Knowledge creation practices at organizational boundaries: the role of ICT in sickle-cell care for tribal communities
03 May 2021-Journal of Knowledge Management (Emerald Publishing Limited)-Vol. 25, Iss: 3, pp 595-617
TL;DR: This study identifies various useful knowledge creation practices in health care delivery for resource-constrained emerging economy contexts and suggests that the involvement of local front-line actors and ICT can become important resources in the delivery of health care in these settings.
Abstract: PurposeThis paper aims to examine the role of information and communication technology (ICT) in the knowledge creation practices adopted by a health care organization The organization is delivering care to patients of a genetic disorder, called the sickle cell, in tribal communities The paper identifies how ICT intermediates knowledge creation practices across the organizational boundaries wherein tribal patients, front-line counselors and expert physicians interact, which then produces context-specific, evidence-based medicine (EBM)Design/methodology/approachThe knowledge-in-practice approach is adopted to conduct an ethnographic study of sickle cell care practices in a non-profit health care organization in Western India The analysis focuses on ICT-mediated interactional practices among the physicians, front-line counselors, tribal patients and their families, for more than a year-long observation These are supplemented with informal and formal interviews, archival records and vignettes based on several episodes to explicate the key knowledge creation practicesFindingsTechnology-mediated informative interactions at organizational boundaries can bridge socio-linguistic and interpretive barriers between actors, while also providing a generative structure that leads to the creation of longitudinal clinical evidence about a rare genetic disorder Three specific ICT-entwined knowledge creation practices emerge, namely, knowing the community, increasing interactional engagement and constructing gradients of socio-clinical history These practices generate organization-wide knowledge about the social and clinical dimensions of the genetic disorder The findings are presented through vignettes and a novel conceptual frameworkResearch limitations/implicationsThis study identifies various useful knowledge creation practices in health care delivery for resource-constrained emerging economy contexts Further, the study suggests that the involvement of local front-line actors and ICT can become important resources in the delivery of health care in these settingsOriginality/valueA novel framework is developed which demonstrates knowledge creation at organizational boundaries wherein the actors use ICT-based practices for effective delivery of health care The proposed framework may be used by health care organizations in similar contexts providing care to marginalized communities
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TL;DR: In this article, the authors explore different facet (dark and bright sides) of technology-enabled knowledge management for rural lay healthcare workers who belong to the bottom of pyramid (BoP) population in India.
30 citations
01 Apr 2022
TL;DR: Wang et al. as discussed by the authors explored the relationship between social capital and the innovation performance of digital firms and examined the mediation effect of cross-border knowledge search on this relationship and investigated the serial mediation effect.
Abstract: This study aims to explore the relationship between social capital and the innovation performance of digital firms. In addition, we examine the mediation effect of cross-border knowledge search on this relationship and investigate the serial mediation effect of cross-border knowledge search and absorptive capacity between social capital and innovation performance. Using data collected from 217 Chinese digital companies, we tested the proposed hypotheses by constructing structural equation models through SPSS 22.0 and AMOS 24.0. Based on the results of theoretical deductions and empirical tests, some conclusions can be drawn. First, for digital firms, social capital remains significantly and positively associated with innovation performance during the COVID-19 pandemic. Meanwhile, digital firms with higher social capital are likely to generate higher innovation performance even if they experience a more severe impact of the COVID-19 pandemic. Second, cross-border knowledge search effectively mediates the relationship between social structural capital, social relational capital, and innovation performance, whereas this mediation effect is not significant between social cognitive capital and innovation performance. Finally, the serial mediation effect of cross-border knowledge search and absorptive capacity on the relationship between social capital and innovation performance is confirmed. Some managerial implications are summarized based on our findings. On the one hand, digital firms should still actively build social capital to enhance innovation performance during the pandemic. On the other hand, social capital can help digital firms implement cross-border knowledge search and develop absorptive capacity. Thus, digital firms can effectively utilize heterogeneous knowledge to enhance their innovation performance.
29 citations
TL;DR: The paper discusses how ACAP integrates with sense-making, knowledge creation and decision-making processes within the health-care context, as well as the emergence of KM as an integrative and strategic approach to hospital management.
Abstract: This paper aims to propose an integrative and result-driven health-care knowledge management (HKM) model and discuss the findings of a research that examines how the KM initiatives of a major private Brazilian hospital system are linked to its health-care performance outcomes.,Data were collected from a top-level Brazilian private hospital system (Mater Dei Healthcare System – MDHS), which is composed of three large hospitals internationally accredited by ISO 9001/2000, NIAHO and JCI. Multiple qualitative approaches were used to collect data such as 16 in-depth interviews with health professionals and managers, document analysis, participatory observation and benchmarking interviews with two reference hospital networks in Brazil.,The proposed health-oriented KM model is an expansion of the organizational knowing cycle model (Choo, 1996), adding absorptive capacity (ACAP) as a new construct. The paper discusses how ACAP integrates with sense-making, knowledge creation and decision-making processes within the health-care context. Information technology and clinical governance were identified as support factors to the HKM processes.,The paper presents a pragmatic and result-driven knowledge management (KM) model using health-care-welfare key performance indicators, as well as the emergence of KM as an integrative and strategic approach to hospital management.,The present study presents a knowledge-based perspective to clinical staff management, demonstrating the tangible results of KM initiatives that contribute to health and management performance outcomes.
14 citations
TL;DR: In this paper, the authors conducted a longitudinal qualitative case study over a 12-month period to explore identity reconciliation practices during the formation of the ED CoP, which was mandated by policymakers to mobilize knowledge between process improvement advisors and clinicians from various hospitals.
Abstract:
Purpose
Communities of Practice (CoPs) are increasingly being created to facilitate knowledge mobilization in organizations. This paper aims to elucidate an underexplored aspect of participation in mandated CoPs – identity reconciliation. Specifically, the authors explore how actors reconcile their existing identities with becoming members of new knowledge mobilization CoPs.
Design/methodology/approach
The authors conducted a longitudinal qualitative case study over a 12-month period to explore identity reconciliation practices during the formation of the “ED CoP” – mandated by policymakers to mobilize knowledge between process improvement advisors and clinicians from various hospitals. Observation and interviews allowed us to uncover “front stage” and “backstage” practices of identity reconciliation.
Findings
The findings reveal two key unexpected modes of identity reconciliation – “distancing” and “peripheral lurking”. These modes resulted in different trajectories of participation of two of the key participant groups – “veteran” improvement advisors and “veteran” clinicians.
Practical implications
Different modes of identity reconciliation of different participants impact the formation of CoPs and how knowledge mobilization occurs within them. This paper offers a sensitizing lens for practitioners creating CoPs which enhances awareness of hidden identity practices, and recommendations to enable practitioners to effectively facilitate CoP formation.
Originality/value
This study suggests that identity reconciliation is an integral aspect of CoP formation, and essential for knowledge mobilization within CoPs. Whereas studies on CoPs in the knowledge management literature have mostly assumed that collaboration produces beneficial knowledge mobilization outcomes, the findings build a more nuanced picture of the processes involved in producing these outcomes.
5 citations
TL;DR: In this paper, an ethnographic study of a social healthcare organization that serves tribal communities in India, the authors integrate organizational imprinting theory to explore mechanisms for resolving challenges associated with professional, modern-day healthcare delivery.
4 citations
References
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TL;DR: This work has shown that legitimate peripheral participation in communities of practice is not confined to midwives, tailors, quartermasters, butchers, non-drinking alcoholics and the like.
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TL;DR: In this paper, the authors propose a paradigm for managing the dynamic aspects of organizational knowledge creating processes, arguing that organizational knowledge is created through a continuous dialogue between tacit and explicit knowledge.
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17,196 citations
PARC1
TL;DR: Work, learning, and innovation in the context of actual communities and actual practices are discussed in this paper, where it is argued that the conventional descriptions of jobs mask not only the ways people work, but also significant learning and innovation generated in the informal communities-of-practice in which they work.
Abstract: Recent ethnographic studies of workplace practices indicate that the ways people actually work usually differ fundamentally from the ways organizations describe that work in manuals, training programs, organizational charts, and job descriptions. Nevertheless, organizations tend to rely on the latter in their attempts to understand and improve work practice. We examine one such study. We then relate its conclusions to compatible investigations of learning and of innovation to argue that conventional descriptions of jobs mask not only the ways people work, but also significant learning and innovation generated in the informal communities-of-practice in which they work. By reassessing work, learning, and innovation in the context of actual communities and actual practices, we suggest that the connections between these three become apparent. With a unified view of working, learning, and innovating, it should be possible to reconceive of and redesign organizations to improve all three.
8,227 citations
TL;DR: In this article, the authors introduce the Japanese concept of "Ba" to organizational theory and present case studies of three companies that employ Ba on the team, division, and corporate level to enhance knowledge creation.
Abstract: This article introduces the Japanese concept of "Ba" to organizational theory. Ba (equivalent to "place" in English) is a shared space for emerging relationships. It can be a physical, virtual, or mental space. Knowledge, in contrast to information, cannot be separated from the context—it is embedded in ba. To support the process of knowledge creation, a foundation in ba is required. This article develops and explains four specific platforms and their relationships to knowledge creation. Each of the knowledge conversion modes is promoted by a specific ba. A self-transcending process of knowledge creation can be supported by providing ba on different organizational levels. This article presents case studies of three companies that employ ba on the team, division, and corporate level to enhance knowledge creation.
4,438 citations
TL;DR: The premise that knowledge in new product development proves both a barrier to and a source of innovation is explored, with a pragmatic view of 'knowledge in practice' developed, describing knowledge as localized, embedded, and invested within a function and how consequences often arise that generate problematic knowledge boundaries.
Abstract: This study explores the premise that knowledge in new product development proves both a barrier to and a source of innovation. To understand the problematic nature of knowledge and the boundaries that result, an ethnographic study was used to understand how knowledge is structured differently across the four primary functions that are dependent on each other in the creation and production of a high-volume product. A pragmatic view of 'knowledge in practice' is developed, describing knowledge as localized, embedded, and invested within a function and how, when working across functions, consequences often arise that generate problematic knowledge boundaries. The use of a boundary object is then described as a means of representing, learning about, and transforming knowledge to resolve the consequences that exist at a given boundary. Finally, this pragmatic view of knowledge and boundaries is proposed as a framework to revisit the differentiation and integration of knowledge.
3,248 citations