ElectronicHealthcare 3(1) June 2004 : 82-88
A recent issue of HealthcarePapers addressed the topic of evidence-based healthcare, or more specifically, its implementation in organizational practice. The lead article by Browman, Snider and Ellis (2003) identified a key gap that impeded the integration of clinical evidence in healthcare practice - specifically, the cultural "solitudes" inhabited by hospital managers, the keepers of the financial keys, and clinicians, the primary custodians of quality care. Other articles in the same issue suggested variations on the metaphor of negotiation and the practice of storytelling proposed to improve evidence uptake. Whatever the specific flavour of sharing adopted, contributors to the issue recognized a core problem in which knowledge management, in a general sense, has a central role. They recognized that innovation was required to resolve the problem. Though the possibilities of negotiation are in a sense unbounded, in essence what was proposed was a movement towards a culture that is more knowledge-friendly than that of the professionally siloed organizations common in healthcare delivery. In this paper, we argue that another important barrier to effective knowledge utilization must be addressed if real knowledge management is to be better, and more fully, implemented in healthcare delivery. This barrier is the failure to use evidence to target knowledge process interventions.
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