2040. Knowledge Management and CPG Implementation: Developing Measures of Knowledge Management Constructs
RG Best, VERDICT, SJ Hysong, University of Houston, FI Moore, University of Texas School of Public Health, JA Pugh, VERDICT

Objectives: This study is part of a larger research effort whose goal is to identify barriers and facilitators to clinical practice guideline implementation, and determine whether such organizational features as a culture for knowledge creation would influence the successful implementation of guidelines. A literature review revealed no established instruments that could assess enablers of knowledge creation. Consequently, a questionnaire was devised to quantitatively assess individuals’ perceptions of knowledge creation climates in their work environments. The study herein presents an assessment of the psychometric properties of this instrument.

Methods: Scale Development—The scale is a 31-item, Likert-type questionnaire.  Based on Nonaka’s theory of Knowledge Creation, the instrument sought to capture the five conditions that enable knowledge creation: (a) autonomy, (b) fluctuation/creative chaos,  (c) intention, (d) redundancy, and (e) requisite variety. Sample and Procedure—Leadership, quality management, and primary care personnel from 15 facilities across four VISNs were invited to participate.  Facilities were chosen based on their EPRP performance scores (1 high, 1 low, and 2 improvers per VISN over a 2-year period).  189 participants completed the questionnaire.

Results: Factor analysis indicates that the instrument resolves to a two-factor structure, rather than to the five factors proposed by Nonaka. The two-factor structure is consistent with Nonaka’s propositions that three of the factors (autonomy, intention, and fluctuation), drive individual knowledge creation, while the other two (redundancy and requisite variety) are more associated with organizational knowledge creation.

Conclusions: We conclude that the instrument shows adequate reliability and exhibits evidence of construct validity at a macroscopic level.  The next step is to examine facility variation and its relationship to performance on clinical practice guidelines.

Impact: This research represents one of the first attempts to develop a quantitative assessment of knowledge management constructs. Knowledge management is highly valued in business as the preferred strategy for achieving sustained competitive advantage. However, research in knowledge management is largely theoretical, lacking valid operationalizations. This research contributes a quantitative tool for assessing knowledge management in health care settings.