Presentation - ICMCC

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Presentation - ICMCC

VALIDATING A KNOWLEDGE

TRANSFER FRAMEWORK IN

HEALTH SERVICES

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

practice.

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


Case Background

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

Ontario.

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

transfer success.

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

own practice.

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


Analysis method:

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%

was obtained.

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

knowledgeable;

The good quality of the relationship between the sender and the

receivers;

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

existing knowledge;

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

points.

Orendorff et al, ICMCC, 2008 9


Further:

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

others.

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


Implications:





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

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