By Nicki Forgham-Healey and Emily Hopkins

The paper for discussion is Ayatollahi and Zeraatkar (2019) Factors influencing the success of knowledge management process in health care organisations: a literature review, Health Information & Libraries Journal, 37, pp. 98–117 https://onlinelibrary.wiley.com/doi/epdf/10.1111/hir.12285

As it’s Knowvember, we are focusing on knowledge management (KM) and knowledge mobilisation, and this review article caught our eye. We read the article, made some notes, and then got together to discuss it and share our reflections. What resulted was a reflective (admittedly quite meandering) conversation, which we’ve shared in its conversational form. We hope our musings are of interest to you, and will show that discussions about journal articles don’t always have to be formal. Having a good natter about an interesting article and sharing some reflections can be a good way to spark ideas!

Background

This article piqued our interest as it is a literature review looking at factors influencing the success of KM in healthcare organisations. Both authors are from Iran University of Medical Sciences, and their focus was international, although one of the papers does cover the NHS in England.

Objectives

The aim of this literature review was to identify factors influencing the success of KM process in health care organisations in developed and developing countries.

Methods

The authors searched key databases for terms related to knowledge management. They have provided their search strategy, and the process of screening the results for relevance to select 13 key papers to then discuss in their review.

Results

The 13 papers were published in a variety of countries, a mixture of developed and developing countries. A summary of the articles is provided in a table to easily see the key points of each.

The findings showed that the most frequent factors influencing the successful implementation of KM were organisational culture, organisational structure, information technology infrastructure, performance evaluation and measurement, and leadership.

Conclusion

“The use of KM in health care organisations, which are rich in information and knowledge, can improve organisational performance and quality of care, and helps to reduce costs and errors. In this review, organisational culture, organisational structure, information technology and performance evaluation and measurement were found to be the most frequent factors influencing the successful implementation of KM in health care organisations. Identifying these factors can help health care organisations to be more realistic and make better decisions before implementing KM projects…”

The reflections which follow use a reflective practice format

What?

NFH: I thought it was a really useful article and raised some interesting points

EH: Yes, having that background from somebody working in the health sector but in a completely different country, with different healthcare system. It was that was interesting to get an international perspective.

NFH: One of the things that I was quite interested in, they quoted “having the knowledge at the right time in the right place…” – well known to us in the NHS!

EH: Yes, a very familiar quote!

NFH: I also got really interested in the search strategy – why did they not use other search terms, was their search strategy quite broad? Should they have looked at other aspects?

EH: Yes, and why the significance of 1980 as a cut-off date, although I think they did mention at some point that KM as a discipline began in the 80s. So I suppose that was their rationale, and it makes sense. Like you, I wondered about also using search concepts like knowledge mobilisation…

NFH: Or Randomised Coffee Trials, or other specific activities, or other terms around health services administration. But they were looking at the broad overview.

EH: And it was honest and clear about the search strategy and what they wanted to look at

NFH: Yes, it’s a good overview, a good flavour, a good mix of developed and developing countries. Also, I know English is the dominant language that is reported, but you wonder what else is out there too. And interesting that they talk about “competition” in a healthcare environment, that’s not a term we talk about as much in UK healthcare, but it is more important elsewhere

EH: Yes, I think that’s why it’s interesting to have that international perspective

So what?

NFH: I thought it was interesting that terms like knowledge transfer, knowledge brokers kept coming up

EH: Definitely, as they’re concepts we’re thinking about ourselves. So interesting that it’s a theme internationally, and for our counterparts in other countries

NFH: It is interesting to look at the skills we’ve got, and how we can utilise them and develop. Training is part of it, but getting out there and delivering stuff, to the right person. It made me think a lot about organisational culture. It made me think about how many organisations have a separate organisational development department, or is it just tagged on to HR. That would be interesting for people using the Knowledge Mobilisation Self-Assessment Tool, to see how many there are. OD leads could help a lot with KM in organisational change and making those connections. How connected are LKS teams to OD teams for example?

EH: Yes, really interesting. In my previous role, the KM team sat alongside the OD team, so we were obviously really integrated and did lots collaboratively. It gave so many opportunities for contributing to organisational development, organisational culture. But I’m sure there are ways to do it even if you’re not formally part of the same structure. Though it’s interesting that the article mentions structure as a theme too – it definitely influences how you’re able to do things. It was also interesting that they mention the opportunity for skills development, or lack of. That made me reflect how KM can be a bit of a Frankenstein discipline, a bit of librarianship, information management, OD, facilitation, you need good IT skills…

NFH: There was a bit where they say knowledge is considered as a critical asset and the most important antecedent for continuous innovation and success in different organisations. How true of that is the health service? Often it’s only a critical asset when there’s been an incident and somebody’s got to learn something from it. And often people don’t want to engage with lessons learned. It’s also interesting think how that will link to the idea Learning Health Systems, so something to reflect on when I attend Tom Foley’s webinar (see Knowvember programme at https://padlet.com/HEE_KLS_/4bqzvwv8g60j6ev8)

EH: And this idea of creating that culture to share knowledge and actually giving people the opportunity, seeing your employees as assets with their own knowledge and skills and so on, and sharing individual learning in a team. Often organisations don’t see the importance of the tacit knowledge in their employees until that person is about to leave, when it might be too late.

Now what?

NFH: Maybe we could do a “fact of the week” in team meetings – share a thing that makes your job easier, or here’s something I learned today, to emphasise the importance of learning. Also to have that time and space to reflect and learn and share properly.

EH: It was interesting it mentioned evidence-based healthcare, particularly for the UK example. So, I suppose we can think more about how we can capitalize on that and show how KM can contribute, as evidence-based medicine is a fundamental principle in the NHS.

NFH: I also thought how a flexible organisational structure can help share knowledge, my previous organisation was very small, so it was easy to speak to the CEO. Even though we might not all have that, how can we best use the structures and links we do have in our organisations to influence knowledge sharing. Maybe we can enable more sharing about that in the LKS community, it would be good to do a knowledge café on.

Consider the following questions for discussion:

  • Do any of the key factors identified sound familiar to you? Do you think they are true in the NHS?
  • What do you think of the role of health librarians as knowledge brokers?
  • What do you think about similarities and differences between developed and developing countries, we you surprised by them?
  • The authors mention more formal education being needed to develop the knowledge broker role. What education and skills do you think are needed?

Further reading

Foley, T, Horwitz L and Zahran R, (2021) Realising the potential for Learning Health Systems. The learning Healthcare project https://learninghealthcareproject.org/wp-content/uploads/2021/05/LHS2021report.pdf [accessed 28/10/21]