Information and knowledge processes as a knowledge management framework in health care. Towards shared decision making?
| Date | 10 July 2017 |
| DOI | https://doi.org/10.1108/JD-11-2016-0138 |
| Pages | 748-766 |
| Published date | 10 July 2017 |
| Author | Helena Känsäkoski |
| Subject Matter | Library & information science,Records management & preservation,Document management,Classification & cataloguing,Information behaviour & retrieval,Collection building & management,Scholarly communications/publishing,Information & knowledge management,Information management & governance,Information management,Information & communications technology,Internet |
Information and knowledge
processes as a knowledge
management framework in
health care
Towards shared decision making?
Helena Känsäkoski
Information Studies Programme, University of Oulu, Oulu, Finland
Abstract
Purpose –Effective knowledge management (KM) enables the health care organisations to reach their goals.
In modern health care the empowered patients are active partners, whose preferences, needs and values
should be taken into account. Shared decision making (SDM) aims at involving the patient and the health
professionals as equal partners in care. The purpose of this paper is to present a new model of health care
information and knowledge processes (IKPs) as a KM framework. The aim is to scrutinise what types of
knowing can be identified the IKPs and how do the knowledge processes support SDM. The role of patients in
the IKPs is discussed.
Design/methodology/approach –The qualitative case study was conducted in two Finnish university
hospital districts in integrated care pathways of childhood obesity. In total, 30 professionals and three
mothers and children were interviewed 2009-2011 and the findings were supported with a survey (n¼13) and
document material.
Findings –The findings indicate that the patients and families involvement in the IKPs is modest.
This implies that SDM is not completely fulfilled which may affect the families commitment to positive
lifestyle changes.
Research limitations/implications –The data of the patients and families were limited due to the
challenges with recruitment.
Practical implications –The detailed IKP model enables the health organisations to scrutinise their own
IKPs and to identify the shortages in order to change practices.
Originality/value –This paper presents a new model of health care KM which recognises the patients as
active partners.
Keywords Health care, Knowledge management, Knowledge processes, Health services,
Shared decision making, Information processes
Paper type Research paper
1. Introduction
Knowledge management (KM) in organisations has shifted from managing the existing
information and from developing information systems towards trying to capture the
knowledge of employees to create new knowledge and innovations in order to enhance
organisational learning and productivity. Information and knowledge processes (IKPs)
ensure that right information and knowledge is available for all the employees in the
organisation. In health care, the term KM has been fairly unfamiliar and research of health
care KM has been rare (Sibbald et al., 2016; Massaro et al., 2015).
Health care is shifting from the paternalistic approach with the health professionals’
hegemony towards a more patient-centred view. This perspective aims at meeting people’s
needs, helping them solve their problems and enabling them to achieve their goals and
wishes (Fredericks et al., 2012). Moreover, the idea of creating patient value, defined as
health and welfare for both the patients and for society, has been a recent interest
(Känsäkoski, 2014; Blumenthal and Stremikis, 2013). The term shared decision making
(SDM) has been implemented in health care emphasising the perspective of patient-centred
Journal of Documentation
Vol. 73 No. 4, 2017
pp. 748-766
© Emerald PublishingLimited
0022-0418
DOI 10.1108/JD-11-2016-0138
Received 16 November 2016
Revised 19 February 2017
Accepted 25 February 2017
The current issue and full text archive of this journal is available on Emerald Insight at:
www.emeraldinsight.com/0022-0418.htm
748
JD
73,4
care and the active role of the patients (Charles et al., 1997, 1999). The earlier prevailing view
of health care organisations (HCOs), professionals and patients as separate units is moving
towards a more collaborative approach which has also been suggested to improve health
outcomes (Greene and Hibbard, 2012).
The aim of this paper is to present a new model of IKPs in health care as a KM
framework and to inspect how the IKPs are related with SDM. Furthermore, the specific
nature of knowledge and knowing in health care and its relationship with the IKPs is
considered. The empirical study was conducted in a multiprofessional integrated care
pathway (ICP) of childhood obesity in Finnish health care.
The research questions are:
RQ1. What kinds of IKPs can be identified in the ICP?
RO2. What types of knowing are involved with the IKPs?
RQ3. How do the identified IKPs support SDM?
The methodology of this study is qualitative aiming at understanding human behaviour
and the reasons that govern this behaviour. Bosio et al. (2012) emphasise the need for
qualitative research in studying knowledge and practice construction in HCOs and settings.
They state that the patient-centred approach shifts the perspective from “inside”to the
“outside”of health organisations and gives voice to patients’meanings and experiences
(Bosio et al., 2012).
First, health care KM, organisational knowledge types, IKPs and patients’role in SDM
are discussed based on a selected literature review. Second, an empirical case study in
Finnish public health care is presented and third, the findings are presented and the new
model of IKPs in health care is outlined. Finally, the implications of the findings to theory
and practice are discussed.
2. KM in HCOs
Health professionals are typical knowledge workers who must keep up with new medical
information and process and apply this information in their daily work (Drucker, 1999).
Knowledge and knowing of the professionals are the prerequisites for all the activities in
HCOs. IKPs enhance HCOs’performance. However, KM as a term and as an activity has not
been widely used in health care although recently the health sector has shown growing
interest in the systematic management of knowledge and information (Kothari et al., 2011;
Ferlie et al., 2012).
KM has been defined in multiple ways but the general idea is that it is a way of reaching
an organisation’s goals through managing information flows and through sharing the
meaningful knowledge that each individual has to create new knowledge and innovations
(Huotari and Iivonen, 2004). The terms knowledge and information are sometimes used in
KM literature interchangeably. Wilson (2002) stresses that knowledge is an asset which
resides in an individual’s mind and it cannot be managed, whereas data, information and
information flows can be managed. Likewise, in this study KM in health care is defined as
management of people as creators of knowledge and management of information and
information flows (e.g. Huotari and Iivonen, 2004).
2.1 Organisational knowledge and knowing in health care
Organisational knowledge is often categorised into typologies. Nonaka and Takeuchi (1995)
identify explicit and tacit knowledge and Choo (2006) sees three knowledge types: explicit,
tacit and cultural. In health care, the knowledge types have been completed with ethical,
emotional, social and behavioural knowledge (Zhou and Nunes, 2012).
749
IKPs as a KM
framework in
health care
To continue reading
Request your trial