An Exploration into Knowledge Transfer Practice in the Development of an NHS Hospital Electronic Patient Record: a Case Study

  • Firas Masri

Student thesis: Phd

Abstract

This study explores Knowledge Transfer (KT) in practice along with Knowledge Management (KM) and Organizational Learning (OL) in the professionalized context of an NHS Trust. This research studies how KT-practice unfolds through relational interactions among varying actors in a healthcare-setting. The scope of the research inquiry centres on the use of the Electronic Patient Record (EPR). This exploration addresses a multidisciplinary transversal inquiry that draws from within the everyday experience of the EPR project. Intrinsically, this study addresses the following research inquiry: “How do different actors perceive and conduct the Knowledge Transfer practice, from different managerial, technical and professional perspectives?” Through developing this question and pursuing answers for it, this research delves into the relational interactions between human artifacts and practices, where collective knowledge is co-produced in the healthcare-situation. In so doing, this thesis draws on Systems Thinking, Communication and Practice-Theory. Accordingly, this study is intended to contribute to a better understanding of how healthcare-settings are (re)arranged through the professional and the informational practices supported by a communication technology. This research aims to unleash a dynamic conflictive view into the KT-practice that incorporates information systems, professional practices and business orientation. Since healthcare faces continued uncertainty, this inquiry aims to account the KT-practice in action, in order to render the contingency of healthcare context in the deeper-and-broader analysis of its sociotechnical complexities. This research carries out this KT-practice accountability through a multiple-perspective analytical lens and a qualitative case-study approach, with a focus on the EPR-project in the healthcare. Each perspective informs about specific dimensions of knowledge-in-practice in the healthcare, by which the KT-practice is enacted in the course of this research. The study finds that the EPR-design dismissed many contingent issues such as professional boundaries and inter-professional conflicts. Some actors were not entirely aware and not necessarily willing to use the EPR as part of their daily routines. For example, doctors engaged a pragmatic attitude when using their position to delegate mundane tasks to nurses. In cross-functional teams, coordination between nurses and doctors often depend on existing relationships rather than on the contingent relationships entailed by the EPR project. Therefore, this study found that the circulation-of-knowledge in the healthcare is not conflict-free. Gradually co-produced by humans and the EPR, what this context requires is facilitating and enhancing the interactive networks at play rather than implementing and transforming-through advanced technology. In other words, the operations of the EPR were designed to integrate ‘knowledge’ through isolating knowledge-in-practice from the context. These operations were also engineered through extracting ‘objectively’ the knowledge-in-practice from the core of the daily relational interactive networks of processes, activities, capacities, professionals and occupations. This research found that the transformational strategy of the EPR was not able to meet and fulfill the needs, interests and expectations of the much more complex reality of the professional practice. Through connecting the dots of this reality differently, this dissertation elaborates an empirical philosophy around three ‘onto-epistemological’ propositions regarding different understandings of the knowledge-in-practice. These propositions synthesise together the possibility of the implementation and KT-processes, the potentiality of the material, and the intentionality of humans and their roles in contemporary networked societies. As a central contribution to transdisciplinary studies of KM, this research thoroug
Date of Award1 Aug 2018
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorA Wood-Harper (Supervisor) & Peter Kawalek (Supervisor)

Keywords

  • Knowledge Management
  • Knowledge Transfer
  • Healthcare
  • Electronic Patient Report
  • and NHS.

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