Knowledge Management in Cleveland Clinic

Mission

“The mission of Cleveland Clinic is to provide compassionate healthcare of the highest quality in a setting of education and research“.

Vision

“When Cleveland Clinic welcomed its first patients on February 28, 1921, its sense of mission was clearly in place: “Better care of the sick, investigation into their problems, and further education of those who serve.” Cleveland Clinic’s four founders set out to develop an institution that would be greater than the sum of its parts — an institution in which diverse specialists would be “able to think and act as a unit.” “

Introduction TO Knowledge Management in Cleveland Clinic

The purpose of this assignment is to discuss knowledge management and theories that are related to it. In reality, the world has come to realize the importance of managing records to extract information from them. Exploiting these records to solve day-to-day challenges then have taking advantage of that knowledge gained from data repositories. A range of strategies is utilized by the management of organizations regarding how data will be collected and employed in making processes more efficient. As Foss (2005) concludes, after careful and intuitive collection of ideas and thoughts from productive members, the information is then analyzed and implemented to bring about innovative products and services. Knowledge management is often explained within two dimensions; the first dimension is to take the components of activities related to business as linked to strategy and practices that should be implemented at all levels within an organization.

The second dimension involves making a direct association between the resources related to the generation of logical and intellectual assets which have the effect of inducing encouraging results. As (Simmers, 2008) theorize, KM involves many processes, but the main ones include the discovery of new talent within the company, generation of new information, and ensuring that there is a way that the information can be easily shared. Although this definition varies from profession to profession, the essence of knowledge management remains the same. He further goes on to state that just as in all management principles, knowledge management is interlinked with other management strategies such as change and risk management. International Medical Center has a linkage program with the Cleveland Clinic which has been the vision of Sheikh Ahmad who happens to be the CEO of Fitahi Company. After the signing of a contract by both the Saudi and Boston architects, the center was constructed at a very fast pace. Groundbreaking of the center was done in January 2003 where the location of the ceremony was in Jeddah. The center offers ambulance services, outpatient clinic services, and a clinic offering anesthesia services. This project is just an illustration of how knowledge shared can contribute to better health.

Concept of Medical Knowledge

As (Simmers, 2008) discusses and summarizes, knowledge can best be defined as the fact or condition of knowing something with familiarity gained through experience or association. Research has shown that knowledge is the application of facts to solve problems that could be hindering a person. Knowledge is often described as an infinite asset because it is the only asset that increases when it is shared. It is also described as the information received and applied in the performance of activities. In addition, knowledge is related to the experiences of people in organizations and societies. Many scholars and researchers have forwarded the concept of knowledge as a resource and an intangible asset and forms part of the so-called intellectual capital of an organization. To fully understand how knowledge-based value creation works, an understanding by management on what it is and how it relates to the competence of the firm is crucial. Most times it is information combined with understanding and capability. It lives in the minds of people and is based on individual experiences, beliefs, and expectations (Chanzer, 2009).

Scholars have often put it that knowledge provides a level of repeatability, reliability, or predictability that usually stems from the recognition of patterns. For example, an astute executive knows the significance of the dollar figures on his /her company’s income statement and this makes him/her capable of taking positive action. It also guides action, whereas data and information can merely inform or confuse. As (Robin, 2004) discusses and summarizes, knowledge is the product of individual and collective learning which is embodied in products, services, and systems.

Forms of Medical Knowledge

Knowledge within Cleveland Clinic includes many forms

1. The competencies and capabilities of medical staff and contractors
2. Knowledge about patients and suppliers of medical equipment and kits.
3. Know-how to deliver specific processes
4. Codified and protected knowledge in the form of patents, licenses, copyrights.
5. Systems for leveraging the clinic’s innovative strength etc.

Types of Knowledge as Used in Cleveland Clinic

Tacit knowledge; is the most common type of knowledge. It refers to private knowledge implanted in personal experiences and involving indefinable factors such as beliefs, perception, and values (Kotelnikov, 2010). In his studies (Robin, 2004) concludes that it is the knowledge that a person may not be deliberately responsive of such as how he/she achieves a particular job. Such knowledge can be extremely difficult to transfer. E.g. Explaining or describing what you know to others can be a difficult task. Organizations themselves may have values, history, written laws, and ways of doing things which also serve as “tacit knowledge” and shape how explicit knowledge is created and used.

(Bontis & Choo , 2002) explain that, Explicit knowledge; refers to tacit knowledge that has been documented. It is the knowledge that the person holds knowingly in intellectual focus in a structure that can be easily exchanged to others. Its knowledge is contained within a database or in a document, such as inpatient records.

It is the knowledge that has been articulated into formal language and can be much more easily transferred among individuals such as doctors and nurses within the clinic. Indeed, making tacit knowledge explicit is one of the key functions of a KM strategy

Evolution of Knowledge Management

The traditional businesses aimed at realizing success based primarily on the management of finite physical resources. The information-based economy of today pursues rapid innovation, business agility, and just-in-time learning as a base for success.

Such organizations like Cleveland clinic, hope to develop and retain their” infinite assets,” the knowledge of their nurses and doctors. Understanding and managing both explicit and tacit knowledge in an organization is likely to achieve the best results. As (Foss,2005) concludes that, it is also worth noting that much knowledge is communicated informally as well as formally in medical sector environments. Hence it is equally important to provide an environment in which casual conversations are encouraged as well as communications in meetings. The medical field environment like the one in the Cleveland Clinic is a complex one and the willingness to share knowledge may vary from individual to individual.

Case study: Implementation of Knowledge management policies in Cleveland Clinic

A report by (Simmers, 2008) explains that Cleveland clinic is an organization that employs over 1800 physicians who are on staff and they represent about one hundred and twenty specialties between them. The organization is large to the extent that it has approximately nine hundred and twenty residents and fellows who are currently undergoing training at the clinic’s facilities. The organization is also at the forefront of establishing research and development initiatives. A report by (Wells, 1940) published and released, discovered that it admits and treats people coming from several outside countries totaling about eighty in number. (Simmers, 2008) goes on to refer the clinic as highly rated as one of the best medical institutions in the whole of the United States. Founded in the early 1920s by a group of surgeons, the clinic has grown in leaps and bounds. The clinic has endured several challenges in its years of existence. The Cleveland medical group is the second most prime health care group in the United States and is only rivaled by the Mayo Clinic. (Simmers,2008). The Cleveland Clinic is known for innovation in coming up with new medical procedures and techniques and all this is attributed to the importance the management in the clinic, place on research initiatives. The clinic has an annual expenditure of two hundred and sixty million dollars devoted to research and is never short of achievements as it boasts to have the best techniques in how to handle intricate and demanding conditions that are present in all hospitals (Simmers, 2008).

The Cleveland Clinic has devoted its time and energy to collecting knowledge from all the practitioners, sharing this information with other practitioners or medical staff. The company has been doing this for the last seventy-five years since its existence. An existing educational program involving ways in which this knowledge can be passed from person to person at the time they need it in an organized manner is one of the achievements that the clinic has tried to ensure but faces challenges in doing so. The clinic has a certification program, which adds to the need for proper spread and utilization of information by members within the medical practice (Simmers, 2008).

His findings, (Simmers,2008) reports that the clinic offers certificates after the completion of several courses that range from Live CME courses to online courses. Actual doctors formulate information regarding topics covered within the program and hence this makes them intellectual assets within the organization (Simmers, 2008).

Why Cleveland Clinic Undertook KM Efforts

(Simmers, 2008) discusses how members of the clinic met and discussed the importance of implementing a knowledge management program in the organization as the general idea is that once implemented, the benefits accrued will not only apply to the profits of the organization but will also enable efficiency in work processes. It is the purpose of this paper to dissect these claims and assess the ones that will be of the most value to the clinic. Typical deliberations of executing such a program included:

• The organization is bound to benefit from the Facilitation and management of innovation and organization learning. This goes hand in hand with leveraging the expertise of people across the organization helps groups and individuals to share valuable organizational insights.
• Increasing network connectively between internal and external individuals.

Intractable a wicked problems

Managing the intellectual capital and intellectual assets in the workforce (such as the expertise and know-how by key individuals). With the new program, there is no need to reinvent the wheel per se as the clinic can trim down training time for new physicians and medical staff. The program will also market current innovations that the clinic would be currently pursuing. A knowledge management initiative make certain that

Market places are increasingly competitive and the ratio of innovation is rising.

• Decrease in recruitment forms a need to substitute unofficial knowledge with official techniques. The early departure of staff from the organization and their escalating mobility leads to the organization losing knowledge. (Simmers, 2008).
• The need for lifelong learning is an inescapable reality as also the number of challenges, especially in the medical field.
• Most of the work is information-based as experiences from one specialist are of great importance to another (Simmers, 2008).

Implementation of Intranet across Cleveland Clinic

(Simmers, 2008) sampled and found out that with a high number of patients and medical staff within the organization, there is a serious need for a clear and strategic method of gathering information from all the specialists within the organization and this can only be done by integrating information technology in all the processes that are used in the handling of records. Records management and knowledge management can better be managed with the assistance of information technology. Cleveland clinic decided to implement an Intranet that will be used across the organization to display information to whoever needs it at the right time. (Simmers, 2008)

Road map to implementation

The clinic decided to incorporate an intranet that was to be used in the storage and display of information such as documents, forms, charts and graphs, pictures & scanned images, databases & corporate and organizational calendars. The intranet that was commissioned by the organization contained relatively static information, somewhat dynamic information, and highly dynamic information. Within the relatively static information are benefits descriptions, policies and procedures, forms, organizational charts, newsletters, document templates, facility locations & maps, and minutes of meetings. Some of the dynamic information listed on the organization’s intranet includes phone listings, internal job listings, project data, including their summaries and schedules. Highly dynamic information on the website incorporated daily news, corporate contacts, individual employee data, email address listings, corporate calendar (Simmers, 2008).

Adoption of the intranet as a Knowledge Management Tool

After the intranet was implemented, the challenge came in the form of sensitizing the users on how to use the intranet and how the new system would ease normal business operations. Instead of refusing to adopt the new technology, users were advised and educated on why operations within the organization would be made much better as there will be faster access to data. A good example of this is how the intranet incorporated web-based reporting tools which enabled information to be accessible anywhere and anytime. Within the system is a central source for user self-help (Online training, user guides). The intranet was shown to reduce the cost of employee training as there is now a new single application interface. After all, this was highlighted to the staff, adoption was made much easier as the technology-savvy members of the organization led the way in adopting the technology (Foss, 2008).

Challenges Faced During Implementation

Some of the challenges faced by the team members and organization during implementation were numerous but the management was able to tackle each one by one. One of the technical challenges faced was the unfriendly user interface which was later corrected by the website developers, out-of-date content, difficulties in uploading and updating content. The initial scope was limited to the headquarters of the Cleveland Clinic. Developers had to come up with a way of making the intranet accessible globally. Successful tests were conducted all around the global offices that the organization operated from and this also included mobile users who used mobile devices to access the intranet. (Simmers, 2008).

An intranet is not only a very influential medium used for communication within the organization, but it is also used as a knowledge base as it possesses advantages over other technologies that were previously used for knowledge management. The intranet assists us in learning and helping members of the organization understand their roles and the processes. With a knowledge base readily available, the organization can record experiences with little effort. As the volume of human communication increases, it is getting increasingly difficult to monitor and this is why the intranet was conceptualized as it can create, monitor, manage, organize and present data to all team members (Foss, 2005).

Policy ratified and adopted by Cleveland Clinic

Developing Cleveland Clinic as a knowledge-based Organization

1. Letting people appreciate Cleveland Clinic as a knowledge market (Foss, 2008). This includes the creation of a place where knowledge is created continuously as people learn and gain experiences. This includes activities such as where people continuously seek information and knowledge to solve specific problems. Knowledge moves through organizations is exchanged bought, forgotten, lost found, generated, and applied to work. Hence need to create effective enabling conditions and market mechanisms for generating and exchanging information, (Simmers, 2008)
2. The clinic should be able to create an enabling condition for knowledge markets example the provision of physical infrastructure, I.T, strategic visions, objectives values incentives, and attitudes, and relationships (Foss, 2008).
3. Principles and rules of knowledge market: Knowledge markets only work if some basic rules and guiding principles are respected e.g. common interest principle and using the lighthouse principle (getting a mentor or give and take principle) (Foss, 2008).
4. Knowledge media: Media through which knowledge in Cleveland clinic is identified, transferred shared, generated e.g. yellow pages (Foss, 2008).
5. Knowledge Maps and skills profiles: This will involve the clinic developing skills profiles and by determining the jobs positions and for each position, determine the roles of people and competence. The clinic can go further by contributing to the staffing of projects. The management of the clinic can come up with a method of Collective memory example databases, groupware applications (software that enables users to work collaboratively on projects via network); capture and retrieve systems for relevant knowledge, codified and described in handbooks, manuals, process descriptions, project files, etc. Gatherings and meetings of practice-bringing experts log will be informally bound log by stored expertise. (Foss, 2008).
6. Knowledge Infrastructure (Tools): With assistance from the Information technology department, tools to support knowledge sharing can be designed to support knowledge media (Foss, 2008). They can include I.T Infrastructure and applications. The infrastructure can be based on Intranets and web-based software. Infrastructure could also consist of physical as well as communication (Foss, 2008).
7. Implementation paths for Knowledge Management: At this stage, we may ask ourselves, which one for Cleveland Clinic? This answer can be answered through many facets ranging from Information management to Knowledge management. We can start with I.T systems and specific applications e.g. databases, yellow pages, discussions panels. This can be followed by knowledge managers as change accounts- designate a knowledge manager to be responsible for knowledge creation and transfer. A problem-oriented path can be followed where solutions are triggered by a need, or knowledge management initiatives within the clinic can be initiated by creating teams with common interests this is best implemented using a top-down approach. Whereby knowledge management is initiated by Cleveland Clinic by corporate management

What can Cleveland clinic do to tackle some of the barriers to KM that were outlined in the case study

Knowledge Identification and Capture

The clinic should ensure that some information is only accessible in the repository, e.g. annual reports, forms, links to the HR system, HR/Finance Manual. There should also be some way that human resources to capture relevant knowledge for the repositories followed by education of Cleveland Clinic staff on the existing repository. The clinic should establish forums to enable staff to share information. Examples include Cleveland Clinic Facebook, Twitter (social networking). There should be Incorporation of documents in staff JDs to ensure that all staff knows their responsibility in terms of creating documents. This should then be an appraisal issue. Finally, there should be a program for building internal capacity for existing staff on documentation (Foss, 2008).

Knowledge Storage

When it comes to the storage of information, the clinic should have a centralized repository with access levels(role-based access) for staff to access and thereby know what is going on. This should go hand in hand with ensuring systematic sorting and allocation of knowledge products into different repositories (Robin, 2004).

Knowledge Sharing

In matters regarding sharing of knowledge, the clinic is responsible for ensuring that there is Human Resource (KM focal persons) to capture relevant knowledge for the different repositories. There should also be some establishment of non-monetary incentives to encourage staff to document and share e.g. ‘Sharer of the month’, in which the staff members can be recognized, KM bulletin, or provide free short courses. The clinic can come up with forums for staff to share e.g. ATM or less formal. A clear and well-formulated knowledge management program demands that the technology is relevant and up to date and that staff are aware of the technology tools available. Management in collaboration with the team members should ensure that the policies in place (organization-wide) are harmonized (Robin, 2005).

Knowledge Application

The application of knowledge management within the clinic demands that the staff appraisals capture the issue of knowledge application and include capacity building on project implementation citing best practices (Robin, 2004).

Knowledge Creation

Knowledge creation within the clinic can be facilitated by clinic staff in tandem with other parties to provide staff with time and space for the creation of knowledge (e.g. a tea time which is held informally and regularly at a central place), to cases encouragement. There should also be a way that, IT structure provides staff with social networks to enable them to interact and come up with new ideas for the establishment of a comprehensive and fair IPR policy (Robin, 2004).

Conclusion

The paper has discussed the theory of knowledge management and how it is important in the transformation, and how it can make processes more efficient within organizations. A case study as to how the intranet has been used as a knowledge management tool and how it has assisted in coming up with more innovative ideas among team members. Knowledge management is the future in making all information accessible to everyone at the time they require. A good example of where this knowledge management policy will apply is in the International Medical Centre (IMC), which has formed in the early 90s. It is responsible for the outpatient services and cardiology medical services to others. The center is of immense importance and collaboration between the doctors. Since Cleveland Clinic has collaborated with IMC in Jeddah, the center has seen its number of medical teams grow and this necessitates the need for an interactive knowledge management policy that will link the center to other personnel worldwide (International Medical Center, 2010).

Reference List

Bontis, N. & Choo, W. (2002). The strategic management of intellectual capital and organizational knowledge. New York: Oxford university press.

Chanzer, N. (2009). Using Technology in Health Care. London: Oxford Publishers.

Foss, K. (2005). Knowledge Management and Intranet Solutions. New York: P.K. Foss.

International Medical Center. (2010). Grand Opening: King Launches Private Health Sector A Dream come True. Perth: Ocean View Publishers.

Kotelnikov, V. (2010) Tacit knowledge as a source of competitive advantage. Perth: Ocean View Publishers.

Robin, C. (2004). Knowledge Management. New York: CRC Press.

Simmers, C. (2008.) The Internet and Workplace Transformation. London: Sharpe.

Wells, H. (1940). Theories of Knowledge Management. New York: Springer.