Sharing knowledge in the hospital across status barriers


Medical professionals can do their jobs better when they share professional knowledge about best medical practices, and the latest insights in patient care. Sharing knowledge improves coordination and reduces the risk of medical errors. But sometimes valuable knowledge does not find its way from doctors to nurses, or from nurses to doctors, because of status differences between the two groups, says researcher Stefano Tasselli of Rotterdam School of Management, Erasmus University. I conducted surveys and interviews in a hospital department to understand why knowledge gets stuck within the organisation. And I found that one of the main problems is that knowledge tends to get stuck within professional groups. So, for example what happens is that doctors tend to rely for advice mainly on other doctors, and not on nurses. Nurses tend to share knowledge with other nurses and not with doctors. One of the reasons for this lack of knowledge exchange is that there are huge status differences between professional groups within the hospital. And that is a missed opportunity for knowledge sharing within the organisation. But the good news is, that there are specific types of actors that enable knowledge exchange and play an important role in the organisation to make knowledge flow. One of the groups that enables knowledge transfer within the organisation is the one of medical directors. They are involved in all kinds of operation and they have the shorter path to communicate with other doctors or nurses. And what’s specifically important is that they try to translate knowledge in a language that is accessible, both to doctors and nurses. For this reason their knowledge tends to be trusted by other professional groups. Junior doctors tend to play the role of knowledge brokers within the organisation. They tend to rotate quickly between departments, they tend to learn the more recent insights about professional practices and for this reasons they exchange knowledge between professional groups. Nurse managers play a similar brokerage role in the organisation. They have a managerial position, so they are able to speak with other doctors, and at the same time they occupy a prominent decision within the intra-professional nurse group. For this reason, they are excellent brokers for exchanging knowledge. Status divides between professions will always remain in hospitals, because professionals have different backgrounds and play different roles in organisation. But hospitals can do more to reduce these divides and at the same time improve knowledge exchange and collaboration. One way of doing that, is introducing forms of inter-professional training, involving nurses and doctors. Another important way can be fostering social gatherings, for example, informal meetings or other informal events. Most importantly, hospitals that want to create a culture of knowledge sharing, need to understand that, because knowledge sharing is a social process, it cannot just be managed through formal organisation, or writing of guidelines, but only through active collaboration between people.

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