Örgütsel Bilgi Paylaşımını Engelleyen Faktörler: Sağlık Sektöründe Bir Görgül Araştırma

Year 2011, Issue: 26, 45 - 61, 01.08.2011

Selma Altındiş Veysel Ağca

Abstract

Sağlık hizmeti veren kurumlar bilgi temeline dayanan bir sektördür ve sağlık hizmetleri faaliyetleri ile ilgili işlemlerin her aşamasında bilgiye gereksinim duyulur. Bu bilgilerin sağlık hizmetlerinin planlama, karar verme, uygulama, kontrol ve değerlendirme temel işlevlerinde kullanılmasıya da bu işlevlerin doğru bir şekilde yerine getirilmesi için sağlık çalışanlarının etkin bilgi paylaşımıfaaliyetini gerçekleştirmesi gerekir. Ancak etkin bilgi paylaşımıfaaliyetlerini önünde bir takım engeller söz konusudur. Örgüt için bilgi paylaşımına yönelik engeller bu çalışmada üç temel başlıkta ele alınmaktadır. Söz konusu bu engeller; bireysel, örgütsel ve teknolojik engellerdir. Bu çalışma, sağlık hizmeti sunan bir üniversite hastanesinde gerçekleştirilmiştir. Araştırmada, örgüt içinde bilgi paylaşımına yönelik bireysel, örgütsel ve teknolojik engellerin belirlenmesine yönelik sağlık profesyonellerinin hekim, hemşire ve teknisyen görüşlerine yer verilmiştir. Sağlık profesyonellerinin konuya ilişkin görüşlerinin tespitinde ise yüz-yüze anket yöntemi kullanılmıştır. Bu çalışma ile örgüt içinde bilgi paylaşımına yönelik bireysel, örgütsel ve teknolojik engellerin belirlenmesi ve sağlık profesyonellerinin demografik özelliklerine göre bu engellerin farklılık gösterip göstermediği tespit edilmiştir. Genel olarak araştırma kapsamındaki hastanede bilgi paylaşımına yönelik engellerle karşılaşıldığıve bu engeller içerisinde anketi cevaplayan sağlık profesyonelleri en düşük düzeyde bireysel sonrasında ise örgütsel daha sıklıkla da teknolojik engellerin görüldüğü algısına sahiptirler. Bu çalışmada demografik değişkenler açısından bilgi paylaşım engelleri değerlendirildiğinde erkeklerin, evli çalışanların, orta ve ileri yaşgruplarının daha fazla bilgi paylaşım engeli algıladığıgörülmüştür. Bunların yanısıra çalışma birimleri ve pozisyonlarıyönünden de bilgi paylaşım engellerinde algıların farklılık gösterdiği belirlenmiştir. Ayrıca yakın geçmişe kadar bu engellerin araştırılmasıve ortaya çıkarılmasıkonusunda da çok az sayıda araştırma yürütülmüştür. Sağlık hizmeti sunan kurumlarda bu konuların araştırılması, sağlıklıbilgi paylaşımının gerçekleştirilmesini sağlamasıyanında hem bu engellerin nasıl ortaya çıktığınıanlaşılmasınıhem de yöneticilerin, çalışanlarının yeni davranışlar sergileyebilmesi ve uygulama süreçlerini başarılıbir biçimde gerçekleştirebilmeleri için teşvik edici bir çevre, politika oluşturmaya katkıda bulunacağıumulmaktadır.

Keywords

Bilgi paylaşımı, bilgi paylaşımıengelleri, sağlık profesyonelleri, sağlık hizmetleri

Organizational Knowledge Sharing Barriers: An Empirical Study in Healthcare Services

Abstract

Health care organizations within health care sector are based on knowledge. Knowledge is needed at every stage of the activities concerning health services. To use these knowledge in basic functions of health services such as planning, decision making, implementation, control and evaluation or to achieve these functions correctly in health services, health care employees need to carry out effective knowledge sharing activities. However, there exist a number of barriers in front of effective knowledge sharing. Some of these barriers include: fear of losing the knowledge power, reluctance to spend time on knowledge sharing, the fear of free use, to avoid revealing the knowledge because of lack of trust, produced strategies against uncertainty, extreme respect for hierarchy and formal power. In research, knowledge sharing barriers within the organization was discussed in the three main dimensions. These are individual, organizational and technological barriers. To successful knowledge sharing in health care services, the removals of these barriers are needed. Because improving the quality of health services, access to industry best practices, a radical redesign of the basic processes, access to the convenient resources and focus on the main field of activity, requires effective knowledge sharing. In this study, firstly it was aimed to determine individual, organizational and technological knowledge sharing barriers within a health care organization. Secondly it was identified whether there were differences in these barriers according to demographic characteristics of health care professional. In this context, a field study was done to examine the relationships between these variables and the levels. The study was conducted at a university hospital providing health care services. Face-to-face survey method was used in the determining health professionals' views on the subject. The scope of the study is 483 health professionals servicing as physicians, nurses and technicians at a university hospital in Afyonkarahisar. Of thequestionnaires distributed, 170 were returned about a month period. 159 questionnaires filled out completely were included in the analysis. Questionnaire was provided to fill by health professionals such as doctors, nurses and technician because of expectation much more reflecting negative effects of these barriers by this group to the effectiveness and efficiency of health services. According to survey results it can said that there exist high level of knowledge sharing barriers within hospital.In general, health care professionals answered the survey have the lowest level individual barriers, intermediate level organizational barriers and highest level technological barriers perceptions, respectively within these barriers.Determining the errors in the past, evaluation and provision of feedback and the time constraint had the highest value within the individual knowledge sharing barriers. Time constraint may indicate a known significant problem of the health professionals working very intensively. Taking high value of notification of error may point to the emergence of a number of punishments as a result of reporting errors, or may mean not feel secure enough about it.Test results show that the existence of high competition within the units in the hospital or among the hospitals and the lack of strategic approach to knowledge management take the lowest values among the organizational knowledge sharing barriers. The lack of a transparent rewards and recognition systems that would motivate people to share more of their knowledge and shortage of appropriate infrastructure supporting sharing practices has the highest values according to results. These values may show that there aren’t enough reward systems for sharing in healthcare services. Moreover, it can be said that deficiency of hospital resources that would provide adequate sharing opportunities exist depending on these results. The outcomes of the survey pointed out that lack of training regarding employee familiarization of new IT systems and processes of hospital employee, lack of demonstration of all advantages of any new systems over existing ones and lack communication have the highest values as being technological barriers in knowledge sharing. These values may indicate that the employees are not able to share of knowledge over technology because of incompetency of knowledge and experience in terms of using new IT systems. In this study, when knowledge sharing barriers are evaluated in terms of demographic variables, it is determined that males, married employees, middle and advanced age groups perceive much more knowledge sharing. Besides these results, it is determined that the perceptions of the employees on knowledge sharing show differences in the sense of units of work and positions. Nurses have much more perception of knowledge sharing barriers than physicians. Nurses’ perceptions of existing knowledge sharing barriers are expected results. Especially, nurses are one of the health professional groups who often need to support knowledge or sharing in processes of care. Moreover, the intensity of health care services as well as the necessity to act with many different specialists can bring with it some problems such as knowledge access and sharing. Considering the presence of a number of information gaps in even health care institutions operating in optimum conditions, this result may be significant. Therefore, if there is a number of knowledge sharing problems in the organization, this group’s perception of these obstacles is a very natural result. However, considering physicians to take have an effective role in knowledge sharing at least until nurses in healthcare services, more positive perception of physicians is an interesting finding. According to work units, perception of knowledge sharing barriers varies. Employees in intensive care units indicated to have more knowledge sharing barriers in terms of technological subjects than the other units. Because the intensive care unit ICU is a demanding environment due to the critical condition of patients and the variety of equipment necessary to support and monitor patients. Therefore, when operating ICU equipment, staff should pay attention to the types of devices and the variations between different models of the same type of device so they do not make an error in operation or adjustment. Also, in intensive care units as distinct from other units, a number of technological devices such as respiratory support equipment ventilator, oxygen source, etc. and patient monitoring systems infusion pump, intracranial pressure monitor, etc. are used. So this difference in perception may indicate the existence of problems in the use of these devices. Based on this survey, in healthcare services that knowledge is shared intensively, continuous support of knowledge sharing and remove knowledge sharing barriers are important. Especially, the emergence of a result related with human life because of a small information gapin areas and patients that need to critical care show to require this effective sharing. Therefore, identifying of sharing barriers is important for effective knowledge sharing. In addition, until the recent past, it has been conducted few the researches to investigate and expose of these barriers. Investigation of these subjects in health care services provides the realization of a healthy knowledge sharing as well as understanding how to emerge of these barriers. Also it is expected that will contribute to the managers in creating the policy and a stimulating environment to achieve the successful implementation processes and to exhibit employees’’ new behaviors. So, this study highlights to determine strategies that will eliminate knowledge sharing barriers of both health managers and employees

Keywords

Knowledge sharing, knowledge sharing barriers, health professionals, health care services

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