Knowledge Management in the Accident and Emergency Department St Mary Hospital - Coursework Example

Knowledge Management in the Accident and Emergency Department St Mary Hospital ID Introduction St Mary Hospital, founded in late 20th century, is among the oldest mission hospitals hospital in the United States. The initial bed capacity was 40 and in 1952, the management renamed the hospital to King George 6. Since the founding, the hospital has been providing specialized, comprehensive health care to the region. Its current bed capacity is one thousand eight hundred beds. Recently, mortality rates in the hospital have increased notably in the Accident and Emergency (A&E) department. Several external auditors have revealed that poor knowledge management in the nursing department contributes a great deal to the increase in mortality. The following report is a critical analysis of the A&E knowledge management (KM) strategies. The report also reveals how different organizational factors in the department affect the hospitals strategies of managing knowledge. St Mary Hospital aims to provide specialized patient-centered care to all its clients. The hospital personnel strives to optimize the experience of the patient by facilitating the provision of innovative health care. The staffs of the hospital takes part in training and research and use the evidence they gather to offer quality care. Every other day, experts in the medical field, discover new methods of managing patients. Researchers need to disseminate the knowledge to the people on the ground to increase its usefulness. In St Mary Hospital, the management of the hospital provides enough resources for training and updating the A&E nurses. However, there are no changes in patient outcomes, and mortality rates are still high. One of the objectives of the organization is to improve clinical outcomes of patients. Hence, a critical appraisal of the organizational factors breaking the chain of KM is necessary for the survival of the hospital. In today’s world, ineffective use of knowledge in an organization could be detrimental to its performance. Knowledge is crucial to the survival and success of every hospital, firm, company, and project (Hislop, 2013). There are new health care providers, enterprises, hospitals, entrepreneurs and service providers flooding the market every minute of every day. Therefore, every firm desires to gain competitive advantage over the others to secure and a place in the global market. The purpose of managing knowledge in the company is to maximize its learning related effectiveness (Greiner, et al., 2007). Likewise, in medical centres, knowledge is of utmost importance. Today’s disease patterns are unique and becoming complicated. Therefore, health care providers need to update themselves on the new management strategies that would be effective and efficient in combatting the diseases. St Mary Hospital has several departments. A&E is one of the major departments in the hospital. The entire hospital has over six thousand workers. During any one shift, there are between fifteen to twenty-five nurses. The department serves over two hundred patients every single day. Therefore, during continuous medical education, few nurses get the opportunity to attend the seminars and learning opportunities. The others on the ground rely on those attending the meetings to disseminate the knowledge. Each step of the knowledge management (KM) process is vital to the success of a firm. The steps include collecting information, clarifying it, disseminating and lastly reusing the information gathered throughout the business or project (Hislop, 2013). In the St Mary Hospital, lower level nurses do not take part in most of the meetings. The management only allows one representative to attend the general meetings. Interesting enough, the team leaders are not the ones who attend the meetings; rather the hospital selects its people to represent the others. Such a procedure is subject to bias and affects the data gathering phase since not everyone gets the chance to share their opinions. Many studies reveal that, the presence of gaps in the process affects the performance of the entire organization negatively. Notably, both explicit and tacit information are essential in the management of knowledge (Liebowitz & Wilcox, 2000). It is important to note, the transfer of knowledge from one person to the other is just but one of the steps crucial to the process. Education needs to be up to date, and its process should be mature, dynamic and allow for self-growth. Organizational culture and KM Several organizational factors influence knowledge management. Corporate culture has a paramount impact on the success of KM in the firm (Yeh, et al., 2006). KM requires a knowledge sharing environment or culture. Trust is a paramount aspect for the success of KM. Although, there are numerous suggestion boxes in St Mary Hospital, many nurses complain about the information they drop in them. In fact, management encourages employees to report their partners who misuse office facilities and mismanage patients. However, one day a supervisor disclosed the name of a nurse (Mary-not her real name) who had volunteered such information. As a result, there was apprehension in the department until the employee quit due to harassment. There are different levels of trust including, interpersonal trust, organizational trust, group trust and institutional trust (Beckman, 1999). The A&E department has also failed to stimulate institutional trust among its employees. Some of the policies that the unit makes are harmful to the employees. For example, the management team of the unit undermines the collective bargaining agreement agreed upon by the nurses and the administration of the hospital. A low level of trust in a firm could hinder the sharing of information among employees and between employees and employers. Moreover, St Mary Hospital conducts surveillance of its employees. The management introduced internet censorship at work a few years ago. They also monitor the amount of time the employees spend online. Several employees have lost their jobs with claims of misusing the internet. Other than just censorship, they also conduct e-mail surveillance. Interestingly, there are no video cameras in the department. Despite the recent terrorist attacks in the country, the management has shown no interest in introducing video surveillance at the hospital. A&E is open to the public, and nurses complain of the prevailing security risk. Inaction from the management results in many nurses wondering whether the establishment cares about them at all. Sadly, when the new administration introduced internet and e-mail surveillance at St Mary Hospital, no manager or supervisor bothered to inform the employees. In fact, some lower-level managers were also not aware. Most of those who were in the dark only got the information through grapevine communication. When employees feel that the management does not trust them, their level of motivation performance and involvement deteriorates. Research reveals that people have an inclination to conceal knowledge when there is the uncertainty of the outcome of disclosure of the information (Greiner, et al., 2007). As a result, organizations should reward knowledge contribution to encouraging others to be free to share information. In Mary’s case, the supervisor committed a gross mistake by revealing her name. In case other employees had such information, they would not share it. The firm needs protocols that protect employees that share such sensitive information. Hence, the first step to successful KM is to build trust in the organization (Singh, 2008). Apart from the trust, ownership of knowledge and liability is the other component of knowledge sharing culture. The firm should encourage truth-telling, allow criticism, support the employees work, and make available information necessary for the employees to accomplish their tasks. For an organization to maximize its knowledge related effectiveness, all employees must have access to knowledge assets and be able to retrieve information without encountering barriers (Liebowitz & Wilcox, 2000). At first, every employee in A&E had access to the internet and information room. At some point, management put restrictions that prevented certain members from accessing certain information. Knowledge does not only belong to the leaders but every worker in the firm. Since trust and knowledge ownership are essential elements of the culture of a company, all hospitals should strive to build trust through participative leadership, education reward, and open communication. Organizational structure and KM The structure of the organization also affects KM. The best performing organizations have a chief knowledge officer, engineer, analyst, manager and steward (Wu, 2008). St Mary Hospital has a hierarchical structure. Supervisors report to lower level managers who report to middle-level managers. Each nursing officer has unique responsibilities. As mentioned earlier, all the staffs at A&E rarely participate in meetings apart from the annual ones. Any employee who seeks to submit a report or offer a suggestion must first approach his or her immediate supervisor. Both information technology and knowledge management system are necessary for the management of knowledge through intranet and internet (Hislop, 2013). Although, enough computers are available, workers do not have access to certain hospital information. According to the knowledge enterprise model of Anantatmula, &Stankoshy the vital issues in the organizational structure are strength and interaction of tacit knowledge (Desouza, 2003). Undoubtedly, the structure of the firm should be in such a way that it allows employees to interact with each other, therefore, supporting knowledge related actions. Organizational networking facilitates interaction among various members. Therefore, the hierarchical system of St Mary Hospital management makes networking difficult. Since A&E conducts internet surveillance of its employees, they do not feel free to utilize the technological infrastructure available to the maximum. Poor use of technology at work is a big impediment to the KM process. Nonetheless, technology is only an enabling factor and management should not rely exclusively on it. It is just a tool, which relies on the human factor to function well (Greiner, et al., 2007). It promotes accurate capture of knowledge, supports knowledge sharing and makes it accessible to the entire organization. The third point to consider when evaluating the effectiveness KM in an organization is the alignment of the structure with its strategies, the environmental culture of trust and openness (Hislop, 2013). The structure of the organization should align itself with the mission, vision, goals and strategies of the firm. According to the model, there should be an integration of system thinking approaches, individual and organization improvement into the structure. Ultimately, experts propose that the structure of a firm should result in organizational learning. Many experts agree that the management of an organization should facilitate learning through the following mechanisms. First, the business enterprise should arrange for sufficient and continuous learning opportunities (Beckman, 1999). Even though A&E sponsors many learning seminars, they rarely involve the subordinates and ordinary nurses. Hence, only a few members of the organization get opportunities for on the job training. The rest of the employees receive an oral feedback from those attending such meetings. Studies conducted in the area of KM reveal that setting of tougher standards encourages better performance and promotes organizational learning (Liebowitz & Wilcox, 2000). Perhaps this is the only method that the department employs to support learning. However, most employees feel that the management only sets high standards to frustrate them, rather than to improve performance. Either way, high standards make medical professionals work harder in order to achieve higher goals. Fostering dialog, inquiry and promoting inclusiveness also facilitates organizational learning, which eventually supports KM strategies, objectives, and goals. The structure of A&E does not encourage dialog at all. First, employees rarely attend meetings. Second, management does not protect those who provide sensitive information about the misconduct of others. Third, the hierarchical structure of the organization discourages dialog between bosses and their subordinates. Most of the time communication is only downward. Lastly, St Mary Hospital does not use learning opportunities to achieve the goals of the organization. Rather, they use them to promote discrimination at work. Only a few managers get to attend all the seminars. Greed for money could be the facilitating factor. One would expect that the ones who get to attend the seminars and training would freely share the information. However, that is not the case. In the event that they do, due to mistrust between nurses, most of those who do not attend the meetings are not willing to learn from others. Leadership and KM Experts in knowledge management agree that leadership plays a crucial role in management and creation of knowledge in any firm. Therefore, the practices that leaders implement have an impact on the learning goals of the enterprise (Singh, 2008). Hence, the top management of the organization should show commitment when it comes to facilitating processes that promote organizational learning (Hislop, 2013). Leaders in businesses are in the strategic position to introduce or facilitate the introduction of knowledge management programs in their organizations. St Mary Hospital does not have a KM program. The hospital does not have any one of the following knowledge managers -a chief KM officer, engineer, analyst, manager or steward. Hence, the leadership of the hospital has failed the community. It is common knowledge that managers should create a climate or environment, which encourages the transmission of knowledge throughout the firm. Hence, people will feel safe to contribute whenever necessary (Hislop, 2013). Importantly, top managers should understand the relevance of knowledge management to be able to support and make decisions that facilitate its use (Greiner, et al., 2007). Beckman, (1999) stated that top managers should provide employees with equal opportunities motivate employees, reward positive behaviour and attitudes related to KM. In A&E, nurse managers show biases when sharing opportunities. The ordinary employees with no positions hardly get any incentives. Nevertheless, other experts agree that incentive programs alone are not enough to achieve effective KM. Organizations require responsible and devoted managers. The managers should provide direction and help employees to resolve conflicts, which employees get into due to contradicting KM practices. Apart from top leaders, executives at every organizational level are responsible for ensuring that KM objectives are in line with the expectations of the entire firm (Liebowitz & Wilcox, 2000). The middle and to level managers show no commitment to KM practices in the firm. Recommendations First, the management of the hospital should investigate the issues affecting the nurses’ welfare and resolve them to promote trust. Second, the administration should create policies, which allow every nurse to attend learning opportunities. Third, the IT team should limit internet censorship to sites that are exclusively entertainment oriented. Lastly, the nurse managers should organize for in- house- training to facilitate dissemination of information to the lowermost workers. Conclusion In a summary, knowledge strategies are the approaches that firms employ to mobilize the resources and capabilities that would deliver the knowledge related objectives. In other words, it is the process of generating, modifying and transmitting both tacit and explicit information within an organization. It involves getting the right, up to date information to the right person in the right manner and at the right time. Hence, every hospital department manager should facilitate the integration of knowledge strategies with the hospital objectives. Many firms and managers have realized that proper and effective utilization of knowledge within a company gives the enterprise a competitive advantage over the others (Desouza, 2003). It is prudent to conclude that successful KM begins with an adequate and proper strategy. The A&E department of St Mary Hospital does not have a knowledge management strategy. Moreover, most of its practices are a barrier to the generation and transmission of knowledge in the organization. It is clear that ineffective KM contributes to the poor performance of an organization. The management of A&E needs to implement the measures stated above to curb the increase in mortality in their department. References Beckman, T., 1999. The current state of knowledge management. In: Knowledge management handbook. Boca Raton: CRC Press LLC, pp. 1-22. Desouza, K. C., 2003. Strategic contributions of game rooms to knowledge management: some preliminary insights. Journal of information and management, 41(1), pp. 63-74. Greiner, M. E., Bohmann, T. & Krcmar, H., 2007. A strategy for knowledge management. Journal of knowledge management, 11(6), pp. 3-15. Hislop, D., 2013. Knowledge management in organizations: a critical introduction. Oxford: Oxford University Press. Liebowitz, J. & Wilcox, L. C., 2000. Knowledge management and its integrative elements. New York: CRC Press LLC. Singh, S., 2008. The role of leadership in knowledge management: a study. Journal of knowledge management, 12(4), pp. 3-15. St. Mary Madison Hospital. http://www.stmarysmadison.com/Patients/Pages/DirectionsMaps.aspx. Wu, W.-W., 2008. Choosing knowledge management strategies by using a combined ANP and DEMATEL approach. Expert systems with applications, 35(1), pp. 828-835. Yeh, Y., Lai, S. & Ho, C., 2006. Critical success factors for implementing knowledge management in small and medium enterprises. Industrial management and data systems, 106(6), pp. 793-810. Read More