Knowledge translation in healthcare: A review of the literature

Working Paper Series 5/2010

Knowledge translation in healthcare: A review of the literature

Oborn, E., Barrett, M. and Racko, G.

Cambridge Judge Business School

Knowledge Translation in Healthcare: A review of the literature

Eivor Oborn School of Management Royal Holloway University of London Egham

Eivor.Oborn@rhul.ac.uk Michael Barrett Judge Business School Cambridge University Cambridge

Girts Racko Judge Business School Cambridge University Cambridge

This work is supported by an NIHR SDO grant on evaluating partnerships, CLA

Introduction

The rapidly expanding literature on knowledge in management research, has outlined a number of different knowledge ‘processes’ such as knowledge sharing, knowledge creation, knowledge exchange and knowledge transfer. A critical issue, often discussed in terms of enabling innovation or competitive advantage, is the need for knowledge embedded within one community or organisational group to become available or known to members in a different community. As conceptualised by the notion of communities of practice (Lave and Wenger 1991, Brown and Duguid 1991, Wenger 1998) knowledge is learned within a social context; individuals who are not familiar with, or members of, a given social context are likely to ascribe a different meaning or understanding to a specified knowledge set. This has led to an elaboration of the ‘stickiness’ of knowledge (Szulanski, 1996, 2000), in that it ‘sticks’ within a social community. In an organisational context, this suggests that members who are expert in one knowledge domain are not easily able to make known their expertise to members from a different area of expertise or another organisational sector.

On the other hand, reliance on collaboration between experts to share knowledge and inform practice (e.g. Van der Vegt et al., 2003) is a dominant feature of contemporary work. Conjoining expertise between colleagues from different backgrounds or groups can enable novel ways of distinguishing and connecting ideas (Leonard and Sensiper, 1998). With the historical differentiation of professional tasks, knowledge exchange among different domains of expertise becomes an increasingly salient requirement of social and organizational life. Yet achieving knowledge integration remains difficult (Milliken and Martins, 1996; Newell and Swan, 2000; Rynes et al 2001), and the process of integrating practice and constructing knowledge across disciplinary domains – including those with expertise in research and those expert in practice - remains largely unexplained (Dopson and Fitzgerald, 2005).

This broader issue of using research to inform practice has been the subject of debate since the 1950’s, and has been of particular concern within the healthcare field. The gap between knowledge held within healthcare research communities and healthcare practice communities causes a substantial time lag between generating research knowledge and the time this knowledge is used in practice (Lomas 2000, Lomas 2007, Dopson and FitzGerald 2005, Nicolini et al 2007, Kontos and Poland 2009). This phenomenon is not unique to healthcare, but has been noted in numerous fields (Rynes et al 2001). Hence advances in research knowledge can take years to be implemented into, or change, practice. Given the pace of innovation and research in the healthcare field, this ‘knowledge gap’ has generated significant concern within the healthcare research and policy, and has been the subject of numerous reports (eg Cooksey 2006), editorials and papers (Lomas 2000, 2005).

In this review we start by organising and critically synthesising the literature on knowledge translation in the context of healthcare delivery in particular. As such the knowledge translation gap we focus on is between knowledge developed in the context of research communities and the knowledge held by those in healthcare practice communities as evidenced by their practices; we examine how this literature has evolved over the past 3 decades. This is followed by a section that synthesises key themes from the broader management literature on knowledge sharing and ‘transfer’ processes. In the penultimate section we focus the relevance of our findings and conclusions from the literature as they related to ‘CLAHRCs’ more specifically. In the final section we elaborate on areas where we have identified gaps in the literatures reviewed and suggest areas of future research.

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