Knowledge Continuity Management In Healthcare - Research Paper Example

 The Application Of Knowledge Management To Record Sytem In Health Care Abstract The given scenario is this: Numerous patients have had their information placed in the wrong patient charts. To make matters worse, some patients are being referred to the main hospital and are being accompanied with the wrong charts. One major difficulty is that the hospital uses an electronic record while the LTC is still using paper records. In addition, the LTC staff is adamant that paper is fine and that they do not have the time to learn an electronic medical record. The objective of this paper is to apply knowledge management theories and concepts to the abovementioned scenario on the health organization’s record system given the newly acquired Long Term Care facility. Introduction The health care industry has shown volatility in terms of turnover of health care practitioners as well as fast medical technological developments. These factors provided the impetus for the evolution and acknowledgement for greater significance of learning theories, concepts and practical applications in the field of knowledge management. With this in mind, a specific scenario on records system of a hospital would be evaluated in relation to its effects on the delivery of health care, personnel and customer satisfaction, compliance to safety and standards imposed by accredited health care organizations. The given scenario is this: Numerous patients have had their information placed in the wrong patient charts. To make matters worse, some patients are being referred to the main hospital and are being accompanied with the wrong charts. One major difficulty is that the hospital uses an electronic record while the LTC is still using paper records. In addition, the LTC staff is adamant that paper is fine and that they do not have the time to learn an electronic medical record. The objective of this paper is to apply knowledge management theories and concepts to the abovementioned scenario on the health organization’s record system given the newly acquired Long Term Care facility. Definition of Terms There have been increasing numbers of studies made on the topic of knowledge management. Knowledge management is the systematic process of creating, maintaining and nurturing an organization to make the best use of knowledge to achieve sustainable competitive advantage or sustainable high performance (Davenport & Prusak, 1998). Rationale for Knowledge Management The increasing significance being accorded by health care organizations to knowledge management steps from reasons which range from protection and safeguarding of assets and investments, improving the delivery of patient care, minimizing the occurrence of medication errors, increasing competitive advantage and minimize costs. The following studies have been quoted for validation: “Since the 1990s, organizations throughout the world have begun investigating and applying principles of knowledge management in order to protect their intellectual assets and investments (Choo & Bontis, 2002). This is also true of healthcare organizations that have the additional goals of improving patient care and decreasing medical errors (Davenport & Glaser, 2002). Knowledge management is the intentional application of processes and procedures that enhance the production, codification, and dissemination of knowledge throughout an organization for the purpose of achieving competitive advantage.  As the pressures on hospitals mount to increase productivity and decrease cost, the management of their knowledge resources is essential (Drucker, 1997; Wickramasinghe et al, 2004).” (Morgan, L.J., Doyle, M.E, & Albers, J.A. 2005) Utilization of Knowledge Management (KM) The scenario presented several pertinent issues for closer review. These issues are: (1) wrong patient charts; (2) difference in record system employed (hospital versus Long Term Care Facility); and (3) staff apprehension to use electronic system. A close review of the scenario would reveal that the issues are repercussions or effects of a deeper problem. The record system being maintained and utilized by the hospital is an electronic system. The record system required from the Long Term Care Facility (LTCF). By these alone, it can be deduced that there is a conflict in the two different systems being concurrently used. Management should take the necessary measures to align the systems and link the LTCF to the mainframe. Another pertinent observation is this: assuming that the hospital uses electronic records, it is a quandary as to why the staff is not familiar with this kind of system. They are more in favor of a paper system utilized by the LTCF, which was just implemented six months ago. By assessing this, it can be surmised that: (1) the staff utilizing the LTCF are all new which confirms their ignorance of the electronic system used by the hospital; (2) their tenure in the hospital also gives credence to their apprehension to learn the electronic system – and there is a possibility that their future plans do not warrant their loyalty to the hospital; (3) no orientation or due monitoring has been instituted by management to ensure that all new staff should undergo updated educational training in terms of policies and procedures, systems, health care delivery, safety precautions, customer satisfaction and compliance to standards. Effects of Tolerating the Problems Wrong charts have serious repercussions to the delivery of health care. Sentinel events and the occurrence of medication errors are very high if wrong patient charts exist. “Sentinel events are undesirable outcomes and involve the potential for sizable malpractice awards and compromise of quality of patient care (Kosel & Olivo, 2002).  The most common causes (as determined by root cause analysis) for sentinel events (an unexpected death or serious physical or psychological injury) are communication, orientation and training, patient assessment, staffing levels, availability of information, competency/credentialing, and procedural compliance (JCAHO, 2004a). These are all problems directly addressed (and mitigated) by knowledge continuity management.” (Morgan et.al. 2005) Process for Knowledge Management According to Morgan et.al. (2005), “the following six steps for knowledge continuity management (Beazley et al, 2002) can be used to address the nursing challenges, to wit: (1)   Conduct knowledge continuity assessment; (2) Determine objectives and scope of the knowledge continuity management (KCM) initiative; (3) Establish coordination responsibility for implementing KCM; (4) Plan KCM initiative including measurements; (5)  Create a methodology to harvest and transfer the critical operational knowledge; and (6) Transfer operational knowledge. Using the abovementioned scenario, the recommended courses of action to solve this problem are: 1. Review and alignment of the Record Systems. The hospital has been utilizing an electronic system due to previous review and assessment of its advantages over paper system. By implementing the new LTCF, its paper record system should be evaluated to align it to the system being used hospital wide to avoid confusion and conflicts. 2. Regular orientation of the new staff of the following areas: policies and procedures, hospital wide record system, code of discipline, among others. By scheduling regular orientations, new staffs would be updated on current policies, procedures, systems, which should strictly be enforced. Any infractions should be dealt with according to the organization’s code of discipline. Wrong patient charts are major errors which should be penalized accordingly. 3. Regular training and development of staff. The human resources department of the hospital should schedule a career path for nurse staff and other health care practitioners. Seminars, workshops and training updates should be scheduled to ensure that the staff would continue learning and upgrade their knowledge on medical issues and patient concerns to improve the delivery of health care. 4. Frequent monitoring of the staff’s performance. A system of rewards and penalties should be strictly enforced. Staff should be required to submit reportorial requirements to fully detail errors (wrong charts, medication errors, patient falls, etc.). Nurse Managers should be assigned to monitor and evaluate the performance of her nurses per department. Career opportunities and paths for level upgrades should be planned with corresponding salary increases and benefits. 5. Monitor customer satisfaction through surveys which should be implemented by the customer service department of the hospital. These would ensure that the staff would always be vigilant and aware that their performance would be evaluated by superiors and customers, alike. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is an organization which regularly monitors compliance of health organizations to standards of health like safety, patient care, customer satisfaction, and other areas. By ensuring that the hospital complies with all the requirements imposed by JCAHO specifically on systems and procedures to ensure the effective delivery of health care, drastic errors from sentinel events could be prevented. Summary The application of appropriate concepts and theories on knowledge management would provide the health care practitioner with the necessary tools to guide them in future decision making process. It is very important to remember that “health is wealth”. This is one of the oldest and most common saying which emphasize the value of good health. The irony of this is that despite ones adeptness in the health topic, there is absolutely no guarantee of perfect health in a lifetime. The responsibility of looking after ones health is shared by the person himself, his family, and local community. The emergences of issues pertinent to health services and knowledge management make health the concern, not only by a nation, but on a global scale. References Beazley H., Boenisch J. & Harden D. (2002). Continuity Management: Preserving Corporate Knowledge When Employees Leave. John Wiley and Sons, Hoboken, NJ. Choo C. & Bontis N. (Eds.), (2002). The Strategic Management of Intellectual Capital and Organizational Knowledge. Oxford University Press. Davenport, T. & Glaser, J. (2002).  Just in Time Delivery Comes to Knowledge Management. Harvard Business Review, July, pp.107-111. Drucker, P. (1997).  The Future That Has Happened Already. Harvard Business Review, 75(5):20-22. Davenport T. & Prusak L. (1998).  Working Knowledge:  How Organizations Manage What They Know. Harvard Business School Press. [JCAHO] Joint Commission on Accreditation of Healthcare Organizations (2004a). Sentinel Event Statistics, Root Causes of Sentinel Events. Retrieved April 14, 2005 from  Kosel, K. & Olivo, T. (2002). The business case for workforce stability. VHA Research Series 2002, Volume 7. VHA Inc. Morgan, L.J., Doyle, M.E, & Albers, J.A. (2005). Knowledge Continuity Management In Healthcare. Journal of Knowledge Management Practice. Retrieved on April 14, 2009 from < http://www.tlainc.com/articl84.htm> Wickramasinghe, N., Fadlalla A. & Sharma S. (2004).  The KM Infrastructure:  Making Knowledge Assets Explicit. Proceedings of the 37th Hawaii International Conference on System Sciences. Read More