This paper focuses on knowledge sharing as an important area in the study of knowledge management (KM). The paper's primary goal is to examine how health-care practices employ knowledge sharing tools and processes to the benefit of their daily work processes. In addition, the study seeks to understand how knowledge sharing would contribute to practices' performance. Adopting a qualitative approach, four health care practices were selected from within a research network to represent larger and smaller practices with different performance levels, two high-performing practices (HP) and two low-performing practices (LP), using standard clinical and health care practice measures. Data collection and analysis involved several iterative steps including interviews and field notes of observations. Four case studies were developed reflecting how each practice implemented knowledge sharing tools and processes and how this implementation influenced performance. The study found that all of the four practices manifested and implemented knowledge sharing tools including knowledge artifacts; sharing social tools, meetings, and communication channels; and processes including training and apprenticeship and communities of practices; however, the level of implementation varied among the four practices. A comparison of the high-performing and lowperforming practices showed that even though the high-performing practices implemented and invested more in knowledge sharing, knowledge sharing processes and tools were not completely integrated throughout the practices including the high performing ones. Moreover, in all practices there was little evidence of encouragement to efficiently use knowledge sharing tools either among staff members or between patients and the practice.Many of the studies investigating knowledge sharing focus on three main aspects: technology, processes, and people. Executives place a stronger emphasis on the role of people in enhancing organizations' ability to compete based on knowledge (Ruggles, 1998). Knowledge sharing is a people-to-people process (Ryu, Ho, and Han, 2003). Still, knowledge sharing is often difficult to implement because people are sometimes reluctant to share knowledge that is perceived to be valuable and important, and look suspiciously upon knowledge from others (Davenport and Prusak, 1998). Changing this natural tendency is the biggest impediment to the knowledge sharing processes.Research related to knowledge sharing and changing work relationships among professionals in health care has begun to emerge (Stefanelli, 2004;Ryu et al., 2003). Ryu et al. (2003) proposed a model for knowledge sharing behavior using existing theories in social psychology. In their study, the authors showed how social psychology theoriesincluding the Theory of Reasoned Action (TRA) and the Theory of Planned Behavior (TPB) -can be used to explain the knowledge sharing behavior of physicians. The study found physicians' subjective norms-i.e. their beliefs about how people they care about will perceive the behavior ...
Knowledge management differences occur within and between practices and can explain differences in performance. By relying more on social tools rather than costly, high-tech investment, KM leverages primary care's relationship-centered strength, facilitating practice redesign as a medical home.
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