Creating a knowledge community in the National Health Service of the United Kingdom

摘要

Many-Health Trusts in the United Kingdom are currently in the process of implementing major organisational change, such as the establishment of Integrated Care Pathways (ICPs) and Primary Care Groups (PCGs). Such changes have significant implications for the restructuring and development of the knowledge infrastructures which support the clinical and administrative communities within each Health Trust environment. They also imply a shift in the cultural paradigm of the National Health Service of the United Kingdom, which seems to indicate a loosening of the grip of traditional professional bureau-cracies as clinical groups adopt an increasingly "teamwork" approach.Systemic information models are being explored in some Trusts in an attempt to put in place more enabling information systems which can support flatter organisational hierarchies and lateral, team-based communication requirements. This paper will discuss the work being carried out within one Health Trust which is taking a systemic approach to the implementation of ICPs. Their view is that such a strategy will enable them to manage a change process which is organisationally complex, and which also has specific implications for the development of integrated information systems to support the care process. This work will be presented in the context of recent thinking and practice concerning knowledge management. Both the technical and socio-cultural views of knowledge management will be examined here, with the aim of presenting some conclusions on the transition of this Health Trust towards a knowledge management culture. In itself, this would represent a radical development for health service management in the United Kingdom.