The Knowledge Management Culture in Health Sectors

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According to Drucker (1999) for getting competitive edge in the market organizations must focus on, that how they can efficiently use and deal with employee knowledge. It is the utmost obligation of the managers and executives to know the importance of this critical issue.

In Pakistan, especially in health care industry KM seems to be a fresh term, if any one use the term of KM people becomes blank and give the concept that it may be managing of knowledge but they don't know how they can manage their valuable knowledge. People use to say it may be a new fad of management and will disappear in few years so why should we use our time and money for this.

Savage (1995) has divided the wave of socio-economic development into three categories; one is agriculture age in which wealth is defined as ownership of land, second one is industrial age in which wealth is based on ownership of capital, and the last one is knowledge age in which wealth is based on possession of knowledge and the ability to use that knowledge to produce or make them better goods and services. This century is the era of knowledge age where KM has given vital importance. Toffler (1991) says that in the age of knowledge economy there is a need for system at the disposal to produce, operate and raise the knowledge of knowledge workers.

The definition goes as: "KM is the process of capturing, creating, and using knowledge in order to increase the performance of the organization. It also refers to a wide range of practices and techniques which are used by organizations to represent, identify, and distribution of knowledge, know-how, expertise, intellectual capital, and other forms of knowledge for control, reuse and transfer of knowledge and learning within the organisation" (Iandoli and Zollo, 2007).

Hospitals are facing one of the biggest dilemmas that they don't have the culture to use collaboration tools for sharing and creating teaching materials. The reason behind this dilemma is the sharing culture is not well nurtured. Like other business professions, it seems that doctors get used to accomplish their duties alone. They don't have time to share their experiences with other doctors and professionals. Why the doctors and other professional are not utilizing IT technology and the answer to this question is that because they are reluctant to utilize it.

For transferring any kind of knowledge with others everyone feels that human relation is required so they hesitate to share their experiences with others. Documenting(converting them into explicit) seems more difficult as it is time consuming task so no one bother to do so which results in loss of valuable assets incase if doctor with leave the hospital. Leaders and top management can play a vital role in nurturing the culture of knowledge sharing and for doing so motivation and commitment is required from them.

IT is one of the tools of KM, it's not all about KM. IT can play the role of enabler and catalyst for sharing of knowledge (Rollett, 2003). With the deployment of intranet communication, collaboration and resource management become easy. Doctors used to send email and circular to one another. With the proper use of IT technology they will be able to place their documents (explicit knowledge) on network storage from where other will be able to access and take advantage from it.

In hospitals, departments can be changed into communities of practice / knowledge communities because doctors of one department or one specialized are facing same problems and usually have same goals so it is natural for them to share their knowledge and experiences. Perhaps they have been doing this for some time, but without KM strategies. IT can facilitate them in sharing anywhere instead of having face-to-face collaboration (Dixon, 2000). For knowledge sharing it is necessary to nurture culture of knowledge sharing as it difficult to disseminate knowledge within organization or the other way around is to develop the trust in them so that they will feel free to share knowledge.

Research Purpose

In this research, knowledge management in health care industry will be taken into consideration to dig out the factors that are affecting them.

Literature does not depict any research study of knowledge management by focusing Pakistan. Therefore, this study intends to fill the knowledge gap that exists in mentioned areas.

This paper has been organized in the following way to give a smooth effect to the reader. Part 1 introduces the background of the topic: what is moral imagination and why we need this, what is its importance. Finally, the research purpose is stated. Part 2 describes the literature review and also focuses on the review of work related to the topic.

Literature Review

The core concept, which has been used in this particular paper, is knowledge management (KM) and intangible assets (IA). There is some misconception in the use of terms in the existing literature of the field. In addition to this, the intangible assets or intangible resources are also known as intellectual capital (IC). Similarly intellectual capital is also used as the invisible wealth, knowledge stock and immaterial resources. These resources don't have material manifestation and basically these all denotes to resources of a company and these are the resources, which are highly important for the business. Similarly the activities that are associated to these resources can be named as intellectual capital management or management of intangibles, in addition to the knowledge management. Here KM is the study that is defined as the skill of creating value by leveraging intangible assets (Sveiby, 1997).

The above definition refers to managing all the important intangible resources like human, organizational and network capital, and overall knowledge exploitation in the company and also balancing and developing of all these valuable intangible resources. The central part of this activity is innovation. In other words if we define KM than, knowledge management is surely the development activity which represents or relates to the intangible assets of the company.

The aspects of intangible assets or intellectual capital such as networks, human capital, social capital routines and processes, these aspects have been under discussion for many decades in the field of business administration and management (Hussi and Ahonen, 2002).

In the recent era of science and technology every firm is implementing different strategies in order to sustain its growth. Every day the competition is becoming worse which is the biggest threat for any firm. But it is well known saying that survival is only for the fittest. Those firms, which have strong competitive advantage, can ensure their existence. Every firm has its own competitive advantage in one-way or the other. We are crawling into an era where the future will be determined by the ability to use knowledge, a universal resource that contains technology and intellectual capital.

All mighty Allah has revealed lot of Quranic verses that shows the importance of Knowledge.

Holy Quran verse:

"And certainly We gave knowledge to Dawood and Sulaiman, and they both said: Praise be to Allah, Who has made us to excel many of His believing servants. And Sulaiman was Dawood's heir, and he said: O men! We have been taught the language of birds, and we have been given all things; most surely this is manifest grace. (27:15-16)"

As we start escalating our indulgent into knowledge, we will soon realize that our coming future is only restricted to our power of imagination. Knowledge management, which is very much in fashion in these days, can also be the competitive advantage for the firms. The Competitive advantage of one firm over other, become obsolete sooner or later because of the advancement and awareness of technology. But there is a probability of knowledge management practices be a font of competitive advantage for a quite long time period.

William Patterson Sheridan (2008) in his books says that ideas always have some history, significance and affects which are accepted by you when you face them, if you will not be conscious that what is going around you then it means you have limited perspective and disable your creativity and productivity so there is a need to broaden view and proactive approach should be adopted to address issues of productivity.

Wigg (1993) as cited in Dalkir (2005) Knowledge is not a commodity that can be transferred easily; it is actually the knowledge of a subject. Knowledge is basically comprises of different understanding, insights, practical know how, that are available to process information and act intelligently where as knowledge management is the smart use of knowhow, and dissimilate that knowledge to make available for everyone (Patricia and Scott, 2005; Hendriks, 1999).

Knowledge is used as the main resource for getting competitive edge in the market. If the goal of the firm is to achieve superior performance in the market to get competitive edge then the firm should continuously integrate and manage their knowledge asset into operational activities (Chung-Jen Chen, Jing-Wen Huang, 2007)

If the knowledge-intensive organizations want to get competitive edge in the market they must emphasize on the productivity element because it is the core competency of any organization which leads towards success. But the main issue is that they have to increase their productivity within limited resources available (Rikka Antikainen & Antti Lonnqvist, 2005)

Knowledge management is acquiring, organizing, storing and disseminating the information or data within the organization. This system gets the correct information to deserving people at the appropriate time.

Knowledge management is the organized way of identifying organizing selecting, and presenting information in ways, which can enhance the comprehension of a particular topic by a person. It enables the organizations to suck benefit from their experiences and tacit know-how. More over it is being implemented as an integral part of the strategies in almost every firm, more or less. When we talk about small and medium enterprises, here the concept of knowledge management also exist and helping the firms in terms of sustained growth and profitability (Mirza, Talib and Kamal, 2009).

With the dawn of twenty-first century and influx of advance technology, it has been witnessed that the world economy is increasingly knowledge-driven. There is a global race for knowledge economy. The prime minister of England throughout the Second World War, Winston Churchill said, "The empires of the future are the empires of the mind." the tendency of cyberspace and enhanced efficiencies in the management of knowledge is rapidly acquiring the status of core competence for enterprises and institutions, which is key to the performance of organization and heart to the efficiency of individuals, as a consequence of the advancement during the field of information technology. The utilization of cyberspace will continues to open new avenues, boulevard and possibilities for knowledge generation, knowledge sharing, its diffusion, deployment and distribution (Chourcri, 2007)

In a broad sense, when we define the term knowledge management than it means the course and process of frequently managing all kinds of knowledge in order to fulfil the needs, and to exploit existing and acquired knowledge for the new opportunities (Quintas et al. 1997). Here it is very interesting to note that, the author has drawn our attention to the point that KM concern is to manage the knowledge of all kinds but only for new opportunities. Iandoli and Zollo (2007) have defied knowledge management which includes aims, concerned knowledge, equipment and stages of KM.

A distinction between explicit and tacit knowledge has been drawn by (Polanyi, 1966; Nonaka and Takeuchi, 1995). The tacit knowledge is established on the complication of knowledge examined and studied. The difference that has been drawn between the tacit and explicit knowledge is important as it deal with two important scopes of knowledge that are vital to the knowledge exchangeability and application of knowledge. Tacit knowledge is a crucial resource of getting long lasting competitive edge because it's very much complicated to replicate or copy for the competitors (Teece, 1998) the reason is that the unconventional behaviour and ambiguity resist the obvious conveying message, and hence lessen sharing capability and allowing transfer (Grant 1996; Simonin, 1999).

Knowledge management is the organized way of identifying organizing selecting, and presenting information in ways, which can enhance the comprehension of a particular topic by a person. It enables the organizations to suck benefit from their experiences and tacit know-how. More over it is being implemented as an integral part of the strategies in almost every firm, more or less.

The term Knowledge management which was evolved in 1990s, similar to knowledge itself, is very hard to define as concepts and patterns. There are couple of issues that are evident in this evolving path: a) unlike land, machines, or capital, knowledge is a very critical resource (Drucker, 1993) the organizations are generally very poor in managing knowledge. The effort of Polanyi (1966) and Nonaka (1994) in the field of knowledge management, the cited categorization of knowledge, differentiate between tacit and explicit knowledge scope. These writers also refer knowledge as an active entity in a person or in a group.

The objectives of an organization are performance, innovation, competitive edge, shared experiences that were learned within an organization and this sharing of experiences increase the productivity of the organization and employees. Knowledge Management put emphasis on particularly this issue and it's their main objective also. Most importantly Knowledge management encourages the sharing of knowledge and it has greater attention towards the managing the knowledge because it's the basic strategic asset. With the proper use of KM, individuals and groups can exchange precious organizational insights in order to decrease unnecessary tasks.

For the training of new employee lot of time is required but with the proper culture of sharing organization can lessen that time period, with the rapid change in the technology, turnover rate of the organizations are also increases because people find new opportunities so it is difficult to retain their intellectual capital but with the help of KM, these assets can be preserved within an organization, it enables all the stakeholders of an organization to familiarize yourself to the rapidly volatile environments and markets (McAdam and McCreedy, 2000; Thompson and Walsham, 2004).

The term Knowledge management was evolved in 1990s. There are couple of issues that are evident in this evolving path: a) unlike land, machines, or capital, knowledge is a very critical resource (Drucker, 1993) the organizations are generally very poor in managing knowledge. Tacit knowledge is a crucial resource of getting long lasting competitive edge because it's very much complicated to replicate or copy for the competitors (Teece, 1998)

The objectives of an organization are performance, innovation, competitive edge, shared experiences that were learned within an organization and this sharing of experiences increase the productivity of the organization and employees.

Most importantly Knowledge management encourages the sharing of knowledge and it has greater attention towards the managing the knowledge because it's the basic strategic asset. With the proper use of KM, individuals and groups can exchange precious organizational insights in order to decrease unnecessary tasks. For the training of new employee lot of time is required but with the proper culture of sharing organization can lessen that time period, with the rapid change in the technology, turnover rate of the organizations are also increases because people find new opportunities so it is difficult to retain their intellectual capital but with the help of KM, these assets can be preserved within an organization, it enables all the stakeholders of an organization to familiarize yourself to the rapidly volatile environments and markets (McAdam and McCreedy, 2000; Thompson and Walsham, 2004). The effort of Polanyi (1966) and Nonaka (1994) in the field of knowledge management, the cited categorization of knowledge, differentiate between tacit and explicit knowledge scope.

There is misunderstanding between 'knowledge' and 'information' though knowledge and information are two different entities. The New Organizational Wealth: Managing and Measuring Knowledge-Based Assets, a book which is written by Karl Erik Sveiby in this he said that the misunderstanding between `knowledge' and `information' has resulted into a big loss, as most of the managers have sunk billions of dollars in technology endeavors' that have ultimately generated insignificant results. He stressed that knowledge takes place in people and knowledge formation happens only in the development of social contact.

(Sveiby, 2001) Is now working as advisor based in Australia? The height of 'intangible assets' and added prospects of 'intellectual capital' is his major emphasis now days. According to his point of view on the question that, 'Why we should manage the knowledge?' in response he said that to manage the knowledge is not the proper term rather "Knowledge Creation or Knowledge Focus" as said by Nonaka is a better term, because this term consider knowledge as an activity and it denotes a mindset. Furthermore this term or mindset didn't take knowledge as an object (Sveiby, 2001).

When we turn towards the most famous, we find that Peter Drucker is the pioneer of the concept of the 'knowledge society' and the 'knowledge economy' (Drucker, 1969), challenges the idea that knowledge can be managed. According to Kotzer (2001) at the Delphi Group's Collaborative Commerce Summit, knowledge cannot be managed because it occupies only in people. Drucker says it is about individual workers or knowledge worker with the knowledge they possess. According to him whenever a knowledge worker leaves the company the knowledge goes with them.

Management of intellectual capital means to encourage information sharing with the employees, i.e., through formal and informal networking and training (Loudes, 1999).

Intellectual gold defines intellectual property as: "Intellectual property" is all about expressed knowledge like "business processes', "methodologies" and knowhow and is not about just patents, copyrights, trademarks database rights and other (KPMG, 2002).

The true secret to success is being in gaining, use, and managing of knowledge. In the new knowledge-based economy, the organizations that can give the right answers to their stakeholders and clients are successful

One of the most momentous evolutions is the dawn of the new economy in the business environment over the past decade. The dynamic nature of markets and velocity has compelled the companies to leverage their knowledge assets as a means of creating value and achieving a competitive advantage. This particular field of managing knowledge assets may also provide small firms new tools for survival, growth and maintaining a sustainable competitive advantage (Omerzel and Antoncic, 2008).

The most part of the literature review on KM reveals that intensive research in this field is focused on large organizations. As a result of which the potential and the effectiveness of KM seems not fully exploited by these SME's.

It is highly important for SME's to manage and share their collective intellectual assets. Five key peculiarities that discriminate knowledge management practices in SME's and MNE's have been discussed by Desouza and Awazu (2006).

First of all there is lack of explicit knowledge repositories In SME's. But each manager or owner acts as the knowledge repository.

The knowledge possessed by members of the SME's is deep rooted and broad.

There are close social ties among the members of the SME, which serve as a deterrence against employees leaving the business. When some employees leave the business, than there are abundance of knowledge resources and knowledgeable workers which are available and that can be mobilized without losing time.

SME's have to look outside the organization, as they cannot spend efforts to create knowledge. There is less use of technology in SME's and they use technology which is very limited (such as the use of cash registers) and for informative purposes (storing of employee contact information in databases).

Triumphant companies are ones that over and over again unveil new knowledge, spread the newly attained knowledge throughout the organizations and swiftly implement and practice the new found knowledge in product and technology. It is a discipline, which deals with intellectual capital as managed asset. It aimed at transmitting information to associate culture, technology and business processes to make businesses as well as people triumphant (Davenport, 1997; Davenport and Prusak, 1988).

Rightly said; 'knowledge is described as a mixture of experiences, principles, and related knowledge information, professional understandings that grants a structure for incorporating and experiencing new information and experiences. It begins and is useful in the "minds of knower". In firms, it is frequently becomes implanted not only in papers but also in "organizational culture, processes, practices and values''. These organizations as discussed by (Davenport and Prusak, 1988). Normally execute KM system, which particularly utilizes explicit knowledge, which is presented in the form of files and other papers. Such organizations also make noteworthy test as well as bring out knowledge from their work experience. Knowledge should mutually share in order to really make it useful and if it is to grow and develop. It is an essential source to mitigate the intensity of ramification of utilizing knowledge. Knowledge is the only reason because of which entrepreneurs can create difference with their rivals (Beijerse, 2000).

Studies have shown that twenty five percent of the fortune 500 organizations have chief knowledge managers, fifty two percent have knowledge management staff and eighty percent have begun activities related to knowledge management (Stovel and Bontis, 2002). Gigantic organizations have willingly adopted KM principles. The results show that, in order to endure, organizations should provide as well as support the realization, allocation and knowledge application of as prerequisite steps (Jaun, 2007). Studies have also shown that in the recent era more than 80% of a firm's profit is because of intangible assets/KM and 20% by tangible assets. Some organizations are now able to perform "internal knowledge audits" in order to measure the new attempt for getting competitive lead. Where knowledge management maturity is high, there the firms are realizing handsome profits and significant increase in growth (Salojärvi, 2005).

Same was concluded by (Matlay, 2000), according to him knowledge management is the way to survive and success in both long and short run.

All the theories of knowledge management considered it as the most significant reserve and also it is the one with the supreme prospective for providing long lasting competitive gain for the company (Grant, 1996; Davenport and Prusak, 1998).

There is also a conception that firm with particular knowledge development is always dependent on its competitive potentials and its capability to access and transfer such capabilities (Ghoshal and Bartlett, 1990; Schulz, 2001).

Continuous wisdom and transmitting of knowledge with associations of ties in various networks smooth the progress of firms' value creation. Knowledge management has been a very helpful instrument in creating value creation and ensuring sustainable growth (Argote et al., 2000).

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