استعرض مصدر 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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