Knowledge Management in Cleveland Clinic

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Introduction

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 for the purpose of extracting information from them. Exploiting these records for the purposes of solving day to day challenges then have taking advantage of that knowledge gained from data repositories. A range of strategies are utilized by the management of organizations regarding how data will be collected and employed in making processes more efficient.

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As Foss (2005) concludes, after careful and intuitive collection of ideas and thoughts form 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 in all levels within an organization.

The second dimension involves making direct association between the resources related to 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. Ground breaking 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 in order to solve problems that could be hindering 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 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. In order 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 expectation.

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.

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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 equipments 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 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 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; this refers to tacit knowledge that has been documented. It is knowledge that, the person holds knowingly in intellectual focus in a structure that can be easily exchanged to others. Its knowledge contained within a database or in a document, such as in patient records.

It is 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 through 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 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 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

In 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 in the establishing research and development initiatives. In a report by Wells (1940) published and released, discovered that it admits and treats people coming from a number of outside countries totaling about eighty in number.

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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 a number of challenges in its years of existence. The Cleveland medical group is the second most prime health care group in the United States and 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 into collecting knowledge from all the practitioners, sharing this information with other practitioners or medical staff. The company has apparently been doing this for the last seventy-five years since its existence. With an existing educational programmed 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 achievement 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).

In 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 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 on 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 group and individual 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. Early departure of staff from the organization and their escalating mobility leads to the organization losing knowledge. Simmers (2008).

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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 is 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 which will be used across the organization in order 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 image, databases & corporate and organizational calendar. 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, news letters, 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 is able to 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 is able to create, monitor, manage, organize and present data to all team members (Foss, 2005 pp 105).

Policy ratified and adopted by Cleveland Clinic

Developing Cleveland Clinic as a knowledge based Organization

STEPS

  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 in order 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 light house 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 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 of 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, link to HR system, HR/Finance Manual. There should also be some a way that human resource to capture relevant knowledge for the repositories followed by education of Cleveland Clinic staff on existing repository. The clinic should establish forums to enable staff to share information. Examples include Cleveland Clinic face book, 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 come to 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 in 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 harmonised (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 practises (Robin, 2004).

Knowledge Creation

Knowledge creation within the clinic can be facilitated by clinic staff in tandem with other parties in order to provide staff with time and space for creation of knowledge (e.g. a tea time which is held informally and regularly at a central place), in order to case encouragement. There should also be a way that, IT structure provides staff with social networks to enable then interact and come up with new ideas 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 in the outpatient services and cardiology medical services to others. The centre is of immense importance and collaboration between the doctors. Since Cleveland Clinic has collaboration with IMC in Jeddah, the centre has seen its number of medical team grow and this necessitates the need for an interactive knowledge management policy that will link the centre to other personnel worldwide (International Medical Center, 2010).

List of References

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

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, Says CEO of Jeddah’s High-Tech Hospital. Web.

Kotelnikov, V. (2010) Tacit knowledge as a source of competitive advantage. Web.

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

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

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

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