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

Roman Kislov
The following methods are used in this stage: (1) analysis <strong>of</strong> organisational documents to provide
background information about <strong>the</strong> projects implemented by <strong>the</strong> <strong>the</strong>mes, <strong>the</strong>ir structure and history; (2)
direct observation <strong>of</strong> <strong>the</strong> activities <strong>of</strong> multidisciplinary teams; and (3) semi-structured ‘orientation’
interviews to get a general overview <strong>of</strong> <strong>the</strong> research topic and formulate <strong>the</strong>oretical propositions to be
explored in <strong>the</strong> second stage <strong>of</strong> <strong>the</strong> project.
In Stage 2, <strong>the</strong>se <strong>the</strong>oretical propositions will be tested to uncover and explain <strong>the</strong> mechanisms which
underlie <strong>the</strong> processes taking place in multipr<strong>of</strong>essional CoPs. In addition to observation which will
continue throughout this stage, a series <strong>of</strong> more structured face-to-face interviews will be conducted
with <strong>the</strong> members <strong>of</strong> <strong>the</strong> multipr<strong>of</strong>essional teams and key informants identified in <strong>the</strong> previous stage.
The data obtained from <strong>the</strong> semi-structured interviews will be <strong>the</strong>n coded and analysed with <strong>the</strong> aid <strong>of</strong>
NVivo s<strong>of</strong>tware.
In Stage 3, template analysis (King 2004) and matrix analysis (Nadin and Cassell 2004) will be
applied to <strong>the</strong> datasets obtained with different methods and at different research sites. The findings
will be triangulated. In this phase, <strong>the</strong> researcher might need to revisit interviewees and research sites
as necessary, for purposes <strong>of</strong> checking and validation <strong>of</strong> initial findings. Initial <strong>the</strong>oretical propositions
developed in stage 1 will be critically revised in light <strong>of</strong> <strong>the</strong> stage 2 data and refined into a series <strong>of</strong>
conclusions related to <strong>the</strong> research questions.
5. Theoretical propositions
The following <strong>the</strong>oretical propositions have been formulated as <strong>the</strong> result <strong>of</strong> analysing <strong>the</strong> data
obtained from Stage 1 <strong>of</strong> fieldwork, which comprised 21 interviews and 32 hours <strong>of</strong> observation.
(1) 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.
(2) 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.
(3) 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.
(4) 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.
(5) 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.
(6) 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.
(7) 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.
6. Conclusion
While it is preliminary at this stage to make any definitive conclusions about using CoP approach as a
way <strong>of</strong> analysing and/or improving joint working in healthcare organisations, <strong>the</strong> literature review and
initial findings presented in <strong>the</strong> paper raise a number <strong>of</strong> important issues. Firstly, <strong>the</strong> evidence <strong>of</strong>
existence and effects <strong>of</strong> deliberately cultivated CoPs is sketchy and <strong>the</strong> possibility <strong>of</strong> <strong>the</strong>ir creation
from scratch remains questionable. Secondly, regardless <strong>of</strong> what approach to knowledge
management is taken by a collaborative organisation operating in healthcare, its successful
implementation is unlikely without addressing <strong>the</strong> issue <strong>of</strong> shared identity and sense <strong>of</strong> belonging.
Finally, successful utilisation <strong>of</strong> CoPs as a knowledge management tool in <strong>the</strong> NHS will depend on <strong>the</strong>
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