AN EVALUATION OF THE INTER-PROFESSIONAL COLLABORATION AND KNOWLEDGE MANAGEMENT TECHNIQUES AMONG THE CLINICAL WORKFORCE IN GENERAL HOSPITALS IN NIGERIA

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Traditionally, information is attributed to individuals within an organisation who possess it, and this knowledge is typically generated and exchanged through human communication (Opele et al., 2019). Knowledge is considered an intangible asset that holds equal importance to the physical assets of an organisation (Opeke & Opele, 2018; Turyahikayo, 2021). Each organisation possesses unique knowledge assets that contribute to the realisation of its vision and goal (Awogbami et al., 2020). Research has demonstrated that intangible assets make up over 75% of the overall assets in the majority of organisations (Opele, Adeyeye, Iyanda, & Olagoke, 2020). The existing literature reports two categories of knowledge: tacit and explicit (Dlamini, 2017; Charles & Nawe, 2017; Awogbami et al., 2020). Tacit knowledge is considered the most useful form of knowledge in organisations (Poell & Van der Krogt, 2017; Ali et al., 2018; Kamal & Buniyamin, 2018). Tacit knowledge is tailored to a particular environment and is highly individualised; it is a type of knowledge that is strongly connected to action, dedication, and engagement. Tacit knowledge is acquired and cultivated by firsthand experience, typically shared through dynamic conversations, storytelling, and collective expertise (Shajera & Ahmed, 2019; Gil & Carrillo, 2020; Halawi et al., 2021).

On the other hand, explicit knowledge is expressed in a more accurate and structured manner. It is occasionally denoted as having knowledge of something (Haqani & Ahlan, 2019). This form of knowledge is readily identifiable, storable, and retrievable. Explicit knowledge is readily codifiable, documented, transferable, and shareable. Explicit information is typically conveyed through linguistic and numerical representations, such as scientific equations, product specifications, manuals, databases, memoranda, notes, documents, and universal principles. In order for the organisation to maintain its competitive edge, it is crucial to efficiently manage these two forms of knowledge (Okunoye, 2019; Opele et al., 2020). Currently, the practice of knowledge management has gained significance in numerous organisations and is currently considered a crucial management strategy for achieving sustainable development (Opele et al., 2020). Both local and international firms are making significant investments in their intellectual assets in order to provide goods and services in a fundamentally different manner (Agarwal & Marouf, 2018). The management of knowledge refers to a collection of activities, initiatives, and methods that organisations employ to generate, store, transfer, and utilise knowledge in order to improve organisational performance (Donate & Guadamillas, 2021; Donate & Sánchez de Pablo, 2019). 

Knowledge management primarily focusses on supporting the processes involved in the creation, sharing, and efficient utilisation of knowledge within organisations (Bavik, Tang, Shao, & Lam, 2018). The importance of implementing a knowledge management strategy in health organisations cannot be overstated. This is because health care institutions not only provide health services to citizens but also participate in research activities that necessitate the collaboration of their expert systems to exchange skills and competencies (Opele et al., 2019). The primary objective of a knowledge management project in a health institution is to promote the dissemination of optimal methodologies and strategies (Kurniawan et al., 2019). 

Knowledge sharing encompasses cooperative efforts aimed at achieving a shared objective, hence enhancing the calibre and safety of patient care (D'amour, et al., 2018). Interprofessional collaboration is achieved by honest communication, mutual trust, respect, and the pursuit of common goals among care providers (Chan et al., 2018). If the highly specialised knowledge in the hospital is not shared, it will negatively impact the treatment of patients seeking medical care at the hospital (Tang, 2017: Breitbach & Richardson, 2019). Thus, it is imperative for the hospital administration to guarantee that its implicit knowledge is clearly expressed and efficiently disseminated and controlled (Halawi et al., 2017).

 Knowledge management is a systematic approach that emphasises the importance of creating, acquiring, and disseminating expertise, and incorporating these activities into the organization's operational procedures and decision-making processes (Chang & Taylor, 2017; GutierrezGutierrez et al., 2018). In order to maintain knowledge management methods, it is essential for the parties concerned to demonstrate a willingness to engage with each other. Haqani & Ahlan (2018) define collaboration as the act of sharing, partnering, exercising authority, relying on each other, and engaging in processes. Collaboration in health institutions involves the cooperation of multiple healthcare professionals with diverse training backgrounds to provide comprehensive services. This collaboration extends to working with patients, family members, carers, and communities to ensure the delivery of high-quality care across various healthcare facilities (Vanderwielen et al., 2018). However, attaining this goal necessitates inter-professional coordination among the parties concerned (Nissen, Evald et al., 2018).

Inter-professional collaboration is essential for achieving the objective of delivering patient-centered, safe, and efficient treatment that addresses the increasing and complex demands of a healthcare organisation (Kenaszchuk et al., 2021). Inter-professional collaboration will not only facilitate the exchange of knowledge but also improve the delivery of sustainable health services (Kaini, 2017). Inter-professional collaboration necessitates the clear expression of knowledge inside an organisation for the goal of collaboration (Bienkowski et al., 2018). Knowledge cooperation encompasses the activities of sharing, transferring, accumulating, transforming, and co-creating knowledge (Juzwishin et al., 2017). Consequently, fostering greater collaboration among healthcare professionals will improve the likelihood of effective knowledge management. 

Orchard, Curran, and Kabene (2019) put up four interconnected components of inter-professional collaboration: partnership, cooperation, coordination, and shared decision making. These factors serve as the foundation for the construct examined in this research (Orchard et al., 2019). Inter-professional collaboration in the healthcare field enables the combined talents and expertise of a team to work together more efficiently than if each member were working alone (Vanderwielen et al., 2018; Breitbach & Richardson, 2019). Collaboration among healthcare professionals leads to enhanced patient outcomes and increased levels of satisfaction (Wong et al., 2017). Hence, it is imperative for health care institutions to comprehend that inter-professional collaboration entails not only mere cooperation, but also effective collaboration with individuals from different disciplines.

Poor inter-professional collaboration and knowledge management methods among Nigeria's clinical personnel have hindered the health sector's ability to provide sustainable health services in recent decades (Olajide et al., 2019; Ojo & Akinwumi, 2019). Another obstacle to ensuring sustainable health service delivery in Nigeria is the challenge of finding individuals who are willing to contribute their valuable knowledge and skills (Awodoyin et al., 2020; Opele & Iyanda, 2019). This paper aims to analyse the identified problems that are impacting the attainment of sustainable health service delivery. It seeks to establish the connection between inter-professional collaboration and knowledge management practices among the clinical workforce in General Hospitals in Nigeria. Additionally, it explores how this interaction can improve sustainable health service delivery in the country.

1.2 Statement of the problem

Effective inter-professional collaboration and efficient knowledge management are essential for the performance of healthcare delivery systems, especially in general hospitals where the coordinated efforts of multiple healthcare professionals are necessary for patient care (Omole et al., 2022). General hospitals in Nigeria play a crucial role in providing healthcare services, typically handling a diverse array of medical conditions despite resource constraints (Henry et al., 2023). Although the significance of teamwork and knowledge sharing among clinical personnel is acknowledged, there is a rising apprehension that insufficient collaboration and ineffective knowledge management techniques may be compromising the quality of care delivered in these settings.

Inter-professional collaboration entails the active engagement of diverse healthcare professionals, including physicians, nurses, chemists, and other allied health practitioners, collaborating harmoniously to provide patient-centered care (Ekpenyong et al., 2022). Nevertheless, obstacles like as hierarchical structures within the workplace, difficulties in communication, and a lack of mutual respect can impede the ability to collaborate effectively (Akaniyene et al., 2021). These problems can result in care that is not coordinated, a higher number of mistakes in medical treatment, and unfavourable results for patients. Knowledge management is crucial for ensuring that healthcare personnel have up-to-date medical information, best practices, and clinical guidelines (Abayomi, 2022; Emeka, 2019). Efficient knowledge management enables the prompt dissemination and use of crucial information, which is essential for making well-informed decisions in patient care. However, knowledge management practices in many general hospitals in Nigeria are frequently insufficient. These hospitals have limited access to up-to-date medical resources, inadequate training on knowledge-sharing platforms, and a lack of structured systems for managing and disseminating clinical information (Abayomi, 2022; Emeka, 2019; Nat et al., 2019; Adesanya, 2017).

The absence of efficient inter-professional collaboration and knowledge management in Nigerian general hospitals presents substantial hazards to patient safety and the overall effectiveness of healthcare provision. These issues can lead to inadequate patient treatment, extended hospital stays, escalated healthcare expenses, and ultimately, inferior health results. The objective of this study is to assess the present condition of inter-professional collaboration and knowledge management methods among the clinical workforce in general hospitals in Nigeria. The research aims to identify the main obstacles and factors that promote successful teamwork and information sharing. It strives to provide practical insights that can be used to design methods for enhancing collaboration and improving the management of clinical knowledge. 

Objectives of the study

The primary objective of this study is to critically evaluate inter-professional collaboration and knowledge management techniques among the clinical workforce in general hospitals in Nigeria. Specific objectives of this study are to:

To find out whether there is a relationship between inter-professional collaboration and knowledge management practice within general hospitals in Nigeria

To determine the impact of inter-professional collaboration on knowledge sharing practices among the clinical workforce in general hospitals in Nigeria.

To identify factors that hinder effective inter-professional collaboration and knowledge sharing among clinical workforce in general hospitals in Nigeria

To offer recommendations for enhancing inter-professional collaboration and knowledge management techniques among the clinical workforce in general hospitals in Nigeria.

1.4 Research Questions

The following research questions which are in line with the objectives of this study will be answered in this study:

Is there a relationship between inter-professional collaboration and knowledge management practice within general hospitals in Nigeria?

What is the impact of inter-professional collaboration on knowledge sharing practices among the clinical workforce in general hospitals in Nigeria?

What are the factors that hinder effective inter-professional collaboration and knowledge sharing among clinical workforce in general hospitals in Nigeria?

What are the recommendations for enhancing inter-professional collaboration and knowledge management techniques among the clinical workforce in general hospitals in Nigeria?

1.5 Research Hypotheses

To determine the effectiveness of this study, the following research null hypotheses will be formulated to guide the study and it will be tested at 0.05% levels of significance.:

Ho: There is no significant relationship between inter-professional collaboration and knowledge management practice within general hospitals in Nigeria.

Ha: There is significant relationship between inter-professional collaboration and knowledge management practice within general hospitals in Nigeria.

1.6 Significance of the study

The significance of this study resides in its potential to enhance healthcare delivery by promoting effective collaboration and knowledge management techniques. Ultimately, this would result in benefits for patients, healthcare providers, and the whole healthcare system in Nigeria.

Efficient cooperation between professionals from different fields and effective management of knowledge are crucial for providing excellent patient care. Through the evaluation of these factors, the study can ascertain methods to enhance collaboration and the exchange of information, resulting in improved patient outcomes. The study aims to identify obstacles that hinder the successful collaboration between professionals from different fields and the appropriate management of knowledge. Gaining a comprehensive understanding of these obstacles is essential in order to create specific strategies to overcome them, resulting in a more unified and efficient healthcare team.

Moreover, the healthcare system in Nigeria encounters obstacles such as limited resources and a large number of patients. Gaining insight into the influence of collaboration and knowledge management on these problems can assist in formulating tactics to tackle systemic inefficiencies and enhance service provision. Effective teamwork and knowledge management can optimize healthcare processes, minimize duplication, and improve decision-making. The study can offer valuable insights for enhancing these systems, potentially resulting in more streamlined and impactful healthcare operations.

Moreover, the study's findings can provide valuable insights to healthcare policymakers and administrators regarding the present status of collaboration and knowledge management techniques. This data can provide guidance for policy reforms and practical adjustments to promote a more cooperative and information-sharing atmosphere inside general hospitals.

Moreover, the study might enhance comprehension of the interplay and knowledge exchange among various healthcare fields. Engaging in cross-disciplinary learning can bolster collaboration, mitigate tensions, and increase the overall coordination of care. Efficient information management and cooperation are essential for maintaining enhancements in healthcare quality. The study's results can provide valuable insights for developing long-term strategies to improve healthcare delivery and effectively respond to changing requirements and problems.

Furthermore, conducting research specifically in the Nigerian context contributes to the worldwide comprehension of inter-professional collaboration and knowledge management in various environments. It offers a helpful viewpoint that may be contrasted with practices in other countries and locations.

1.7 Scope of the study

Broadly, this study focus is to critically evaluate inter-professional collaboration and knowledge management techniques among the clinical workforce in general hospitals in Nigeria. Specifically, this study seeks to find out whether there is a relationship between inter-professional collaboration and determine the impact of inter-professional collaboration on knowledge sharing practices among the clinical workforce in general hospitals in Nigeria. 

Further, this study will focus on identifying factors that hinder effective inter-professional collaboration and knowledge sharing among clinical workforce in general hospitals in Nigeria and it also seeks to offer recommendations for enhancing inter-professional collaboration and knowledge management techniques among the clinical workforce in general hospitals in Nigeria.

 The study is carried out in Nigeria. 

1.8 Limitations of the study

Throughout the assessment, the researchers encountered many minor limitations, which are typical in any human undertaking. The primary constraint was the limited amount of comprehensive literature on the topic, resulting from the scarcity of data regarding the assessment of inter-professional collaboration and knowledge management methods among the clinical workforce in Nigerian general hospitals. Hence, a substantial allocation of time and exertion was required to ascertain the suitable materials, books, or information and amass data. 

Moreover, this study is limited by its limited sample size and restricted geographic coverage, concentrating exclusively on Nigeria. Thus, the ability to generalize the results of this study to a wider environment is limited, emphasizing the necessity for more research. 

Furthermore, the researcher's shortcomings were mostly attributed to financial restraints, as they are a student without any financial means to support themselves. The excessively high transportation fees at the research site presented a difficulty in fulfilling the financial responsibilities associated with transportation costs.

In addition, the researcher encountered a time limitation as a result of the necessity to do this research while simultaneously completing the responsibilities of attending lectures and engaging in other educational endeavors.

1.9 Definition of terms

Interdisciplinary teamwork: Interdisciplinary teamwork (also known as Inter-Professional collaboration) in healthcare refers to the collaborative approach where professionals from different disciplines work together to deliver comprehensive patient care.

Patient outcome: Patient outcomes are the results from care and treatments patients have received whilst in hospital, other clinical or care settings. They focus on meeting the physical, social, and emotional needs of patients from their own perspective to highlight what is important to them.

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