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Skip to 0 minutes and 4 seconds GRAEME CURRIE: Hi. I’m Graeme Currie, Professor of Public Management, Warwick Business School, and today I’m going to talk about knowledge mobilisation in networks within healthcare If we take those two words starting with networks, I think one of the things to recognise is that there are different types of networks, and the three dimensions that appear important in relation to knowledge mobilisation are first, whether a network is policy-mandated or bottom-up. If it’s policy-mandated there are likely to be performance management criteria that drive out knowledge mobilisation. The second characteristic is the extent of the network within healthcare Is it within a hospital? Is it across healthcare organisations? Or does it go beyond healthcare to social care and education?

Skip to 1 minute and 2 seconds For example, the more extensive the network, the greater the knowledge mobilisation challenge. The third dimension of a network that’s important is a professional organisation that underpins networks, in particular, whether a network is medically led or not. Where it’s medically led, you may see power dynamics, particularly significant in shaping knowledge mobilisation. The bottom line for me is process needs to drive structure, not the other way around. You can’t just set up a network and expect effective knowledge mobilisation. Let’s deal with that word, knowledge mobilisation. It may be an unusual word for many of you. You may expect me to talk about knowledge exchange or knowledge transfer with respect to the way that knowledge is shared.

Skip to 1 minute and 59 seconds No, I talk about knowledge mobilisation to capture the dynamic nature of the way that knowledge is shared in healthcare settings. There’s a political dimension to knowledge sharing, why should you share knowledge where it gives you power? There’s a cultural dimension to knowledge sharing, different professions and organisations have different perspectives upon what constitutes knowledge. And finally there are two dimensions to knowledge. We’re not just talking about knowledge in terms of formal knowledge or explicit knowledge, i.e., research evidence or guidelines, for example. But a lot of knowledge is what we call tacit, such as the experiential knowledge held by professionals that are delivering health care, and that’s particularly challenging to mobilise.

Skip to 2 minutes and 52 seconds To illustrate some of my points about the way knowledge mobilisation occurs in networks, I’m going to refer to a funded programme of research I led, which focused upon children’s networks. If we take the example of three of these networks, there was a regional cleft lip and palate network, which was mandated by policy to concentrate service in hospital B, which was the hub of the network, with A, C, and D hospitals relating to hospital B. That network was particularly dominated by surgeons. There was a safeguarding network designed to engender child protection that consisted of organisations beyond healthcare including social care, voluntary services, emergency services, and these had particularly significant performance criteria applied to, and they were very visible.

Skip to 3 minutes and 54 seconds For example, accountability around child deaths. And the final network is a paediatric nephrology network. This was a more bottom-up network. Now, I’m going to refer to these three networks to make some points about knowledge mobilisation within networks. If we take the cleft lip and palate network, what happened there was a network structure was imposed upon professional practice with which it was not aligned. So the expertise held by high-status surgeons was located in hospital A. Yet the specialist service was going to be delivered out of hospital B. Perhaps unsurprisingly, the surgeons in hospital A hoarded knowledge rather than shared it with the professionals in hospital B. Hence we see the politics of knowledge sharing.

Skip to 4 minutes and 49 seconds With the safeguarding board, knowledge was also not freely shared. There was concentrated knowledge sharing across three members of that network who were accountable for the performance of the local authority, the mental health provider, and the acute hospital. So knowledge sharing occurred around accountabilities, but didn’t extend to other members of that network. The network that was networked in terms of knowledge mobilisation was the paediatric nephrology network. What allowed this to happen? Well, firstly, it was a bottom-up network. It didn’t have a policy mandate imposed upon it. It had a powerful medical lead, the paediatric nephrologist, who supported open knowledge sharing, indeed was evangelistic about it.

Skip to 5 minutes and 45 seconds So when junior doctors were trained within that network, he socialised them into the idea that they freely share knowledge and accept knowledge as legitimate from others, even where they were low-status. A particularly interesting feature was one of the key people immobilising knowledge within that network was a low-status play worker. Indeed, the middle level doctors were less significant players in knowledge mobilisation. Further, that the network was organised in that way, crossing professional boundaries was evidence-based. And so it enjoyed the support of the professional association. Just to emphasise, the bottom line of my critique of networks and knowledge mobilisation is structure should follow process. We shouldn’t expect process to follow structure.

Skip to 6 minutes and 44 seconds Therefore what you should do is build on what’s already there in terms of professional practice. And if it’s networked, then it may well be suitable for network structures. You cultivate networks, not mandate them. Thank you.

Clinical networks and knowledge mobilisation

Here we turn to the topic of clinical networks and how networks that link practitioners together, both within and between organisations, may foster innovation in healthcare. This step also builds on earlier insights from Week 1, specifically in relation to knowledge mobilisation.

Please watch the short video by Professor Graeme Currie, Warwick Business School, exploring how the differences in the structure of networks can either facilitate or hinder knowledge sharing and knowledge mobilisation. Specifically, Professor Currie suggests that networks that emerge in a ‘bottom-up’ way are likely to exhibit more extensive knowledge sharing. Other conditions that enhance knowledge mobilisation in networks include professional champions, evidence that networks work and support from relevant professional bodies.

To support your learning in this step, please also read the supporting text (download link below) on the background theory and research relating to clinical networks.

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Leadership for Healthcare Improvement and Innovation

The University of Warwick