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Creating conditions for effective knowledge brokering : a qualitative case study

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Burns, Prue, Currie, Graeme, McLoughlin, Ian, Robinson, Tracy, Sohal, Amrik and Teede, Helena (2022) Creating conditions for effective knowledge brokering : a qualitative case study. BMC Health Services Research, 22 (1). 1303. doi:10.1186/s12913-022-08559-1 ISSN 1472-6963.

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Official URL: https://doi.org/10.1186/s12913-022-08559-1

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Abstract

Background: Process improvement in healthcare is informed by knowledge from the private sector. Skilled individuals may aid the adoption of this knowledge by frontline care delivery workers through knowledge brokering. However, the effectiveness of those who broker knowledge is limited when the context they work within proves unreceptive to their efforts. We therefore need greater insight into the contextual conditions that support individuals to broker process improvement knowledge to the frontline of care delivery, and how policy makers and organizations might generate such conditions. Methods: Our research took place in a healthcare system within an Australian State. We undertook a qualitative, embedded single case study over the four year period of a process improvement intervention encompassing 57 semi-structured interviews (with knowledge brokers, policy makers, and executive sponsors), 12 focus groups, and 137 h of observation, which included the frontline implementation of actual process improvement initiatives, where knowledge brokering took place. Results: We identified four phases of the process improvement intervention that moved towards a more mature collaboration within which knowledge brokering by improvement advisors began to emerge as effective. In the first phase knowledge brokering was not established. In the second phase, whilst knowledge brokering had been initiated, the knowledge being brokered lacked legitimacy amongst frontline practitioners, resulting in resistance. Only in the fourth and final phase of the intervention did the collective experience of policy makers result in reflections on how they might engender a more receptive context for knowledge brokering. Conclusion: We highlight a number of suggested actions that policy makers might consider, if they wish to engender contextual conditions that support knowledge brokering. Policy makers might consider: ensuring they respect local context and experience, by pulling good ideas upward, rather than imposing foreign knowledge from on high; facilitating the lateral diffusion of knowledge by building cultural linkages between people and organizations; strengthening collaboration, not competition, so that trans-organisational flow of ideas might be encouraged; being friend, not foe, to healthcare organizations on their knowledge integration journey. In sum, we suggest that top-down approaches to facilitating the diffusion and adoption of new ideas ought to be reconsidered.

Item Type: Journal Article
Subjects: H Social Sciences > HD Industries. Land use. Labor
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Social Sciences > Warwick Business School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Medical care -- Australia, Knowledge management -- Australia, Primary health care -- Australia, Health services accessibility -- Australia
Journal or Publication Title: BMC Health Services Research
Publisher: Biomed central
ISSN: 1472-6963
Official Date: 29 October 2022
Dates:
DateEvent
29 October 2022Published
11 September 2022Accepted
Volume: 22
Number: 1
Number of Pages: 23
Article Number: 1303
DOI: 10.1186/s12913-022-08559-1
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 22 November 2022
Date of first compliant Open Access: 22 November 2022
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
LP140100243Australian Research Councilhttp://dx.doi.org/10.13039/501100000923
UNSPECIFIEDNational Health and Medical Research Councilhttp://dx.doi.org/10.13039/501100000925

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