Knowledge management in the National Health Service: an empirical study of organisational and professional
antecedents to knowledge transfer in knowledge management
PhD thesis, University of Nottingham.
This PhD research started from an interest in how organisational and professional antecedents affect knowledge transfer in the professionalised context of the National Health Service. It was further motivated by findings from previous studies (Currie, Finn, & Martin, 2008a; Currie, Finn, & Martin, 2008b; Currie, Martin, & Finn, 2009; Currie & Suhomlinova, 2006a; Currie, Waring, & Finn, 2008c; Martin, Currie, & Finn, 2009; Martin, Finn, & Currie, 2007; Waring & Currie, 2009) which highlighted both the need for more contextual studies in the area of knowledge management and interesting issues around the role of professional boundaries in knowledge transfer.
This research investigates and evaluates organisational and professional antecedents to knowledge transfer in the professionalised context of the UK National Health Service, to create empirical and useful results to researchers, practitioners and policy-makers. To achieve this goal, a range of literatures were evaluated, focusing primarily on knowledge management. The review of these literatures revealed a number of research gaps from within the Knowledge Management theory to which this study responds. The two most significant gaps for this are a) a need for empirically based studies on the influence of organisational antecedents on knowledge transfer in professionalised contexts at both organisational and individuals levels and b) a need for empirically based studies on the influence of professional antecedents on knowledge transfer in professionalised contexts at the level of the organisation and the individual.
This research is underpinned by a subjectivist ontology, an interpretive epistemology and a multi-method research design. It is exploratory, evaluative, longitidunal, comparative and inductive research with two primary data sets gathered from nurses who participated in a knowledge transfer initiative in the NHS (19 semi-structured interviews) and from key informants of the nursing profession giving their opinion on the dissemination of knowledge in the nursing profession (10 semi-structured interviews). Each data set is used to better understand the impact of organisational and professional antecedents on knowledge transfer in a professionalised context. This research project also contributed to a larger research project led by Professor Graeme Currie from the University of Nottingham aimed at evaluating NHS genetics service investments on a national scale (Martin et al., 2007). This larger research project was based on a comparative analysis of organisational and professional antecedents affecting the implementation of genetic service investments. In total, 85 interviews, including that of the researcher, were conducted over a two-year period with key members of the projects such as General Practitioners, hospital consultants, scientists and nurses.
The main finding of the current study is that knowledge transfer initiatives are difficult to implement into practice when taking into the impact of a professional hierarchy on organisational mechanisms of the National Health Service. As a result, the data provide empirical evidence to suggest that KM theories are not necessarily relevant enough to a professionalised context such as the NHS.
Essentially, the study finds that existing power relationships between the medical profession and the nursing profession inhibit knowledge transfer and, as a result, poses problems for mainstreaming specialist knowledge such as genetics into generalist care settings of the NHS. In such context, knowledge transfer is influenced by professional institutions that regulate the transfer of knowledge in a profession. Therefore, the research contributes to organisation studies research by providing conceptual and empirical understanding into how organisational and professional antecedents become boundaries to knowledge transfer in a professionalised context. The study also contributes to the medical sociology literature by providing a refreshing look at the ubiquitous theme of medical dominance in healthcare systems (Armstrong, 2002; Dingwall, 1987; Dopson, 2005; Ferlie, Fitzgerald, Wood, & Hawkins, 2005; Larkin, 1978). The study finally contributes to management practice and government policy-making by providing an evaluation of knowledge management programmes in the NHS, and by making some strategic recommendations to respond to these issues.
Thesis (University of Nottingham only)
||knowledge management, knowledge transfer, knowledge sharing, national health service, professions, organisational and professional boundaries
||H Social sciences > HD Industries. Land use. Labor
||UK Campuses > Faculty of Social Sciences, Law and Education > Institute for Science and Society
||17 Oct 2011 09:46
||14 Sep 2016 21:36
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