VALIDATING A KNOWLEDGE
TRANSFER FRAMEWORK IN
Doug ORENDORFF, Alex RAMIREZ and Elayne COAKES
Sprott School of Business, Carleton University (Canada)
and Westminster Business School, Westminster University
The study of knowledge transfer (KT) has been
proceeding in parallel but independently in
health services and in business, presenting an
opportunity for synergy, learning and sharing.
A central challenge in health care is keeping up
to date with best practice and how to translate
scientific medical evidence into medical
We propose here that the ways in which
implicit knowledge is transferred within
business can be utilised for health care
knowledge transfer also.
Orendorff et al, ICMCC, 2008 2
This study concerned how the implicit and
explicit knowledge relating to the care of
patients presenting with Acute Myocardial
Infarction was transferred from central
specialists to outlying specialist units.
It is based in Canada in the Province of
The central unit was the Ottawa Heart
Institute and the outliers were 14 hospitals
in the Champlain District.
Orendorff et al, ICMCC, 2008 3
What did we want to find out?
The major research question was:
• What are the determinants of successful horizontal
knowledge transfer in Health Services?
We used relevant business articles (32
empirical studies from over 900 searched) to
identify potential determinants for knowledge
We then looked at how the Heart Institute
transferred its guidelines on coronary care to
the outlier hospitals and how the staff of
these hospitals transferred this now explicit
knowledge into usable knowledge for their
Orendorff et al, ICMCC, 2008 4
Informants for the study:
Hospital representatives from the 14 outlier
hospitals participated. These
representatives were individually
responsible for best practice improvements.
Overall 33 health professionals were
interviewed: 6 Physicians; 8 Managers; 7
(Team) Leaders; 4 Educators; 5 Directors;
2 Co-ordinators; and 1 Vice-President.
Orendorff et al, ICMCC, 2008 5
The NVivo package was utilised for
coding of the transcripts.
There were 3 coding iterations.
The data had a preliminary test after
3 interviews to confirm data validity.
An Inter-Rating Reliability of 80%
Orendorff et al, ICMCC, 2008 6
From our literature review:
We broke down the elements of
transfer into separate determinants;
And compared the literature to our
findings to see which elements
impacted on, and enabled, a
successful explicit knowledge transfer
into implicit knowledge.
Orendorff et al, ICMCC, 2008 7
The elements of successful transfer
that we found:
Ability of knowledge being utilised to be used in a codified form;
The source of the knowledge being considered credible and
The good quality of the relationship between the sender and the
The recipients having prior knowledge of the topic matter;
And the organisational context and culture being receptive of the
new knowledge and the capability to learn.
A positive attitude towards receiving new knowledge and
motivation to learn;
The ability of the recipients to ‘unlearn’ previous knowledge and
thus utilise the new knowledge in a different manner or to replace
The distance [not physical but mental model and topic
understanding] between the sender of the knowledge and the
receiver being close enough;
Orendorff et al, ICMCC, 2008 8
We also found:
It was important for the person responsible
for receiving the new guidelines [on cardiac
care] to be able to decode the new
information and sense make from their own
experience in order to make a valid
judgement as to the reliability of the new
knowledge being sent;
In their own words: we went through it,
line by line, made notes on it, talked about
it, we had discussions around certain
Orendorff et al, ICMCC, 2008 9
It required an integration and in some
instances, an unlearning of old tacit and
implicit knowledge to fully develop the new
knowledge, and for some knowledge
receivers this was more difficult than
As a result, in some instances the new
knowledge also required face to face
involvement with the sender before it was
fully integrated into the receivers’ own tacit
and implicit knowledge.
Orendorff et al, ICMCC, 2008 10
We anticipate that those responsible for sending new
detailed guidelines (practical knowledge) around the
Health Services will need to assess the readiness of
those receiving before issuing blanket guidelines.
Motivation and credibility of the new knowledge will need
to built up prior to outlier carers attempting to put this
new knowledge into practice.
Additionally, a good working relationship with significant
trust levels will need to be established before such
(potentially) harmful, if misunderstood, knowledge is put
into practice with an accepted assurance from the sender
of the validity of the new best practice.
In some instances the best practice guidelines or similar
will require face to face meetings for further explanation
not just paper or computer based evidence. Trust is built
by physical interaction.
Orendorff et al, ICMCC, 2008 11