essional CoPs in primary care are characterised by such features as division <strong>of</strong> functions,
interconnectedness with co-existent unipr<strong>of</strong>essional communities, and operational proximity <strong>of</strong> its
members.
• Formation <strong>of</strong> emergent multipr<strong>of</strong>essional and multi-organisational CoPs is influenced by <strong>the</strong>ir
relationship with pre-existing communities and networks, enthusiasm <strong>of</strong> CoP participants and adequate
leadership.
• Identity formation in <strong>the</strong>se newly formed communities takes place in <strong>the</strong> context <strong>of</strong> multimembership in
several relevant CoPs and may be hampered by strong identification with existing pr<strong>of</strong>essional and
organisational communities.
• Knowledge sharing between CoPs can be promoted by a combination <strong>of</strong> external and internal facilitation
whereby knowledge brokers deploy a number <strong>of</strong> context-tailored boundary objects and boundary
interactions.
• Distinct boundaries between general practices, which are only partially permeable, as well as marked
barriers to <strong>the</strong> development <strong>of</strong> supra-organisational CoPs in primary care, underscore <strong>the</strong> importance <strong>of</strong>
external facilitation in <strong>the</strong> process <strong>of</strong> implementing change.
• Achieving and sustaining improvement introduced by healthcare collaboration may be influenced by <strong>the</strong>
degree <strong>the</strong> change is embedded in <strong>the</strong> routines <strong>of</strong> <strong>the</strong> organisation, <strong>the</strong> presence <strong>of</strong> knowledge sharing
channels between all CoPs involved and <strong>the</strong> clarity <strong>of</strong> goals agreed by <strong>the</strong> participants.
By fur<strong>the</strong>r exploring <strong>the</strong>se propositions in <strong>the</strong> next stage <strong>of</strong> <strong>the</strong> fieldwork, this study <strong>of</strong>fers <strong>the</strong> prospect <strong>of</strong> making
a contribution to analytic frameworks applied to <strong>the</strong> understanding <strong>of</strong> interpr<strong>of</strong>essional and inter-organisational
work, enhancing <strong>the</strong> understanding <strong>of</strong> barriers to joint working, and identifying effective knowledge management
strategies which could be utilised in <strong>the</strong> UK healthcare context.
Keywords: communities <strong>of</strong> practice; healthcare collaboration; multipr<strong>of</strong>essionality; knowledge sharing; identity
1. Background
With a policy turn towards collaboration and partnership working over <strong>the</strong> last decade, <strong>the</strong> issues
related to interpr<strong>of</strong>essional and inter-organisational joint working in UK healthcare require more
attention from researchers. While it is implicitly implied by policy-makers that healthcare pr<strong>of</strong>essionals
and healthcare organisations are able and willing to work toge<strong>the</strong>r in <strong>the</strong> improvement <strong>of</strong> healthcare
services, <strong>the</strong>se assumptions are not always grounded in sound scientific evidence. Fur<strong>the</strong>rmore, we
do not always understand what mechanisms and contextual factors underpin successful collaboration,
how <strong>the</strong> benefits and drawbacks <strong>of</strong> joint working are perceived by healthcare pr<strong>of</strong>essionals, and how
people from different pr<strong>of</strong>essional and organisational backgrounds learn to effectively communicate
with each o<strong>the</strong>r when brought toge<strong>the</strong>r in <strong>the</strong> healthcare field.
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