Enabling integrated knowledge acquisition and management in health care teams

Change and improvement 50 years in the making: a scoping review of the use of soft systems methodology in healthcare

Introduction

Improving the quality of healthcare has proven to be a challenging task despite longstanding efforts. Approaches to improvements that consider the strong influence of local context as well as stakeholders’ differing views on the situation are warranted. Soft systems methodology (SSM) includes contextual and multi-perspectival features. However, the way SSM has been applied and the outcomes of using SSM to stimulate productive change in healthcare have not been sufficiently investigated.

Aim

This scoping review aimed to examine and map the use and outcomes of SSM in healthcare settings.

Method

The review was based on Arksey and O’Malley’s framework. We searched six academic databases to January 2019 for peer-reviewed journal articles in English. We also reviewed reference lists of included citations. Articles were included if they were empirical studies focused on the application of SSM in a healthcare setting. Two reviewers conducted the abstract review and one reviewer conducted the full-text review and extracted data on study characteristics, ways of applying SSM and the outcomes of SSM initiatives. Study quality was assessed using Hawker’s Quality Assessment Tool.

Result

A total of 49 studies were included in the final review. SSM had been used in a range of healthcare settings and for a variety of problem situations. The results revealed an inconsistent use of SSM including departing from Checkland’s original vision, applying different tools and involving stakeholders idiosyncratically. The quality of included studies varied and reporting of how SSM had been applied was sometimes inadequate. SSM had most often been used to understand a problem situation and to suggest potential improvements to the situation but to a lesser extent to implement and evaluate these improvements.

Conclusion

SSM is flexible and applicable to a range of problem situations in healthcare settings. However, better reporting of how SSM has been applied as well as evaluation of different types of outcomes, including implementation and intervention outcomes, is needed in order to appreciate more fully the utility and contribution of SSM in healthcare.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-020-05929-5.

Acquired, transferred and integrated knowledge: a study of M&A knowledge performance

Purpose

The acquisition of knowledge through mergers and acquisition (M&A) may not create value—usually because the knowledge may not be transferred, or transferred but not integrated. The purpose of this paper to develop and test a theoretical model of knowledge and performance in the M&A process.

Design/methodology/approach

Theory, model and case analysis.

Findings

The literature review led us to distinguish between three main categories of knowledge along the different stages of the M&A process: acquired knowledge in the pre-merger stage; and transferred knowledge and integrated knowledge in the post-merger stage. The application of the model is illustrated in a case study of technology M&A, which includes data collected from annual reports before and after the merger.

Research limitations/implications

The model recommends acknowledging the differences between the acquired knowledge, transferred knowledge and integrated knowledge when examining the relationship between knowledge and performance in M&As. In addition, the model suggests considering several factors that influence future knowledge integration in the pre-merger stage. Ignoring the three categories and the factors may be the reason for the reports of previous studied stating that the acquisition of knowledge-based resources is associated with negative announcement returns to the acquiring firm.

Originality/value

The paper presents new procedures to measure knowledge, collecting data on R&D employees by using annual reports. In addition, the paper suggests adding “in-process R&D” as an “Acquired Knowledge” measure.

Organizational knowledge and capabilities in healthcare: Deconstructing and integrating diverse perspectives

Diverse concepts and bodies of work exist in the academic literature to guide research and practice on organizational knowledge and capabilities. However, these concepts have largely developed in parallel with minimal cross-fertilization, particularly in the healthcare domain. This contributes to confusion regarding conceptual boundaries and relationships, and to a lack of application of potentially useful evidence. The aim of this article is to assess three concepts associated with organizational knowledge content—intellectual capital, organizational core competencies, and dynamic capabilities—and to propose an agenda for future research. We conducted a literature review to identify and synthesize papers that apply the concepts of intellectual capital, organizational core competencies, and dynamic capabilities in healthcare settings. We explore the meaning of these concepts, summarize and critique associated healthcare research, and propose a high-level framework for conceptualizing how the concepts are related to each other. To support application of the concepts in practice, we conducted a case study of a healthcare organization. Through document review and interviews with current and former leaders, we identify and describe the organization’s intellectual capital, organizational core competencies, and dynamic capabilities. The review demonstrates that efforts to identify, understand, and improve organizational knowledge have been limited in health services research. In the literature on healthcare, we identified 38 papers on intellectual capital, 4 on core competencies, and 5 on dynamic capabilities. We link these disparate fields of inquiry by conceptualizing the three concepts as distinct, but overlapping concepts influenced by broader organizational learning and knowledge management processes. To aid healthcare researchers in studying and applying a knowledge-based view of organizational performance, we propose an agenda for future research involving longitudinal comparative case studies.

Adapting nurse competence to future patient needs using Checkland's Soft Systems Methodology

BACKGROUND

New emerging technologies, health globalization, demographic change, new healthcare paradigms, advances in healthcare delivery and social networking will change the needs of patients in the future and consequently will require that new knowledge, competence and skill sets be acquired by nurses.

METHOD

Checkland's Soft Systems Methodology, focusing on the enriched CATWOE and PQR elements of the root definitions, combined with our own developed "Too much - Too little constraint" approach was used to devise impending knowledge, competence and skill sets.

RESULTS

The analysis revealed ten needs among patients of the future, 63 constraints and 18 knowledge, competence and skill sets for the future nurse.

CONCLUSION

The completed study showed that SSM is an appropriate tool for high level structuring of a "messy" real-world problem situation to meet prospective nursing challenges.