A Study of How Health Visitors Exchange Knowledge in the Context of Organisational and Policy Change

By Lindsay Louise Brigham.

Published by Knowledge Management: An International Journal

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Article: Electronic $US5.00

This paper draws upon selected findings from a small scale qualitative study of the situated practice of health visitors. The study was carried out in a context of local organisational change, after the merger of two primary care trusts in the north of England, and emergence of national policy drivers positioning health visitors in a leadership role in the delivery of integrated services to children and families. The findings from four focus groups give grounded and context specific examples of the types of knowledge that health visitors value and ways in which they exchange knowledge and draw upon the distributed knowledge and expertise of others. The results are interpreted through the lenses of different discourses of knowledge, and barriers to change are identified through an iteration between practice-based narrative and theoretical frameworks. These barriers include: dominance of linear and hierarchical transmission models of knowledge transfer rather than promotion of a knowledge sharing/creating culture; a devaluing of context specific and practice based knowledge in comparison to abstract knowledge; bureaucratisation of knowledge; defensive practices emerging from a perceived threat to professional identity; and limited tools and allocation of time for collaborative work within the profession and across professional boundaries. Recommendations and strategies to drive change and enable health visitors to take on leadership roles in multi skilled teams and a multi agency context are underpinned by the argument that what is needed in this context is a transformational model of knowledge exchange and co creation of knowledge that works with tensions between different discourses of knowledge and promotes collaborative dialogue and practice across professional and organisational boundaries.

Keywords: Health Visitors, Discourses of Knowledge, Knowledge Exchange, Knowledge Transfer, Transformation, Cultural Historical Activity Theory

Knowledge Management: An International Journal, Volume 12, Issue 1, pp.17-31. Article: Print (Spiral Bound). Article: Electronic (PDF File; 293.425KB).

Lindsay Louise Brigham

Senior Lecturer and Staff Tutor, Faculty of Health and Social Care, The Open University, Gateshead, UK

I am a staff tutor for the Open University, based in a regional centre in Gateshead. I have a combination of academic, academic management and administrative responsibilities. The latter are related to the management and development of academic staff within the Faculty of Health and Social Care. My recent research and scholarship interests are based on a series of studies that were funded through our Professional and Practice Based Centre for Excellence in Teaching and Learning.