Crafting a System of Profound Knowledge Management in Long-Term Care

Crafting a System of Profound Knowledge Management in Long-Term Care by Charlotte Johnson MA, University of South Florida, 1999 BA, University of South Florida, 1989 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Education Walden University December, 2016 Abstract The paradigm shift to a knowledge economy, predicted by Drucker, is currently reflected in a knowing-to-doing gap in healthcare, potentially threatening the lives of long-term care (LTC) residents and sustainability of LTC organizations. The purpose of this grounded theory study was to seek a substantive conceptual theory to explain how LTCThe paradigm shift to a knowledge economy, predicted by Drucker, is currently reflected in a knowing-to-doing gap in healthcare, potentially threatening the lives of long-term care (LTC) residents and sustainability of LTC organizations. The purpose of this grounded theory study was to seek a substantive conceptual theory to explain how LTC uses knowledge management (KM) to improve performance by probing the a priori views and lived experiences of 11 LTC knowledge creators, managers, and users. Data were collected via semi structured interviews that were transcribed and coded. The research questions guided by the conceptual concentrated on how KM is used in LTC, what KM processes enhance or inhibit performance in LTC, the nature of knowledge in LTC, and the potential impact of Deming’s theory of profound knowledge on KM in LTC. Data analysis included coding, categorizing, constant comparison, conceptualizing, and theorizing to reveal a tentative unified theory of crafting a system of KM in LTC that theoretically extends Deming’s organizational theory of profound knowledge to integrate the individual knower within Deming’s organizational perspectives. Findings included participant use of sentinel data and bridging decisions in response to emergent knowledge needs, risk management versus quality management performance drivers, and participant perceptions of resource dependence in response to emergent knowledge needs. Findings also include social change implications for LTC facilities, residents, and staff driven by systematic KM to facilitate clinical best practices, lessons learned, and resourcing the use of knowledge to enhance LTC performance capabilities. Study conclusions include a call for future research related to study findings across the healthcare continuum. Crafting a System of Profound Knowledge Management in Long-Term Care by Charlotte Johnston MA, University of South Florida, 1999 BA, University of South Florida, 1989 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Education Walden University December 2016 Dedication This work is dedicated to my parents, Peregrine and Dolores Radcliffe. They raised seven daughters into independent women, without education or money, dedicating themselves to their children throughout their lives and unselfishly giving whatever they had to help us in any way they could; when we were 16, and when we were 60. They taught me about perseverance and dedication to whatever I wanted to achieve. I want to also dedicate this work to my life partner Jeff Sully who was my rock through this effort, always offering me love and support to keep me going through each life complication that made it difficult. Jeff provided me with the intellectual partnership, respect, and encouragement that made me always reach a little higher to accomplish this. I further wish to dedicate this work to Bernie Turner, who founded Walden University with Rita Turner. Bernie took some time with me at the Walden site in Naples, Florida in the 1970s. I did not even know what a degree was at that time, but knew I wanted to become an educator. I had never known anyone with an advanced education and Bernie’s kindness and re-assurance during our brief meeting was inspirational and aspirational for me. He assured me I could follow the steps he laid out for me to obtain the necessary education, and added he looked forward to me someday coming back and getting my doctorate at Walden. This made me feel someone who really knew what to do saw potential in me. I was able to thank Bernie 35 years later at a Walden residency in Baltimore and told him “I’m back”. It was one of the proudest moments of my life.