Thim, Christof | Weber, Nadja

Management Of Tacit Knowledge To Overcome Learning Barriers Between Profession

Abstract

The health care sector is under heavy pressure from lawmakers and stakeholders to reduce costs and raise the quality of services. Hospitals are obliged to introduce a quality management system. They need to become learning organisations in order to adapt to this new demands. This paper evaluates which problems arise from the professional segmentation and how hospital management tries to cope with it. Therefore the paper ties aspects of the management of knowledge structures to sensemaking in the process of learning. Research will be framed by a systems theory approach, which divides learning into two phases: triggering irritation and attached modification of knowledge structures. Knowledge and sensemaking coin learning . Both aspects are affected by profession which is imposing specific interpretation and observation schemes on its members. In result, this should lead to asynchronous learning stages and different learning content throughout the organization. This problem has to be tackled by knowledge management techniques and governance. In a case study structured narrative interviews about quality management and daily working routines were conducted. In addition cognitive maps were used to analyse the interpretation patterns in each profession. The coordinating role of quality management evaluated subsequently. Interviews and maps revealed hidden semantic connections with group-typical knowledge and sensemaking schemes. A shared knowledge core around the definition of „quality“ was oriented towards the cure and professional autonomy. Yet each professional group retained their own set of aims, which leads to different dysfunctional learning results. Quality management instruments were used to structure and explicate knowledge on the scale of the whole organization. This synchronized the system's elements temporarily, in the long run only emergent inter-professional collaboration lead to a mutual understanding, that made hidden interpretations transparent and consensual affiliations possible. It becomes clear, that to master the dynamics of organizational learning in health care institutions strategies of explication of and access to knowledge alone fall short. Management of tacit knowledge is necessary to align different interpretation schemes and ensure cross-professional learning.