Factors Affecting Knowledge Management & Knowledge Use

A Case Study

Leila Shahmoradi

, Maryam Zahmatkeshan

and Mahtab Karami

Tehran University of Medical Sciences, Department of Health Information Management, 5th Floor- School, Tehran, Iran

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

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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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

13.32 No res

onse

-- Alwa

Permanent documentation of yourself knowledge

for reuse.

6.71 Often

53.38 Sometimes

203 Rarel

6.71 Neve

13.32 No res

onse

8012 Yes

Innovation in products and service, due to the

acquisition of knowledge.

13.32 No

6.71 No res

onse

66.610 Yes

Creation of knowledge due to continuous education

in relation to your job

203 No

13.32 No res

onse

609 Yes

Creation of knowledge resulting from Passing the

training courses abroad

203 No

203 No res

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

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(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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