Can incident reporting improve safety? Healthcare practitioners' views of the effectiveness of incident reporting

OBJECTIVE: Recent critiques of incident reporting suggest that its role in managing safety has been over emphasized. The objective of this study was to examine the perceived effectiveness of incident reporting in improving safety in mental health and acute hospital settings by asking staff about their perceptions and experiences. DESIGN: /st>Qualitative research design using documentary analysis and semi-structured interviews. SETTING: /st>Two large teaching hospitals in London; one providing acute and the other mental healthcare. PARTICIPANTS: /st>Sixty-two healthcare practitioners with experience of reporting and analysing incidents. RESULTS: /st>Incident reporting was perceived as having a positive effect on safety, not only by leading to changes in care processes but also by changing staff attitudes and knowledge. Staff discussed examples of both instrumental and conceptual uses of the knowledge generated by incident reports. There are difficulties in using incident reports to improve safety in healthcare at all stages of the incident reporting process. Differences in the risks encountered and the organizational systems developed in the two hospitals to review reported incidents could be linked to the differences we found in attitudes to incident reporting between the two hospitals. CONCLUSION: /st>Incident reporting can be a powerful tool for developing and maintaining an awareness of risks in healthcare practice. Using incident reports to improve care is challenging and the study highlighted the complexities involved and the difficulties faced by staff in learning from incident data.

The role of SHRM in turning tacit knowledge into explicit knowledge:a cross-national study of the UK and Malta

We propose that strategic human resource management (SHRM) practices nurture a context of knowledge sharing where tacit knowledge can be turned into explicit knowledge and that this type of knowledge sharing promotes innovative behaviours. We draw on the fields of knowledge management and international human resource management to show why organisations need to turn tacit knowledge into explicit knowledge to gain most from their workforce skills and creativity. Findings from a couple of cross-national case studies show how SHRM promotes employees to interact and share knowledge so that there is a conversion of tacit knowledge to explicit knowledge that informs innovative behaviour. In Case Study 1, the focus is on a UK local authority that implemented a bundle of SHRM practices through a people management programme, which resulted in a flattened management structure. In Case Study 2, the focus is on a geriatric hospital in Malta that introduced a management presence to an interdisciplinary team working to improve patient care. The analysis also highlights the methodological contribution of qualitative research for enabling inductive enquiry that yields emergent themes - an approach not typically seen in SHRM innovation studies. © 2013 Taylor & Francis.

Automatically Extracting Procedural Knowledge from Instructional Texts using Natural Language Processing

Procedural knowledge is the knowledge required to perform certain tasks, and forms an important part of expertise. A major source of procedural knowledge is natural language instructions. While these readable instructions have been useful learning resources for human, they are not interpretable by machines. Automatically acquiring procedural knowledge in machine interpretable formats from instructions has become an increasingly popular research topic due to their potential applications in process automation. However, it has been insufficiently addressed. This paper presents an approach and an implemented system to assist users to automatically acquire procedural knowledge in structured forms from instructions. We introduce a generic semantic representation of procedures for analysing instructions, using which natural language techniques are applied to automatically extract structured procedures from instructions. The method is evaluated in three domains to justify the generality of the proposed semantic representation as well as the effectiveness of the implemented automatic system.

A process view of knowledge management:it ain't what you do, it's the way that you do it

Knowledge management needs to consider the three related elements of people, processes and technology. Much existing work has concentrated on either people or technology, often to the exclusion of the other two elements. Yet without thinking about process – the way people, organisations and even technology actually do things – any implementation of a knowledge management initiative is at best risky, and at worst doomed to failure. This presentation looks at various ways in which a process view has appeared, explicitly or implicitly, in knowledge management research and practice so far, and reflects on how more “thinking about process” might improve knowledge management in the future. Consistent with the presentation’s own overall viewpoint, the issues generally centre not on what a process view would suggest should be done, but on the way that it would be implemented in practice.

Structural funds and the knowledge-based economy:a regional case-study (1999-2009)

The research presented in this thesis investigates the nature of the relationship between the development of the Knowledge-Based Economy (KBE) and Structural Funds (SF) in European regions. A particular focus is placed on the West Midlands (UK) and Silesia (Poland). The time-frame taken into account in this research is the years 1999 to 2009. This is methodologically addressed by firstly establishing a new way of calculating the General Index of the KBE for all of the EU regions; secondly, applying a number of statistical methods to measure the influence of the Funds on the changes in the regional KBE over time; and finally, by conducting a series of semi-structured stakeholder interviews in the two key case study regions: the West Midlands and Silesia. The three main findings of the thesis are: first, over the examined time-frame, the values of the KBE General Index increased in over 66% of the EU regions; furthermore, the number of the “new” EU regions in which the KBE increased over time is far higher than in the “old” EU. Second, any impact of Structural Funds on the regional KBE occurs only in the minority of the European regions and any form of functional dependency between the two can be observed only in 30% of the regions. Third, although the pattern of development of the regional KBE and the correlation coefficients differ in the cases of Silesia and the West Midlands, the analysis of variance carried out yields identical results for both regions. Furthermore, the qualitative analysis’ results show similarities in the approach towards the Structural Funds in the two key case-study regions.

Knowledge management in support of enterprise risk management

Risk management and knowledge management have so far been studied almost independently. The evolution of risk management to the holistic view of Enterprise Risk Management requires the destruction of barriers between organizational silos and the exchange and application of knowledge from different risk management areas. However, knowledge management has received little or no attention in risk management. This paper examines possible relationships between knowledge management constructs related to knowledge sharing, and two risk management concepts: perceived quality of risk control and perceived value of enterprise risk management. From a literature review, relationships with eight knowledge management variables covering people, process and technology aspects were hypothesised. A survey was administered to risk management employees in financial institutions. The results showed that the perceived quality of risk control is significantly associated with four knowledge management variables: perceived quality of risk knowledge sharing, perceived quality of communication among people, web channel functionality, and risk management information system functionality. However, the relationships of the knowledge management variables to the perceived value of enterprise risk management are not significant. We conclude that better knowledge management is associated with better risk control, but that more effort needs to be made to break down organizational silos in order to support true Enterprise Risk Management.

A conceptual framework of knowledge integration in multisourcing arrangements

As organizations are increasingly outsourcing interdependent IT and business services to multiple vendors, the issue of knowledge integration between client and multiple vendors is becoming of high relevance today. This paper explores the antecedents and mechanisms which facilitate the success of knowledge integration across multiple stakeholders in multisourcing and the outcomes of successful knowledge integration in this context. The paper develops a conceptual framework of knowledge integration in the multisourcing arrangements, based on a detailed review of current literature on knowledge integration and applying it to the multi-vendor environment. This paper concludes by calling for further empirical study to examine the integrative framework of the key antecedents, mechanisms and consequences of knowledge integration in the multisourcing arrangements.

Knowledge transfer in website design:exploring the processes and benefits of design collaboration for non-creative Micros

This thesis explores the interaction between Micros (<10 employees) from non-creative sectors and website designers ("Creatives") that occurred when creating a website of a higher order than a basic template site. The research used Straussian Grounded Theory Method with a longitudinal design, in order to identify what knowledge transferred to the Micros during the collaboration, how it transferred, what factors affected the transfer and outcomes of the transfer including behavioural additionality. To identify whether the research could be extended beyond this, five other design areas were also examined, as well as five Small to Medium Enterprises (SMEs) engaged in website and branding projects. The findings were that, at the start of the design process, many Micros could not articulate their customer knowledge, and had poor marketing and visual language skills, knowledge core to web design, enabling targeted communication to customers through images. Despite these gaps, most Micros still tried to lead the process. To overcome this disjoint, the majority of the designers used a knowledge transfer strategy termed in this thesis as ‘Bi-Modal Knowledge Transfer’, where the Creative was aware of the transfer but the Micro was unaware, both for drawing out customer knowledge from the Micro and for transferring visual language skills to the Micro. Two models were developed to represent this process. Two models were also created to map changes in the knowledge landscapes of customer knowledge and visual language – the Knowledge Placement Model and the Visual Language Scale. The Knowledge Placement model was used to map the placement of customer knowledge within the consciousness, extending the known Automatic-Unconscious -Conscious model, adding two more locations – Peripheral Consciousness and Occasional Consciousness. Peripheral Consciousness is where potential knowledge is held, but not used. Occasional Consciousness is where potential knowledge is held but used only for specific tasks. The Visual Language Scale was created to measure visual language ability from visually responsive, where the participant only responds personally to visual symbols, to visually multi-lingual, where the participant can use visual symbols to communicate with multiple thought-worlds. With successful Bi-Modal Knowledge Transfer, the outcome included not only an effective website but also changes in the knowledge landscape for the Micros and ongoing behavioural changes, especially in marketing. These effects were not seen in the other design projects, and only in two of the SME projects. The key factors for this difference between SMEs and Micros appeared to be an expectation of knowledge by the Creatives and failure by the SMEs to transfer knowledge within the company.

The unequal segmentation of public preparedness for mass evacuation:a cross-national perspective

This thesis is concerned with understanding how Emergency Management Agencies (EMAs) influence public preparedness for mass evacuation across seven countries. Due to the lack of cross-national research (Tierney et al., 2001), there is a lack of knowledge on EMAs perspectives and approaches to the governance of public preparedness. This thesis seeks to address this gap through cross-national research that explores and contributes towards understanding the governance of public preparedness. The research draws upon the risk communication (Wood et al., 2011; Tierney et al., 2001) social marketing (Marshall et al., 2007; Kotler and Lee, 2008; Ramaprasad, 2005), risk governance (Walker et al., 2010, 2013; Kuhlicke et al., 2011; IRGC, 2005, 2007; Renn et al., 2011; Klinke and Renn, 2012), risk society (Beck, 1992, 1999, 2002) and governmentality (Foucault, 1978, 2003, 2009) literature to explain this governance and how EMAs responsibilize the public for their preparedness. EMAs from seven countries (Belgium, Denmark, Germany, Iceland, Japan, Sweden, the United Kingdom) explain how they prepare their public for mass evacuation in response to different types of risk. A cross-national (Hantrais, 1999) interpretive research approach, using qualitative methods including semi-structured interviews, documents and observation, was used to collect data. The data analysis process (Miles and Huberman, 1999) identified how the concepts of risk, knowledge and responsibility are critical for theorising how EMAs influence public preparedness for mass evacuation. The key findings grounded in these concepts include: - Theoretically, risk is multi-functional in the governance of public preparedness. It regulates behaviour, enables surveillance and acts as a technique of exclusion. - EMAs knowledge and how this influenced their assessment of risk, together with how they share the responsibility for public preparedness across institutions and the public, are key to the governance of public preparedness for mass evacuation. This resulted in a form of public segmentation common to all countries, whereby the public were prepared unequally.  - EMAs use their prior knowledge and assessments of risk to target public preparedness in response to particular known hazards. However, this strategy places the non-targeted public at greater risk in relation to unknown hazards, such as a man-made disaster. - A cross-national conceptual framework of four distinctive governance practices (exclusionary, informing, involving and influencing) are utilised to influence public preparedness. - The uncertainty associated with particular types of risk limits the application of social marketing as a strategy for influencing the public to take responsibility and can potentially increase the risk to the public.

Network evolution and the spatiotemporal dynamics of knowledge sourcing

Knowledge accessing from external organisations is important to firms, especially entrepreneurial ones which often cannot generate internally all the knowledge necessary for innovation. There is, however, a lack of evidence concerning the association between the evolution of firms and the evolution of their networks. The aim of this paper is to begin to fill this gap by undertaking an exploratory analysis of the relationship between the vintage of firms and their knowledge sourcing networks. Drawing on an analysis of firms in the UK, the paper finds some evidence of a U-shaped relationship existing between firm age and the frequency of accessing knowledge from certain sources. Emerging entrepreneurial firms tend to be highly active with regard to accessing knowledge for a range of sources and geographic locations, with the rate of networking dropping somewhat during the period of peak firm growth. For instance, it is found that firms tend to less frequently access knowledge sources such as universities and research institutes in their own region during a stage of peak turnover growth. Overall, the results suggest a complex relationship between the lifecycle of the firm and its networking patterns. It is concluded that policymakers need to become more aware that network formation and utilisation by firms is likely to vary dependent upon their lifecycle position.

Knowledge management in support of enterprise risk management

Risk management and knowledge management have so far been studied almost independently. The evolution of risk management to the holistic view of Enterprise Risk Management requires the destruction of barriers between organizational silos and the exchange and application of knowledge from different risk management areas. However, knowledge management has received little or no attention in risk management. This paper examines possible relationships between knowledge management constructs related to knowledge sharing, and two risk management concepts: perceived quality of risk control and perceived value of enterprise risk management. From a literature review, relationships with eight knowledge management variables covering people, process and technology aspects were hypothesised. A survey was administered to risk management employees in financial institutions. The results showed that the perceived quality of risk control is significantly associated with four knowledge management variables: perceived quality of risk knowledge sharing, perceived quality of communication among people, web channel functionality, and risk management information system functionality. However, the relationships of the knowledge management variables to the perceived value of enterprise risk management are not significant. We conclude that better knowledge management is associated with better risk control, but that more effort needs to be made to break down organizational silos in order to support true Enterprise Risk Management.

Knowledge sources, innovative activity and the performance of UK new technology based firms

We present an innovation value chain analysis for a representative sample of new technology based firms (NTBFs) in the UK. This involves determining which factors lead to the usage of different knowledge sources and the relationships that exist between those sources of knowledge; the effect that each knowledge source has on innovative activity; and how innovation outputs affect the performance of NTBFs. We find that internal (i.e. R&D) and external knowledge sources are complementary for NTBFs, and that supply chain linkages have both a direct and indirect effect on innovation. NTBFs' skill resources matter throughout the innovation value chain, being positively associated with external knowledge linkages and innovation success, and also having a direct effect on growth independent of the effect on innovation. ©2010 IEEE.

Knowledge sources, innovative activity and the performance of UK new technology based firms

We present an innovation value chain analysis for a representative sample of new technology based firms (NTBFs) in the UK. This involves determining which factors lead to the usage of different knowledge sources and the relationships that exist between those sources of knowledge; the effect that each knowledge source has on innovative activity; and how innovation outputs affect the performance of NTBFs. We find that internal (i.e. R&D) and external knowledge sources are complementary for NTBFs, and that supply chain linkages have both a direct and indirect effect on innovation. NTBFs' skill resources matter throughout the innovation value chain, being positively associated with external knowledge linkages and innovation success, and also having a direct effect on growth independent of the effect on innovation. ©2010 IEEE.