Accounting for knowledge embedded in artefacts within healthcare settings: Defining the direction of the research

This research takes place within the framework of the Knowledge and Information Management (KIM) is an EPSRC funded Grand Challenge Project which brings together expertise from management and engineering disciplines. The project recognises that, 'in response to customers‟ changing needs, organisations across all sectors are increasingly being asked not only to provide products in the first instance, but also to support them throughout their service life' (KIM 2006).Thus, the need to consider ways in which knowledge can be preserved in practices, records and artefacts is considered. The aim of this research, which is in its earliest stages, is to explore multi-disciplinary contributions to this problem from the knowledge management and production management perspectives. The focus is on the role of artefacts in preserving and communicating knowledge. An ethnomethodological approach will be used to produce uniquely adequate (UA) accounts of the situated meaning of artefacts within social processes. The proposed settings for research are healthcare facilities where the researcher will adopt an ethnographic approach to achieve a UA understanding of how patients, staff and visitors in chosen healthcare settings make sense of their built environments

Achieving a lean wayfinding system in complex hospital environments: Design and Through-life Management

Complex products, such as buildings and other infrastructure, should aim to provide value to the customer over all stages of the product life-cycle. This paper considers some of the challenges associated with maximising customer value when designing, producing, implementing and maintaining a wayfinding system for complex hospital environments. The hypothesis of this paper is that the tri-partite conception of knowledge flow provides a robust evaluative framework for the problems of wayfinding in complex hospital environments. The framework supplements the concepts of information and practice, conventionally applied in knowledge management, with a conception of physical objects and environments as knowledge carrying entities which are constituted, recognised and used in the course of social practice. From a lean perspective, the problems of wayfinding must be reduced or eliminated through adopting a lean knowledge management approach. A review of knowledge management, design, wayfinding and lean literature, together with ongoing participant action research at Salford Royal hospital, are reported in this paper. To ensure that wayfinding information remains immortal throughout the long life cycles of the building, a Through Life Management (TLM) approach is suggested. Thus TLM is viewed as an important consideration in lean construction

Wayfinding : embedding knowledge in hospital environments

The traditional use of signs has failed to overcome the problem of wayfinding in hospitals. As wayfinding problems are clearly linked to healthcare outcomes there is need to find a more integrated approach to solving the problem. In this paper it is shown that it is possible to embed forms of knowledge that make it easier for people to find their way with little need for signs. Evidence from literature and from fieldwork supports this assertion. Methods used for our research included direct observation, analysis of photographs and discussion with members of staff and other users of the setting

Using the physical properties of artefacts to manage through‐life knowledge flows in the built environment: an initial exploration

Effective through‐life management of built facilities requires effective through‐life knowledge management to support it. The KIM (Immortal Information and Through‐Life Knowledge Management) project attempted to develop such an approach, based on a dichotomy of knowledge and information. Knowledge is conceived in terms of communities of practice. An initial philosophical analysis demonstrates deficiencies in this conception. Drawing inspiration from production theory, a tripartite analysis is offered, suggesting that knowledge flows consist of: social practices, information and physical properties. Literature on physical properties from design studies, production management and ethnomethodology is briefly reviewed to demonstrate the information bearing functions of physical properties. Fieldwork conforming to the unique adequacy requirement of methods was carried out on construction sites, in hotel and hospital facilities during the use stage of their life cycles. Safety barriers on construction sites were found to have informational properties beyond their function as a physical barrier. The quality of information delivered by wayfinding signs was found to depend upon both the physical placement of the signs in relation to the surrounding environment and the physical layout of the sign itself. It was found that social practices are institutionalized to repair the knowledge flow when the physically instantiated wayfinding system breaks down. Finally, through the investigation of practices surrounding emergency resuscitation equipment, it was found that if the physical properties of information are not designed to mesh with the work practices of the setting, this will lead to a breakdown in the knowledge flow. It is suggested that elements of knowledge management, ethnomethodology, production management and design studies might be integrated to form the basis of a hybrid discipline