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Implementing a knowledge management system within an NHS hospital: a case study exploring the roll-out of an electronic patient record (EPR)

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Knowledge Management Research & Practice

Abstract

This research aims to contribute to understanding the implementation of knowledge management systems (KMS) in the field of health through a case study, leading to theory building and theory extension. We use the concept of the business process approach to knowledge management as a theoretical lens to analyse and explore how a large teaching hospital developed, executed and practically implemented a KMS. A qualitative study was conducted over a 2.5 year period with data collected from semi-structured interviews with eight members of the strategic management team, 12 clinical users and 20 patients in addition to non-participant observation of meetings and documents. The theoretical propositions strategy was used as the overarching approach for data analysis. Our case study provides evidence that true patient centred approaches to supporting care delivery with a KMS benefit from process thinking at both the planning and implementation stages, and an emphasis on the knowledge demands resulting from: the activities along the care pathways; where cross-overs in care occur; and knowledge sharing for the integration of care. The findings also suggest that despite the theoretical awareness of KMS implementation methodologies, the actual execution of such systems requires practice and learning. Flexible, fluid approaches through rehearsal are important and communications strategies should focus heavily on transparency incorporating both structured and unstructured communication methods.

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References

  • Alavi M and Leidner DE (1999) Knowledge management systems: issues, challenges, and benefits. Communications of the Association for Information Systems 1(2es), 1.

    Google Scholar 

  • Alavi M and Leidner DE (2001) Review: knowledge management and knowledge management systems: conceptual foundations and research issues. MIS Quarterly 25(1), 107–136.

    Article  Google Scholar 

  • Alavi M and Tiwana A (2002) Knowledge integration in virtual teams: the potential role of KMS. Journal of the American Society for Information Science and Technology 53(12), 1029–1037.

    Article  Google Scholar 

  • Barcelo-Valenzuela M, Sanchez-Schmitz G, Perez-Soltero A, Rubio FM and Palma J (2008) Defining the problem: key element for the success of knowledge management. Knowledge Management Research & Practice 6(4), 322–333.

    Article  Google Scholar 

  • Batalden P and Splaine M (2002) What will it take to lead the continual improvement and innovation of health care in the twenty-first century. Quality Management in Health Care 11(1), 45–54.

    Article  Google Scholar 

  • Beer S (1985) Diagnosing the System for Organisations. Wiley, Chichester.

    Google Scholar 

  • Berg M and Toussaint P (2003) The mantra of modeling and the forgotten powers of paper: a sociotechnical view on the development of process-oriented ICT in health care. International Journal of Medical Informatics 69(2–3), 223–234.

    Article  Google Scholar 

  • Bou E and Sauquet A (2004) Reflecting on quality practices through knowledge management theory: uncovering grey zones and new possibilities of process manuals, flowcharts and procedures. Knowledge Management Research & Practice 2(1), 35–47.

    Article  Google Scholar 

  • Braganza A (2001) Knowledge (mis)management … and how to avoid it. Presented at Information Management 2001, Olympia, London, 1–2 November.

  • Broechner J and Badenfelt U (2011) Changes and change management in construction and IT projects. Automation in Construction 20(7), 767–775.

    Article  Google Scholar 

  • Carlucci D, Marr B and Schiuma G (2004) The knowledge value chain: how intellectual capital impacts on business performance. International Journal of Technology Management 27(6/7), 575–590.

    Article  Google Scholar 

  • Cegarra-Navarro J and Cepeda-Carrion G (2010) How to implement a knowledge management program in hospital-in-the-home units. Leadership in Health Services 23(1), 45–56.

    Article  Google Scholar 

  • Chalmeta R and Grangel R (2008) Methodology for the implementation of knowledge management systems. Journal of the American Society for Information Science and Technology 59(5), 742–755.

    Article  Google Scholar 

  • Chua A and Lam W (2005) Why KM projects fail: a multi-case analysis. Journal of Knowledge Management 9(3), 6–17.

    Article  Google Scholar 

  • Collis J and Hussey R (2003) Business Research: A Practical Guide for Undergraduate and Postgraduate Students. 2nd edition, Palgrave Macmillan, Houndmills, UK.

    Google Scholar 

  • Creswell JW (2007) Qualitative Inquiry and Research Design: Choosing Among Five Approaches. Sage Publications, Thousand Oaks, CA.

    Google Scholar 

  • Davenport T, De Long DW and Beers MC (1998) Successful knowledge management projects. Sloan Management Review 39(2), 43–57.

    Google Scholar 

  • Davenport TH and Glaser J (2002) Just-in-time delivery comes to knowledge management. Harvard Business Review 80(7), 107–111.

    Google Scholar 

  • Davenport TH and Prusak L (1997) Information Ecology : Mastering the Information and Knowledge Environment. Oxford University Press, New York.

    Google Scholar 

  • Desouza KC (2002) Knowledge management in hospitals: a process oriented view and staged look at managerial issues. International Journal of Healthcare Technology and Management 4(6), 468–497.

    Article  Google Scholar 

  • Earl M (2001) Knowledge management strategies: toward a taxonomy. Journal of Management Information Systems 18(1), 215–233.

    Google Scholar 

  • Earl MJ (1994) The new and the old of business process redesign. The Journal of Strategic Information Systems 3(1), 5–22.

    Article  Google Scholar 

  • Edwards JS (2009) Business processes and knowledge management. In Encyclopedia of Information Science and Technology (Khosrow-Pour M, Ed), 2nd edn, pp 471–476, IGI Global, Hershey, PA.

    Chapter  Google Scholar 

  • Edwards JS (2011) A process view of knowledge management: it ain't what you do, it's the way that you do it. Electronic Journal of Knowledge Management 9(4), 297–306.

    Google Scholar 

  • Edwards JS, Hall MJ and Shaw D (2005) Proposing a systems vision of knowledge management in emergency care. Journal of the Operational Research Society 56(2), 180–192.

    Article  Google Scholar 

  • Edwards JS and Kidd JB (2003) Knowledge management sans frontieres. The Journal of the Operational Research Society 54(2), 130–139.

    Article  Google Scholar 

  • Eisenhardt KM (1989) Building theories from case study research. Academy of Management Review 14(4), 532–550.

    Google Scholar 

  • Fahey D and Burbridge G (2008) Application of diffusion of innovations models in hospital knowledge management systems: lessons to be learned in complex organizations. Hospital Topics 86(2), 21–31.

    Article  Google Scholar 

  • Gallupe RB (2000) Knowledge management systems: surveying the landscape. Framework Paper 04 – Queen’s University at Kingston, October 2000.

  • Gastaldi L, Lettieri E, Corso M and Masella C (2012) Performance improvement in hospitals: leveraging on knowledge asset dynamics through the introduction of an electronic medical record. Measuring Business Excellence 16(4), 14–30.

    Article  Google Scholar 

  • Ghosh B and Scott JE (2007) Effective knowledge management systems for a clinical nursing setting. Information Systems Management 24(1), 73–84.

    Article  Google Scholar 

  • Grover V and Davenport TH (2001) General perspectives on knowledge management: fostering a research agenda. Journal of Management Information Systems 18(1), 5–21.

    Google Scholar 

  • Hammer M (1990) Re-engineering work: don’t automate, obliterate. Harvard Business Review 68(4 (July/August)), 104–112.

    Google Scholar 

  • Hansen MT, Nohria N and Tierney T (1999) What's your strategy for managing knowledge? Harvard Business Review 77(2), 106–116.

    Google Scholar 

  • Kautz K (2011) Investigating the design process: participatory design in agile software development. Information Technology & People 24(3), 217–235.

    Article  Google Scholar 

  • Kwan MM and Balasubramanian P (2003) Process-oriented knowledge management: a case study. Journal of the Operational Research Society 54(2), 204–211.

    Article  Google Scholar 

  • Maier R (Ed) (2007) Knowledge Management Systems – Information and Communication Technologies for Knowledge Management. Springer, Berlin-Heidelberg; New York.

    Google Scholar 

  • Maier R and Remus U (2003) Implementing process-oriented knowledge management strategies. Journal of Knowledge Management 7(4), 62–74.

    Article  Google Scholar 

  • Marchand D, Kettinger W and Rollins J (Eds) (2001) Making the Invisible Visible: How Companies Win with the Right Information, People and IT. John Wiley and Sons, Chichester.

    Google Scholar 

  • McNulty T (2002) Reengineering as knowledge management: a case of change in UK healthcare. Management Learning 33(4), 439–458.

    Article  Google Scholar 

  • Mei YM, Lee ST and Al-Hawamdeh S (2004) Formulating a communication strategy for effective knowledge sharing. Journal of Information Science 30(1), 12–22.

    Article  Google Scholar 

  • Millet P-A, Schmitt P and Botta-Genoulaz V (2009) The SCOR model for the alignment of business processes and information systems. Enterprise Information Systems 3(4), 393–407.

    Article  Google Scholar 

  • Moteleb AA and Woodman M (2007) Notions of knowledge management systems: a gap analysis. The Electronic Journal of Knowledge Management 5(1), 55–62.

    Google Scholar 

  • Nonaka I (1994) A dynamic theory of organizational knowledge creation. Organization Science 5(1), 14–37.

    Article  Google Scholar 

  • Pedersen MK and Larsen MH (2001) Distributed knowledge management based on product state models – the case of decision support in health care administration. Decision Support Systems 31(1), 139–158.

    Article  Google Scholar 

  • Phillips E and Pugh D (Eds) (2000) How To Get A PhD. Open University Press, Philadelphia, PA.

    Google Scholar 

  • Reuthe E and Allee V (1999) Knowledge management: moving the care model from a ‘snapshot’ to a ‘story’. Health Forum Journal 42(3), 26–28.

    Google Scholar 

  • Rothschild AS, Dietrich L, Ball MJ, Wurtz H, Farish-Hunt H and Cortes-Comerer N (2005) Leveraging systems thinking to design patient-centered clinical documentation systems. International Journal of Medical Informatics 74(5), 395–398.

    Article  Google Scholar 

  • Schiuma G, Carlucci D and Lerro A (2012) Managing knowledge processes for value creation. VINE: The journal of information and knowledge management systems 42(1), 4–14.

    Article  Google Scholar 

  • Setia P and Patel PC (2013) How information systems help create OM capabilities: consequents and antecedents of operational absorptive capacity. Journal of Operations Management 31(6), 409–431.

    Article  Google Scholar 

  • Smith H, Mckeen J and Singh S (2010) Creating the KM mindset: why is it so difficult? Knowledge Management Research & Practice 8(2), 112–120.

    Article  Google Scholar 

  • Tenkasi RV and Boland RJ (1996) Exploring knowledge diversity in knowledge intensive firms: a new role for information systems. Journal Of Organizational Change Management 9(1), 79–91.

    Article  Google Scholar 

  • Van Beveren J (2003) Does health care for knowledge management? Journal of Knowledge Management 7(1), 90–95.

    Article  Google Scholar 

  • Wenger EC, Mcdermott R and Snyder WM (2002) Cultivating Communities of Practice: A Guide to Managing Knowledge. Harvard Business School Press, Boston, MA.

    Google Scholar 

  • Yin RK (Ed) (2009) Case Study Research: Design and Methods. Sage Publications Ltd, London.

    Google Scholar 

Download references

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Authors and Affiliations

  1. Operations and Information Management Group, Aston Business School, Aston University, Birmingham, U.K.

    Sara S McCracken & John S Edwards

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  1. Sara S McCracken
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  2. John S Edwards
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Correspondence to John S Edwards.

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McCracken, S., Edwards, J. Implementing a knowledge management system within an NHS hospital: a case study exploring the roll-out of an electronic patient record (EPR). Knowl Manage Res Pract 15, 1–11 (2017). https://doi.org/10.1057/kmrp.2015.7

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