A Knowledge Management Process-Based Approach to Support Corporate Crisis Management

In the crisis-prone and complex contemporary business environment, modern organisations and their supply chains, large and small, are challenged by crises more than ever. Knowledge management has been acknowledged as an important discipline able to support the management of complexity in times of crisis. However, the role of effective knowledge retrieval and sharing in the process of crisis prevention, management and survival has been relatively underexplored. In this paper, it is argued that organisational crises create additional challenges for knowledge management, mainly because complex, polymorphic and both structured and unstructured knowledge must be efficiently harnessed, processed and disseminated to the appropriate internal and external supply chain actors, under specific time constraints. In this perspective, a process-based approach is proposed to address the knowledge management needs of organisations during a crisis and to help management in establishing the necessary risk avoidance and recovery mechanisms. Finally, the proposed methodological approach is applied in a knowledge- intensive Greek small and medium enterprise from the pharmaceutical industry, producing empirical results, insights on knowledge pathologies during crises and relevant evaluations.

Organisational and systems factors impacting on patient safety in acute care organisations: lessons from four multi-site research studies

Background Patient safety is concerned with preventable harm in healthcare, a subject that became a focus for study in the UK in the late 1990s. How to improve patient safety, presented both a practical and a research challenge in the early 2000s, leading to the eleven publications presented in this thesis. Research question The overarching research question was: What are the key organisational and systems factors that impact on patient safety, and how can these best be researched? Methods Research was conducted in over 40 acute care organisations in the UK and Europe between 2006 and 2013. The approaches included surveys, interviews, documentary analysis and non-participant observation. Two studies were longitudinal. Results The findings reveal the nature and extent of poor systems reliability and its effect on patient safety; the factors underpinning cases of patient harm; the cultural issues impacting on safety and quality; and the importance of a common language for quality and safety across an organisation. Across the publications, nine key organisational and systems factors emerged as important for patient safety improvement. These include leadership stability; data infrastructure; measurement capability; standardisation of clinical systems; and creating an open and fair collective culture where poor safety is challenged. Conclusions and contribution to knowledge The research presented in the publications has provided a more complete understanding of the organisation and systems factors underpinning safer healthcare. Lessons are drawn to inform methods for future research, including: how to define success in patient safety improvement studies; how to take into account external influences during longitudinal studies; and how to confirm meaning in multi-language research. Finally, recommendations for future research include assessing the support required to maintain a patient safety focus during periods of major change or austerity; the skills needed by healthcare leaders; and the implications of poor data infrastructure.