Journal of Healthcare Management - May/June 2013 - (Page 188)

Journal of H ealt H care M anage Ment 58:3 M ay /J une 2013 iNtrodUCtioN Modern healthcare practices require substantial use of knowledge management (KM). KM is a broader term than data management or information management. Whereas information or data is the qualitative or quantitative description, respectively, of an object, a concept, or a process, knowledge is the result of the evaluation, abstraction, or synthesis of information (Alavi & Leidner, 2001). Knowledge includes comparisons, opportunities for improvement (OFIs), and inferences about causes or corrections. For example, clinical care requires assessment of patient needs, coordination among a large number of providers, and the application of complex technologies. KM for care must manage information from ongoing patient assessments and treatment records (compare with Bohmer, 2009) as well as hundreds of professional guidelines and protocols integrated into lengthy, multistep processes. KM involves not only the storage and use of information but also the evaluation, effectiveness, and continuous improvement of both the individual steps in care processes and their integration into treatment plans. Consequently, KM must go beyond data and information to include reporting structures, analytic processes, and strategic coordination. More specifically, Alavi and Leidner (2001) define the four major elements in KM systems: knowledge creation— formal research, literature review, or field observation that leads to discrete statements of findings (consensusbuilding activity and the resulting agreement are part of knowledge creation); knowledge application—use of specific knowledge in an economically valued service or production activity; knowledge storage and retrieval—recording specific knowledge in a manner that captures its unique characteristics and supports its recovery; and knowledge transfer—communication of knowledge by voice, sign, or messaging system and by explicit training. In this article, we examine these four elements of KM in high-performing healthcare organizations (HCOs). White and Griffith (2010) conclude that high-performing HCOs pursue consistent strategies that include measurement, benchmarking, and continuous improvement in all areas. These high-performing systems also empower their workers to challenge practices on subjective and qualitative grounds, and they monitor challenges and unexpected events. The combined information is used throughout the organization to forecast, analyze, and improve work processes. Hence, institutionalized mechanisms to support effective knowledge creation, application, storage and retrieval, and transfer are critical. Positive deviance We identified the KM practices of nine healthcare recipients of the Malcolm Baldrige National Quality Award (refer to Table 1 for names, locations, and other organization information) using applications posted for public view (Baldrige Performance Excellence Program, 2002–2008). We employed a positive deviance approach that requires identifying (1) high-quality outcomes and (2) organizational practices key to those outcomes within a narrow set of high performers (Bradley et al., 2009). 188

Table of Contents for the Digital Edition of Journal of Healthcare Management - May/June 2013

Journal of Healthcare Management - May/June 2013
Contents
Interview with Thomas C. Dolan, PhD, FACHE, CAE, President and CEO, American College of Healthcare Executives
Equity in Care: Picking Up the Pace
How Might a Reforming U.S. Healthcare Marketplace Threaten Balance Sheet Liquidity for Community Health Systems?
Assessing the Productivity of Advanced Practice Providers Using a Time and Motion Study
A Positive Deviance Perspective on Hospital Knowledge Management: Analysis of Baldrige Award Recipients 2002–2008
How to Improve Breast Cancer Care Measurement and Reporting: Suggestions from a Complex Urban Hospital
The Fear Factor in Healthcare: Employee Information Sharing

Journal of Healthcare Management - May/June 2013