Factors Affecting Knowledge Management & Knowledge Use
A Case Study
Leila Shahmoradi
1
, Maryam Zahmatkeshan
1
and Mahtab Karami
2
1
Tehran University of Medical Sciences, Department of Health Information Management, 5th Floor- School, Tehran, Iran
2
Kashan University of Medical Sciences, Kashan, Iran
Keywords: Knowledge Management, Organization, Administration, Knowledge Use, Knowledge.
Abstract: Knowledge management (KM) is the process of capturing, storing, organizing, using, and creating
Knowledge. Ample attention and insight into such processes result in optimal performance in management
approaches. We investigated the level of awareness of mangers about KM programs and the mechanism of
creation and usage of knowledge within the Iranian Ministry of Health and Medical Education (MOHME).
After a systematic review, we identified the necessary tools for the measurement, usage, and creation of
knowledge in the MOHME. Such tools were reviewed and verified by a subject expert panel. We
incorporated such tools to measure the level of awareness, among the MOHME employees, toward
knowledge and knowledge management. The results of our study were reviewed by subject matter experts
and analysed using IBM SPSS software. The level of awareness toward KM programs and Knowledge
usage and knowledge creation are relatively at an acceptable level at the MOHME. Although most of the
mangers at the MOHME were aware of the knowledge management tools, knowledge creation and usage
were remain relatively at low levels. The lack of active sponsors and transparency programs for supporting
knowledge creation and usage within the MOHME are among the main reasons for such low activities.
1 INTRODUCTION
Knowledge is the most valuable resource in the
information age and active management of
knowledge is important to an organization’s success.
The primary focus of knowledge management (KM)
is the development of a knowledge-friendly culture
in a social environment that must be supported by
appropriate methods and technologies. KM
framework is based on the idea that the most
valuable resource of an organization is the
knowledge itself that is created by the people
themselves (Dubois and Wilkerson, 2008, Hulse et
al., 2012).
Managers of an organization usually consider
knowledge as a great leverage in market
competitions (Jasinskas et al., 2015). Seidler and
Hartmann (2008) stated that knowledge &
information management have two clear objectives:
to facilitate the creation of new knowledge and to
manage the way in which people share and use
knowledge (Seidler-de Alwis and Hartmann, 2008).
By understanding the principles and ideas
behind KM frameworks, executives can better
employ the development of the infrastructure and
knowledge sharing culture that is required in their
environments. If KM is done correctly it can be a
great value-added tool with numerous benefits for
any organization. A key element in creating a
successful KM system is the proper use of "change
management" cycle (Liebowitz et al., 2000). The
lack of a mechanism for knowledge sharing is the
main obstacles in managing knowledge effectively
(Liu et al., 2012). Advocating for a culture of
knowledge sharing behaviors should be the main
focus of a change management executive in any
organization. If the change management cycle is
implemented and executed correctly and the
potential pitfalls of KM utilization are avoided, the
resultant intelligence can secure a bright future for
the organizational growth.
Absence of a KM strategy as an integral part of
the mission of an organization, lack of support and
active participation in the management system at
higher organizational levels, and poorly designed
KM tools are among the main reasons for the failure
of knowledge management(Liebowitz et al., 2000).
Governments may find themselves in situations
152
Shahmoradi, L., Zahmatkeshan, M. and Karami, M..
Factors Affecting Knowledge Management & Knowledge Use - A Case Study.
In Proceedings of the 7th International Joint Conference on Knowledge Discovery, Knowledge Engineering and Knowledge Management (IC3K 2015) - Volume 3: KMIS, pages 152-158
ISBN: 978-989-758-158-8
Copyright
c
2015 by SCITEPRESS Science and Technology Publications, Lda. All rights reserved
where KM initiatives become necessary for
improving management plans more efficiently,
providing more accurate and timely information
flow to the individuals, and raising the satisfaction
levels from governmental policies & procedures.
By design, KM frameworks can transfer tacit
knowledge, convey practical or experimental
knowledge in the methods and workflow designs,
promote standardization and analysis of document
contents, and establish a basis for creating
competencies, competitive environment and
sustainable developmental frameworks within an
organization (Chang et al., 2009)
Today, the theoretical knowledge in healthcare
organizations is considered as a "high-value
informational asset" that acts as a core operational
engine for data transactions. For all practical
purposes, the modern healthcare system has massive
amounts of data that is "rich in knowledge";
however, such assets are not fully utilized for
management improvement and the delivery of
healthcare services (Abidi, 2001). Knowledge
management techniques not only use information
technologies but also emphasize on knowledge sharing
mechanisms (Ogiela, 2015). Several studies have
shown that KM and data mining techniques can
create a foundation for the development of clinical
decision support tools within electronic medical
record systems (Abidi, 2001).
Since the Ministry of Health and Medical
Education (MOHME) is a major national decision
maker organization in Iran, the huge amount of
knowledge generated in this organization is
required to be managed effectively. All academic
and teaching hospitals, as well as medical schools,
in Iran fall under the supervision of MOHME. A
survey by the authors of this article shows there is
no coherent plan for knowledge management at
MOHME yet. Due to the lack of knowledge
management programs at MOHME many duplicate
projects currently run in parallel in different
departments at MOHME. Therefore, in the absence
of KM systems, to be utilized by high-level
managers, there is no transparency and exposure
of projects’ information; hence, valuable
resources are being wasted at MOHME.
It has been shown that the use of KM systems
can create opportunities for improving the
management and decision-making processes (Abidi,
2001, Sibbald and Kothari, 2015). Therefore, the
main objectives of this research are to study how
knowledge is being generated and used at MOHME
as well as to evaluate the awareness of managers
about KM programs.
2 MATERIAL AND METHODS
Our research is a descriptive cross sectional study where
we first reviewed all previous studies in the field of KM
and then established an expert panel with tools required
for content validity and reliability tests with Cranach’s
alpha (0.91) standard. The panel originally included 21
expert invitees; however, due to the absence of 6 experts
during orientation meetings we finalized the number of
panel to 15 people. Without reaching an agreement in
the first panel discussion that took 45 minutes we held
another 35 minutes long meeting. Experts who
participated in the two panels were divided into two
groups: experts with the necessary theoretical
background in the KM area and experts with fieldwork
and familiarity with the history and details of KM field
projects.
Our survey included 8 questions in the field of KM
and comprised of 4 questions about the status of usage
of KM products and 4 questions about the status of
knowledge creation in the MOHME. The MOHME is
the highest-level organization for decision-making in
the health sector in Iran. The study population consisted
of 15 senior managers as well as policy makers from the
Policy Council, Center for KM & Organizational
Learning, International Affairs, Center for Management
and Development Administrative Reform, and the
Center for Statistics and Information Technology
departments within the MOHME. We conducted a
structured interview with above-mentioned senior
managers to collect the information we needed for our
survey. Some of the questions had more than one
answers. IBM SPSS software is used to analyze the
results in the form of descriptive statistics.
3 RESULTS
Most of the managers who participated in this study
were males (60%) and aged between 35 to 40 years
(46.6%). Also, 66.7% of them had fieldwork experience
between 6 to 9 years. Sixty percent of the participants
have a PhD degree in various fields such as health
services management, social medicine, and executive
management. Forty percent of the expert participants
work in the Center for Management and Development
Administrative Reform.
Our findings are presented in the two following
sections:
1. Level of awareness about KM programs among
MOHME employees.
2. Status of knowledge usage in the MOHME.
1. Level of Awareness about KM Programs
among MOHME Employee
Factors Affecting Knowledge Management & Knowledge Use - A Case Study
153
Table 1: Level of employee’s awareness about KM in MOHME.
Percent Frequency Answers Item
86.713 yes
Benefits of implementing KM for organizations
6.71 No
-- I Don't know
66.61 No response
609 yes
Clear understanding about the purpose of KM
for you
33.35 No
-- I Don't know
6.71 No response
53.38 yes
Opportunities to increase your knowledge about
strategic management, information and
knowledge by the organization.
33.35 No
-- I Don't know
13.32 No response
53.38 yes
Business opportunities through the development
of knowledge processes
406 No
-- I Don't know
6.71 No response
93.314 yes
Awareness of the existing & potential values of
knowledge in the organization
6.71 No
-- I Don't know
-- No response
73.311 yes
Awareness of the availability of knowledge and
resources
203 No
-- I Don't know
6.71 No response
609 yes
Information on how the current knowledge
flows
26.74 No
- - I Don't know
13.3 2 No response
6.7 1 center of KM and organizational learning
The person who is responsible for KM programs
6.7 1 yourself Deputy
73.3 11 Others
13.3 2 No response
13.3 2 center of KM and organizational learning
The person who is responsible for creating
opportunities for increasing your knowledge
about strategic management,, knowledge, and
information
20 3 yourself Deputy
46.7 7 Other
20 3 No response
6.7 1 Technical
Awareness about the type of knowledge flow
among individuals
6.7 1 Commercial
93.7 14 Management
60 9 Information on services
46.7 7 Information about other organizations
66.7 10 Latest News
6.7 1 Other
26.7 4 I Don't know
20 3 No response
53.3 8 Face to face and one to one
Flow of available information and knowledge in
the organization from bottom to top
93.3 14 Meetings
80 12 Seminars
80 12 Workshops
53.3 8 Training courses
40 6 Conference
66.7 10 Journals
73.3 11 Bulletin
6.7 1 Other
26.7 4
Face to face and one to one
Flow of existing knowledge & information
within the organization (top to bottom)
100 15
Meetings
93.3 14
Seminars
53.3 8
Workshops
46.7 7
Training courses
53.3 8
Conference
40 6
Journals
53.3 8
Bulletin
6.7 1 Other
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154
According to Table 1, over 80% of employees were
aware of the benefits of KM for the organization.
Despite the fact that the MOHME occasionally runs
workshops and educational programs about the
importance of KM for managers there is still room
for improvement in this area. Statistical data in Table 1
indicates that the goal of a KM system has been
clearly explained to only 60% of the study
population. Fifty-three percent of the respondents
mentioned that the organization provided some
opportunities for them to enhance their knowledge
about strategic management, knowledge, and
information. The Lack of such opportunities for
other employees could be the cause of their
unawareness toward the benefits of a KM system.
While more than 90% of the respondents
recognized that value of knowledge itself, only 60%
of the participants understood how knowledge
actually flows within the organization. Most
managers acknowledged the importance of
knowledge but did not know how to manage it
(Table 1).
Only two people responded that the department
of KM & Organizational Learning is responsible for
explaining the importance and purpose of KM and
increasing employee’s awareness about KM.
Most people believed that no one is currently
taking the responsibility of KM tasks and the
department of KM and organizational learning is no
longer active in this area.
Table 1 shows 26.7% of the respondent did not
know what knowledge flow is and how it works in
their organization. About 66.7% of the participants
believed that news access in their organization are
possible only through the intranet portal of the
MOHME. The majority convinced that the
managerial knowledge in the organization is
constantly flowing while everybody believed that
existing knowledge & information only flows
through the high level meetings in the Ministry of
Health and Medical Education.
2. Status of Knowledge Usage in the MOHME
Table 2 shows the majority of the managers agreed
that knowledge sharing could expedite scientific
publications and facilitate innovative movements in
Table 2: Survey results about the status of knowledge in MOHME.
Percent Frequency Options Items
93.3 14 Production of scientific papers
When you share knowledge with others, What
would you expect of them to apply it?
93.3 14 For projects
93.3 14 Provide innovation in products and service
93.3 14 All of the above
13.3 2 Other
6.7 1 No response
13.3 2 Not enough time
What is the reason for the lack use of available
knowledge?
53.3 8 Being busy with daily activities
40 6 Not valid available knowledge
73.3 11 Not up to date available knowledge
93.3 14 Adequate use of available knowledge
6.71 Othe
r
13.32 No res
p
onse
-- Alwa
y
s
Permanent documentation of yourself knowledge
for reuse.
6.71 Often
53.38 Sometimes
203 Rarel
y
6.71 Neve
r
13.32 No res
p
onse
8012 Yes
Innovation in products and service, due to the
acquisition of knowledge.
13.32 No
6.71 No res
p
onse
66.610 Yes
Creation of knowledge due to continuous education
in relation to your job
203 No
13.32 No res
p
onse
609 Yes
Creation of knowledge resulting from Passing the
training courses abroad
203 No
203 No res
p
onse
66.610 YesCreation of knowledge resulting from publication of
articles, researches, reports, and operation
instructions by the organization
13.32 No
20 3 No response
66.6 10 Yes
Creation of knowledge resulting from the
publication of material in the context of meetings,
seminars, workshops, presentations and conferences
13.3 2 No
20 3 No response
Factors Affecting Knowledge Management & Knowledge Use - A Case Study
155
the delivering projects, products and services.
Similarly, it was believed that using shared
knowledge in the workflow could improve
established organizational and functional processes.
Many managers mentioned existing knowledge
within the organization is suffice enough; however,
busy schedule, not being up-to-date with the latest
project information, insufficient use of the existing
knowledge, and the lack of interest, were among the
major reasons for inadequate usage of knowledge
within the MOHME. Furthermore, documentation
about included knowledge in a given project has not
been consistently done among managers.
4 CONCLUSION
KM is a complex process that goes beyond simple
electronic documentation. Formal frameworks are
essential for creating and managing knowledge
repositories. It has been shown that KM programs
have many benefits such as advancing
organizational strategies, solving problems quickly,
disseminating best practices, improving knowledge
in products & services, increasing opportunities for
innovation, enabling organizations for a better
competition, decreasing redundancy, improving
internal processes, reducing errors, enhancing
participation levels of personnel in decision-making,
and retaining organizational intellectual capitals
(Dubois and Wilkerson, 2008; Lee et al., 2014).
Our study findings showed that 66.6% of
managers of the MOHME were actively participated
in continuing education about KM in their domain.
However, only 60% of them passed the training
courses. Most of the managers stated the pamphlets,
reports and the operating instructions that have been
published by the organization were useful for KM
activities. We also found out the release of
information about meetings, seminars, workshops,
presentations, and conferences had a major effect on
knowledge generation practices by managers. As
other researchers have suggested, the design and
implementation of a KM system with continuous
training could lead to the creation of knowledge
itself by individuals. Similarly, institutions that did
not invest in KM systems have generated more
duplicate knowledge compared to other institutions
with heavy investments in KM systems(Cheung et
al., 2007; Hourcade-Bellocq et al., 2008).
Although the majority of the managers from the
Department of KM at MOHME were aware of KM
benefits, they didn’t have much information about
the methods for implementing a KM framework.
The findings of this study showed only half of the
managers at MOHME were aware of the existence
of available knowledge and resources within the
organization. It was also apparent that the majority
of managers who participated in our study kept their
knowledge in their head versus recording it on a
piece of paper or storing the knowledge in electronic
databases. Such findings are in accordance with
other studies like (Cheung et al., 2007; Choy et al.,
2004; Handzic et al., 2008; Hourcade-Bellocq et al.,
2008 and Liebowitz et al., 2000).
In terms of opportunities for knowledge sharing
for managers and staff, our finding suggests that
only a small portion of the participant (24%)
indicated knowledge sharing meetings were actually
useful. On the other hand, almost half of the
participant in our study agreed that work group
meetings created more opportunities for them for
knowledge sharing purposes. In terms of knowledge
transfer from more experienced employees to others,
almost half of the participants in our study believed
that such transfer culture does not exist today at the
MOHME. The other half, however, believed that
such knowledge exchange happens regularly
throughout the project team meetings only
(Hourcade-Bellocq et al., 2008). Asemahagn (2014)
shown that the more participants emphasized need to
share knowledge and experience in their activities.
49% of people had sharing knowledge and
experience and 70% of people were eager to share
their knowledge and experiences. This study also
demonstrated although, respondents know the
importance of sharing knowledge and experiences
just a few of people do that. Those people who
awarded of knowledge sharing, they performed it
just about 4 fold further than other people and
around 70% of health professionals satisfied with
knowledge sharing in hospital(Asemahagn, 2014).
LEE and HONG (2014) study on nursing staff
shows working in a environment with a culture of
knowledge sharing can actually improve knowledge
management principles as well as employee’s
performance (Lee et al., 2014).
Hussein and Wahba (2003) studied the readiness
of the members of the Egyptian Information
Decision Support Center in 2003 for adoption of a
KM program. Their analysis showed the cabinet
members were tackling their tasks by referring to the
data (knowledge) obtained from previous projects.
Telephone and fax line, electronic emails, internet &
intranets, pamphlets, and fact sheets were among the
main methods of capturing the required information
KMIS 2015 - 7th International Conference on Knowledge Management and Information Sharing
156
(Hussein and Wahba, 2003).
Our findings show that more than half of the
managers are aware of the existing knowledge and
resources at the MOHME; however, they may not
necessarily use it. Hourcade-Bellocq et al., (2008)
showed that the majority of the respondents in their
study had access to the information about HIV but
the data was limited, out of date, inaccurate, and in
general, were not useful at all
(Hourcade-Bellocq et
al., 2008).
We also found that many managers believe the
existing knowledge within the organization is
both adequate and in active use. Busy schedule
(53.3%), not being up-to-date with the latest project
information (73.3%), insufficient use of the existing
knowledge (93.3%), and the lack of interest (6.7%),
were among the major motives for inadequate use of
knowledge within MOHME.
Many researcher indicated the required
knowledge in most cases (>70%) is adequate and
applicable to the situation, while others believe that
a busy schedule (40%) and out of date information
(61%) make it difficult to use knowledge and
knowledge tools in a given organization (Cheung et
al., 2007; Choy et al., 2004; Handzic et al., 2008;
Hourcade-Bellocq et al., 2008; Liebowitz et al.,
2000)
. In another study conducted in Latin America
and Caribbean (2008) showed that the existing
knowledge within an organization was not usable
due to the lack of the satisfactory results from
knowledge based decision making systems and
change in people’s behavior toward KM. They also
found that the lack of a reliable knowledge source,
inadequate time, and busy schedule were among the
main reasons for managers not to participate in KM
activities. Building a team of managers is essential
for the purpose of updating accurate information and
transferring it to others (Hourcade-Bellocq et al.,
2008). Karamitri et al (2015) suggested holding
training courses, meetings and workshops about KM
and knowledge sharing can be useful in this and
similar cases (Karamitri et al., 2015).
Organizational culture, leadership, knowledge
flow & process, technology infrastructure and
organizational structure & mission, are all among
important factors in influencing a KM
system(Albers, 2009; Lee et al., 2014). In order to
establish a successful knowledge management and
integration framework, appropriate strategies for
KM implementation should be adopted so that
accessing and sharing knowledge become easily
available within the working environment. Having
strong leadership support is essential for a successful
implementation of a KM system. KM is a systematic
process for creating, maintaining and using
organizational knowledge for optimal usage of
knowledge, achieving a sustainable competitive
state, and increasing organizational performance and
output. In simple terms, KM is the integration of
people, processes, and technologies all
together(Albers, 2009).
Healthcare organizations lay special emphasis on
knowledge management and knowledge sharing in
order to improve the quality of clinical care, shrink
costs, and reduce medical errors (Gider et al., 2015;
Platt and Kardia, 2015, Yun, 2013). In the healthcare
domain, KM frameworks can be used for applying
formal methods and techniques to facilitate the
generation, acquiring, maintaining, and
disseminating knowledge. The healthcare industry is
comprised of organizations with gigantic
investments empowered by knowledge and complex
information resources (Abidi, 2001).
In general, the use of KM in the MOHME in Iran
is currently at acceptable levels.
We concluded that people who are involved in
the KM process should go under appropriate and
rigorous trainings that are compatible with the
mission and vision of the organizations they work
for.
Although encouraging employees of an
organization to share organizational knowledge is a
challenging task, it can be achieved by thoughtful
incentives for the purpose of motivating employees.
We propose to change the current practices of
knowledge storage and fragmented KM methods at
the MOHME so that a comprehensive and global
KM framework can be designed and implemented.
Such action warrants a deeper analysis of the
requirements so that a customized KM framework
can be developed that is entirely based on the
mission and vision of the MOHME. We also
recommend including public awareness courses,
especially at the manager level, about KM as one of
the main items in any KM training programs.
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