Les processus de dissémination et de création des connaissances dans les organisations de santé : le cas du Bureau de transition du Centre universitaire de santé McGill
Health organizations are characterized by the complexity of their activities and a high level of care fragmentation that inevitably result in service coordination stakes. Their main coordination mechanism, knowledge and expertise standardization is an essential, but limited, mechanism. Thus, the challenge still stands for a health organization to promote knowledge utilization at an organizational level. This project evaluates how an organizational structure aiming at mobilization and knowledge utilization in decision making helps to improve the coordination services in a health organization. This research relies on a specific case: the Transition Support Office (TSO) of the McGill University Health Center (MUHC).  The analysis uses a conceptual framework of organizational knowledge creation inspired by the work of Nonaka et al. Data have been collected by observations, documentary and interview analyses. This theory driven evaluation explains how the conversion process of tacit knowledge to explicit knowledge allows the dissemination and creation of new organizational knowledge and contributes to the improvement of service coordination. The evaluation demonstrates the influence of contextual factors on the processes of knowledge creation/utilization. The research shows that it is necessary to otherwise conceptualize the use of empirical data in decision making by highlighting their specific role in the social process of knowledge creation. We propose a new knowledge use typology in decision making. We also show how an organizational structure like the TSO can contribute to the care and service coordination in a health organization. Results also enrich the scientific knowledge on governance and organization transformation.
Healthcare coordination Knowledge creation Organizational learning Knowledge use in decision-making Implementation evaluation Theory driven evaluation