Knowledge Sharing Practices in Healthcare Centers

Introduction:

Since long time, we have heard the “phrase knowledge is power”. The expression means that the knowledge is a major part of people’s life everywhere and anytime. When looking to knowledge in the practice, we can clearly notice its ability to form the best model in social, economic, political and educational activities. The continuous increasing of innovations and technological development mostly comes through the accumulated knowledge transmitted between humans. However, one of the most important problems associated with knowledge is the difficulty of getting the right ones. This is can be solve through sharing research result to others who may build on previous work to move knowledge forward.

Knowledge sharing can be defined as the exchange of knowledge between and among individuals, groups, and organizations, and it is a way for the organization to make an effective use of the volume of knowledge retained by its members (Swacha, 2015). The behavior of Knowledge sharing can be shaped and expressed by a variety of forms and factors such as motivation, social relationship, and organizational culture (Trivellas et al., 2015). For the success and spread of the culture of sharing, the organizations need to encourage employees to work together more effectively and share a certain knowledge base in order to arrive at the same understanding of information and knowledge (Rexhepi, 2015). When rapidly disseminate and share tacit and explicit knowledge with team members, health professionals will contribute to enhance the team’s decision-making skills on care actions, which will directly affect the quality of health care delivery (Rocha et al., 2012).

Research problem:

Health sector in Saudi Arabia receives a great attention by the government and decision-makers in order to provide advanced health care. There is a desire to provide all available capabilities for the improvement of health services provided to citizens (“Big development in Saudi health care,”2014) . The health practitioners need to develop their skills to be part of the achievement of the goals of health institutions. Among the most prominent means of development is to access the latest information and resources and share it with peers. Knowledge sharing g can help health professionals to update themselves and deliver quality health care services. However, there is no evidence that sharing information and knowledge is utilized in health sectors in Saudi Arabia. This study investigates the perception and practice of knowledge sharing by workers and practitioners in primary health care in Saudi Arabia.

Research questions:

To investigate the stated problem of the study, the following research questions were formulated:

RQ1. What are the ways of knowledge sharing that primary health centers use?

RQ2. Does management provide support and encouragement for the sharing of knowledge?

RQ3. What efforts do health practitioners make to obtain knowledge and share it with others?

RQ4. What is the perceived value of knowledge sharing on the work environment from the perspective of the health workforce?

RQ5. What technology is available for health workforce to share knowledge and information?

Literature review:

knowledge sharing as one of the important parts of the knowledge management system means that an individual, team, and the organization share the knowledge with other members in the form of activities through the various ways (Navimipour & Charband, 2016). It is a learning activity with which people not only professionalize themselves, but contribute to the professional development of their colleagues as well (Runhaar & Sanders, 2015). Knowledge sharing also affects the long run performance of organizations (Akram & Bokhari, 2011; Masa’deh & Gharaibeh, 2013; Obeidat et al., 2014).

Despite the importance of knowledge sharing, organizations sometimes face difficulties in the deployment of this culture in the work environment, such as the absence of trust among its members or insufficient incentives rewarded to those who deserved it (Tan, 2015). Abrams et al. (2003) stated that in order for professionals and specialists to be known as reliable sources of knowledge, they should try to disclose their expertise and limitations by clarifying what they know and do not know. The managers could have a role in reducing some difficulties through encouragement of formal and informal communication, learning exchange, and putting knowledge into practice (Al Saifi, Dillon, & McQueen, 2016).

In health care setting, knowledge sharing practices can be effectively institutionalized within an organization with the aid of institutional structures (Yong-Mi, Newby-Bennett & Song, 2012). Healthcare organizations have recently realized that medical knowledge not only needs to be managed but also shared among professionals and patients. knowledge sharing in healthcare industry may no longer be a “nice to have” process but changes into a “must have” one (Tabrizi & Morgan, 2014). Therefore, the Knowledge for Health (K4Health) project uses a knowledge sharing and capacity building approach to improving health services (Ahmed, Limaye & Harlan, 2015).However, organizations may face obstacles to disseminate the culture of sharing knowledge. One major dimension of this problem that has been identified relates to the fragmentation of care, with a lack of communication and coordination between the different physicians involved seen to create inefficiency as well as potentially serious quality breakdowns (Marabelli, Newell, Krantz, & Swan, 2014). Other barriers such as power/political issues, clinical management conflicts, lack of trust, and lack of leadership that make knowledge sharing difficult in health care (Nicolini et al , 2008).

Although the importance of knowledge sharing  has become evident, this subject in Saudi Arabia received very little attention. In a study investigating knowledge sharing in Taif University (Althinibat, Albuqoor, & Alotaibi, 2011), the authors found a positive view among faculty members towards knowledge sharing,  so they are willing to share their knowledge and expertise with their peers if there is an appropriate environment and positive encouragement.  However, some obstacles may reduce the practice of sharing such as the absence of a clear and explicit system determines the importance and type of knowledge sharing that can be exchanged (Albadry & Arif, (2013).

Methodology

The health services through primary healthcare centers in the city of Riyadh is provided by dividing the city into five health sectors: northern sector, western sector, eastern sector, southern sector, and the middle sector. This study opted the workers in the northern health sector to achieve the goals of the study.  A quantitative research approach was adopted to investigate knowledge sharing in health environment. This required  the development and dissemination of a questionnaire survey  that  was distributed to 112 physician and paramedical staff working at primary healthcare centers  in the northern health sector. The main goal of the questionnaire is to gather two types of information: (i) perception of participants toward sharing health knowledge in the work environment and (ii) the role of administration in the process of supporting and encouraging the sharing of knowledge among employees.

Data Analysis and Results

Descriptive statistics on each variable of the study are used to investigate the situation of sharing information in primary healthcare centers. The percentage for each survey item question is reported in the tables that follow. The results are divided into categories that address the previously mentioned issues, namely the demographic characteristics of participants, perceptions toward sharing knowledge in the work environment, administration support and encouragement for employees to share knowledge.

The data gathered were analyzed following the rule of the Five Point Likert Scale. Strongly disagree was scored as one (1), disagree as two (2), neutral as three (3), agree as four (4) and strongly agree as five (5). . Never was scored as one (1), rarely as two (2), sometimes as three (3), often as four (4) and always as five (5). The mean of the answers from the test questionnaire was calculated per question or statement. The mean obtained was interpreted based on the scale showed in table 1.

Table 1. The Scale Used in the Interpretation of Data

Mean	Verbal Interpretation
4.20 – 5.00	Strongly Agree/Always
3.40 – 4.19	Agree/Often
2.60 – 3.39	Neutral/Sometimes
1.80 – 2.59	Disagree/Rarely
1.00 – 1.79	Strongly Disagree/Never

Demographic Characteristics

As shown in Table 2, gender distribution revealed higher female participation than male with a percentage of 76.1%. Participants were asked to identify their job title to which relatively the half (48.2%) identified technician. The reminder reported 16.1% as specialist, 14.3% as pharmacist, 14.3% as physician, 3.6% as clerk, and 3.6% other job titles. Participants were also asked to identify their discipline. Findings highlight the diversity of specialty. Nursing (39.2%) was the most frequently reported discipline, with laboratory (21.2%) the next most frequent. Diversity was also evident in length of time participants had spent in workforce. As shown in table 1, (35.7%) reported working for 5 years or less, (33.9%) from 6 to 10 years, (17.9%) more than 15 years, and the least participants have worked from 11 to 15 years.

Table 2. Demographic characteristics

Variable	Characteristics	Percentage
Gender	Female Male	76.8 23.2
Job title	Pharmacist Physician Technician Clerk Specialist Other	14.3 14.3 48.2 3.6 16.1 3.6
Specialty	Nursing Laboratory Dentistry Pharmacy Nutrition Radiology General Other	39.2 21.2 7.1 14.6 1.8 5.4 10.7
Years in Practice	≤ 5 years 6-10 years 11-15 years >15 years	35.7 33.9 12.5 17.9

RQ1. What are the ways of knowledge sharing that primary health centers use?

Table 3 shows the opinion of participants in the frequency of  each method that  health centers use to share knowledge. Dissemination of health information and make it available to others found to be the highest sharing method and often used (mean=3.42) among health centers.

However, the general result of the axis indicated that knowledge sharing is sometimes practiced (mean=2.83) by the centers.

Table 3. Ways of knowledge sharing primary health centers use

Statements of axis	Always	Often	Sometimes	Rarely	Never	Mean	SD	Result
Requesting needed information from others centers	10.7	16.1	46.4	12.5	14.3	3.03	1.13
offering information to others centers	25	14.3	35.7	8.9	16.1	2.76	1.35
Dissemination of health information and make it available to others	8.9	17.9	23.2	21.4	28.6	3.42	1.31
Preparing lectures and workshops	16.1	23.2	23.2	21.4	16.1	2.98	1.32
Provision of a journal or a website for the dissemination of research and studies	55.3	16.1	16.1	1.8	10.7	1.96	1.32
Result of the axis	2.83	.95

RQ2. Does management provide support and encouragement for the sharing of knowledge?

According to participants answers, the administration seems to not have satisfactory role in supporting sharing knowledge. Although providing lectures and participating in scientific activities outside the center are allowed (mean=3.42), the overall result indicates that administration do not play an important role in this regard. Participants are natural towards the opinion saying that administration encourage sharing knowledge among the employees in the centers (mean=3.05)

Table 4. Administration support and encouragement for sharing knowledge  

Statements of axis	Strongly agree	agree	natural	disagree	Strongly disagree	Mean	SD	Result
the environment in the center is appropriate to share knowledge	23.2	10.7	32.1	21.4	12,5	2.89	1.32
incentives are provided to employees for sharing knowledge	33.9	14.3	12.5	19.6	19.6	2.76	1.56
sharing knowledge is considered by administration in the annual performance evaluation of the employees	19.6	14.3	19.6	26.8	19.6	3.12	1.40
providing lectures and participating in scientific activities outside the center are allowed	14.3	5.4	23.2	37.5	19.6	3.42	1.27
Result of the axis	3.05	1.21

RQ3. What efforts do health practitioners make to obtain knowledge and share it with others?

As table 5 shows, analysis of the answers indicates that participants make efforts to share knowledge with others. These efforts vary with different proportions, as the communication with the experts to take advantage of their knowledge comes in first place among these efforts. Overall, the mean of this axis is 3.58, which means that participants often making self efforts in order to exchange knowledge with others.

Table 5. Efforts taken to obtain and share knowledge

Statements of axis	Always	Often	Sometimes	Rarely	Never	Mean	SD	Result
I take the initiatives to raise issues and brainstorming scientific issues with my colleague	10.7	7.1	37.5	21.4	23.2	3.39	1.22
I attend traditional and virtual discussion forums and workshops	8.9	14.3	28.6	25.0	23.2	3.39	1.24
I am keen to join interest groups to exchange knowledge and interaction with others	10.7	5.4	19.6	35.7	28.6	3.66	1.24
I communicate with experts to take advantage of their experiences	7.1	3.6	21.4	30.4	37.5	3.87	1.17
Result of the axis	3.58	1.04

RQ4. What is the perceived value of knowledge sharing on the work environment from the perspective of the health workforce?

Answers show that participants have a positive perception towards the importance of knowledge sharing in the work environment with a mean of 4.12. The answers of the axis items range between agree or strongly agree with a mean range from 3.98 to 4.37. Table 6 shows that the item saying sharing knowledge helps to raise the level of my performance and functional skills is the highest impact  among others.

Table 6. Perceived value of knowledge sharing on the work environment

Statements of axis	Strongly agree	agree	natural	disagree	Strongly disagree	Mean	SD	Result
Mutual knowledge contributes to the achievement of quality and development of work	5.4	5.4	7.1	35.7	46.4	4.12	1.10
Sharing knowledge helps to raise the level of my performance and functional skills	5.4	1.8	5.4	25.0	62.5	4.37	1.04
knowledge sharing supports the design and development of systems and procedures in the work environment	10.7	1.8	7.1	39.3	41.1	3.98	1.23
exchange of knowledge makes me more aware of the news and activities of the work locally and abroad	5.4	1.8	14.3	41.1	37.5	4.03	1.03
Result of the axis	4.12	1.03

RQ5. What technology is available for health workforce to share knowledge and information?

When technology provided to workface to share knowledge were examined, it was found that participants did not indicate that technology is not provided adequately (Table 7). This was reflected in average mean scores for the questionnaire statements ( Χ = 2.91). The highest mean scores were found for the statements, “Internet is provided to facilitate the process of knowledge communication within the center” ( Χ =3.21), which means that Internet access is not given to everyone. Other statements received lower mean scores. For example, it was observed that electronic archive is not commonly provided ( Χ = 2.67).

Table 7. Available technology for health workforce

Statements of axis	Strongly agree	agree	natural	disagree	Strongly disagree	Mean	SD	Result
Internet is provided to facilitate the process of knowledge communication within the center	23.2	16.1	10.7	16.1	33.9	3.21	1.60
administration provides email service to facilitate the communication between employees	25.0	17.9	8.9	23.2	25.0	3.05	1.55
digital libraries and databases are provided to facilitate the access of information and knowledge	26.8	21.4	19.6	17.9	14.3	2.71	1.40
Electronic archive is provided to preserve information resources and retrieve it when needed	32.0	17.9	16.1	17.9	16.1	2.67	1.48
Result of the axis	2.91	1.38

Discussion:

The findings of this study revealed that the staff in healthcare centers has a positive perception towards the importance of knowledge sharing in the work environment. This result is in consonance with other earlier research (Manaf & Marzuki, 2014; Chalak, Ziaei, and Nafei, 2014; Daniel, 2015) that found that the awareness of knowledge-sharing has been on the increase among employees in organizations. This is a positive aspect science individual perspective can facilitate the procedures of implementation of sharing scientific knowledge and help to encourage employees to cooperate with each other to exchange information that can solve the problems they face. According to Bock, Zmud, Kim and Lee (2005) trust among employees is an important factor that influences share knowledge in work setting. Another positive individual perceptive is the enjoyment.  Wu and Zhu (2012) found that perceived enjoyment in helping others has a positive effect on the knowledge worker’s attitude towards knowledge sharing.

Although the previous result indicated that participants aware of the importance of sharing knowledge with others, it was found that sharing is not commonly practiced. One explanation could be deduced from the result that showed that administration do not play an important role in this regard despite of  the result of previous study which found that managers play a key role in the knowledge sharing process in the organization (Gaál, Szabó, Obermayer-Kovács, & Csepregi, 2012). Moreover, conscious administration encourages explicit communication networks and a spirit of trust, enabling transmission and sharing of knowledge (Slater & Naver, 1995). Mushtaq and Bokhari (2011) stated that it has become a commonplace to claim that leadership plays an effective role in knowledge creation, sharing, and exploitation. To overcome the lack of administration’s encouragement, employees in health centers  depends on self effort to share knowledge and apply it  in the work environment. In fact,  it is not effective to rely on informal and self effort to spread knowledge sharing culture in any organization. Therefore, the authority in Saudi Arabia should integrate knowledge sharing activities in the daily work, and involve the all employees so that they feel responsible for applying these activities.

Another result indicated that technology relating to knowledge sharing is not provided adequately in health centers.  Research stated that technologies is a major factor to unlock new pathways for knowledge transfer and to maintain knowledge sharing (Garcia-Perez & Ayres, 2010; Oye, Salleh, & Noorminshah, 2011; En, 2011). It becomes  known that ICT is a major component to manage knowledge effectively in organizations. Therefore,  decision- maker should  provide internet, email, digital libraries, and electronic archive to all workforce in health care organizations and encourage them to use for scholarly communication.

Conclusion:

Knowledge sharing has become one of the important activities in health sectors in order to increase the scientific and cognitive skills of professionals and practitioners. It also helps in the development of services and the rapid spread of new innovations. It’s necessary that institutions of all kinds encourage employees to transfer knowledge and science they generate or gained to their peers.

The present study addressed the sharing of knowledge in health centers from the perspective of employees. The most significant findings is the presence of awareness of the importance of sharing knowledge among workers in the health centers. They have the desire to exploit all available potentials to transfer, exchange, and provide new knowledge within the centers. However, some factors found to be  barriers to share knowledge such as administration  discouragement and lack of technology that support knowledge management. For this reason, the authorities and supervisors of the health sector in Saudi Arabia should try to overcome these difficulties through the dissemination of sharing knowledge culture and its importance among managers in the health centers and giving them powers to reward workers who produce and share knowledge with their colleagues. In addition, it is necessary to provide technologies and applications that support the sharing of knowledge through storing, retrieving, and dissemination.

References:

1. Abrams, L. C., Cross, R., Lesser, E., & Levin, D. Z. (2003). Nurturing interpersonal trust in knowledge sharing networks. Academy of Management Executive, 17(4), 64-77.
2. Ahmed, N., Limaye, R. J., & Harlan, S. V. (2015). A multilevel approach to knowledge sharing: Improving health services for families and children. Annals of Anthropological Practice. 39(2), 192-204.
3. Akram, F., & Bokhari, R. (2011). The role of knowledge sharing on individual performance, considering the factor of motivation-the conceptual framework. International Journal of Multidisciplinary Sciences and Engineering, 2(9), 44-48.
4. Al Saifi, S., Dillon, S., & McQueen, R. (2016). The relationship between management support and knowledge sharing: An exploratory study of manufacturing firms. Knowledge and Process Management, 23(2), 124-135.
5. Albadry, A. & Arif, M., (2013). The role of knowledge sharing in the scientific councils in Saudi universities: An empirical study. Journal of King Fahad National Library, 19(2), 371-390.
6. Althinibat, M., Albuqoor, K., & Alotaibi, M. (2011). Knowlege sharing at the University of Taif: Proposed framework to development knowledge management from the perspective of the faculty members. Scientific Journal, (51), 200-239.
7. Bock, G. W., Zmud, R. W., Kim, Y. G., & Lee, J. N. (2005). Behavioral intention formation in knowledge sharing: Examining the roles of extrinsic motivators, social-psychological forces, and organizational climate. MIS quarterly, 29(1), 87-111.
8. Chalak, A. M., Ziaei, S., & Nafei, R. (2014). A survey of knowledge sharing among the faculty members of Iranian library and information science (LIS) departments. Library Philosophy and Practice.
9. Daniel, A. (2015). Knowledge sharing among librarians in university libraries in Nigeria. Information and Knowledge Management, 5(2), 31-36.
10. En, L. S. (2011). Factors influencing knowledge sharing intention in higher education institution (Doctoral dissertation, Master Dissertation. University Technology Malaysia).
11. Gaál, Z., Szabó, L., Obermayer-Kovács, N., & Csepregi, A. (2012). Middle managers’ maturity of knowledge sharing: Investigation of middle managers working at medium-and large-sized enterprises. Electronic Journal of Knowledge Management, 10(1), 26-38.
12. Garcia-Perez, A. and Ayres, R. (2010), Wikifailure: The limitations of technology for knowledge sharing, Electronic Journal of Knowledge Management, 8(1), 43-52.
13. Manaf, H. A., & Marzuki, N. A. (2014). The roles of personality in the context of knowledge sharing: A Malaysian perspective. Asian Social Science,10(1), 138-150.
14. Marabelli, M., Newell, S., Krantz, C., & Swan, J. (2014). Knowledge sharing and health-care coordination: The role of creation and use brokers. Health Systems, 3(3), 185-198.
15. Masa’deh, R., & Gharaibeh, A. (2013, March 25-26), Antecedents and outcomes of knowledge sharing: a proposed causal model on Jordanian telecommunication firms, Proceedings of the 20th IBIMA Conference on Entrepreneurship Vision 2012: Innovation, Real Estate Investment, Development Sustainability, and Economic Growth, Kuala Lumpur.
16. Mushtaq, R., & Bokhari, R. H. (2011). Knowledge sharing: Organizational culture and transformational leadership. Journal of Knowledge Management Practice, 12(2).
17. Navimipour, N. J., & Charband, Y. (2016). Knowledge sharing mechanisms and techniques in project teams: Literature review, classification, and current trends. Computers in Human Behavior, 62, 730-742.
18. Nicolini, D., Powell, J., Conville, P. & Martinez-Solano, L. (2008). Managing knowledge in the healthcare sector: A review. Journal of Management Reviews, 10(3), 254-263.
19. Obeidat, B. , Masa’deh, R. & Abdallah, A. (2014).The relationships among human resource management practices, organizational commitment, and knowledge management processes: A structural equation modeling approach. International Journal of Business and Management, 9(3), 9-26.
20. Oye, N. D., Salleh, M., & Noorminshah, A. (2011). Knowledge sharing in workplace: Motivators and demotivators. International journal of managing information technology, 3(4), 71-84.
21. Trivellas, P., Akrivouli, Z., Tsifora, E., & Tsoutsa, P. (2015). The impact of knowledge sharing culture on job satisfaction in accounting firms: The mediating effect of general competencies. Procedia Economics and Finance, 19, 238-247.
22. Saudi arabia: Big development in Saudi health care. (2014). MENA Report, Retrieved from http://search.proquest.com/docview/1507479148?accountid=142908
23. Rexhepi, H., (2015). Improving healthcare information systems: A key to evidence based medicine, Informatics. Licentiate Dissertation,
24. Rocha, E. S. B., Nagliate, P., Furlan, C. E. B., Rocha Jr, K., Trevizan, M. A., & Mendes, I. A. C. (2012). Knowledge management in health: a systematic literature review. Revista latino-americana de enfermagem, 20(2), 392-400.
25. Runhaar, P., & Sanders, K. (2015). Promoting teachers’ knowledge sharing: the fostering roles of occupational self-efficacy and human resources management. Educational Management Administration & Leadership, 44(5), 794-813.
26. Slater, S. F. & Naver J. C. (1995). Market Orientation and the Learning Organization. Journal of Marketing, 59(3), 63-74.
27. Swacha, J. (2015). Gamification in knowledge management: motivating for knowledge sharing. Polish Journal of Management Studies, 12(2), 150-160.
28. Tabrizi, N. M., & Morgan, S. (2014). Models for describing knowledge sharing practices in the healthcare industry: Example of experience knowledge sharing. International Journal Of Management And Applied Research, 1(2), 48-67.
29. Tan, C. N. L. (2015). Enhancing knowledge sharing and research collaboration among academics: Tthe role of knowledge management. Higher Education, 71(4), 525-565.
30. Trivellas, P.; Akrivouli, Z., Tsifora, E., & Tsoutsa, P. (2015). The Impact of Knowledge Sharing Culture on Job Satisfaction in Accounting Firms. The Mediating Effect of General Competencies. Procedia Economics and Finance 19, 238-247.
31. Wu, Y., & Zhu, W. (2012). An integrated theoretical model for determinants of knowledge sharing behaviours. Kybernetes, 41(10), 1462-1482.
32. Yong-Mi, K., Newby-Bennett, D., & Song, H. (2012). Knowledge sharing and institutionalism in the healthcare industry. Journal of Knowledge Management, 16(3), 480-494.