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从策略到行动:肯尼亚基于项目的体验式学习在医疗保健组织中知识转移的显著影响因素的定性研究。

From strategy to action: a qualitative study on salient factors influencing knowledge transfer in project-based experiential learning in healthcare organisations in Kenya.

机构信息

Institute of Healthcare Management, Strathmore University Business School, Strathmore University, Nairobi, Kenya

Institute of Healthcare Management, Strathmore University Business School, Strathmore University, Nairobi, Kenya.

出版信息

BMJ Open. 2019 Sep 30;9(9):e031100. doi: 10.1136/bmjopen-2019-031100.

Abstract

OBJECTIVES

Knowledge transfer is recognised as a key determinant of organisational competitiveness. Existing literature on the transfer of knowledge and skills imply diminutive return on investment in training and development due to the low application of learnt knowledge. Following devolution of health services provision to new counties in Kenya in 2013, Strathmore Business School designed an experiential facility improvement project-based leadership training programme for healthcare managers in the new counties. Selected healthcare management teams participated in the leadership training to improve health systems performance in the devolved counties in Kenya. Despite similar training, the projects implementation contexts were different, leading to different implementation completion rates. The aim of this study was to investigate the reasons for this disparity and then recommend solutions.

DESIGN

A qualitative study using semi-structured interviews. A thematic framework approach was used in data analysis.

SETTING AND PARTICIPANTS

Thirty-nine projects teams constituting; 33 successful and 6 unsuccessful project teams, were purposively selected based on their project implementation success rates at the end of the leadership training. The managers had undertaken a team-based institutional improvement project. The prioritised projects were housed within; 23 public, 10 faith-based and 6 private health facilities in 19 counties in Kenya.

RESULTS

Our findings indicate projects completion rates were influenced by (training design, work environment climate, trainee characteristics, team-based coaching and leveraging on occurring opportunities). Transfer barriers were (inadequate management support, inadequate team and staff support, high staff turnover, misalignment of board's verses manager's priorities, missing technical expertise, endemic strikes, negative politics and poor communication). Recommendations were (need-driven curriculum, effective allocation and efficient utilisation of resources, proper prioritisation, effective communication, longitudinal coaching and work-teams recruitment).

CONCLUSION

The findings reveal that unless training interventions are informed by a need-driven curriculum customised to real-world work teams, the potential knowledge and skill transfer can be thwarted.

摘要

目的

知识转移被认为是组织竞争力的关键决定因素。现有的知识和技能转移文献表明,由于所学知识的应用率低,培训和发展的投资回报微不足道。2013 年,肯尼亚将卫生服务提供权下放到新的县后,斯特拉斯莫尔商学院为新县的医疗保健管理人员设计了一个基于体验式设施改进项目的领导力培训计划。选定的医疗保健管理团队参加了领导力培训,以提高肯尼亚新下放县的卫生系统绩效。尽管培训相似,但项目实施背景不同,导致实施完成率不同。本研究旨在调查这种差异的原因,并提出解决方案。

设计

使用半结构化访谈的定性研究。在数据分析中使用了主题框架方法。

设置和参与者

39 个项目团队,其中包括 33 个成功和 6 个不成功的项目团队,根据领导力培训结束时的项目实施成功率有目的地选择。这些管理人员参与了基于团队的机构改进项目。优先项目位于肯尼亚 19 个县的 23 个公立、10 个信仰和 6 个私立卫生机构中。

结果

我们的研究结果表明,项目完成率受到(培训设计、工作环境氛围、学员特点、团队式辅导和利用现有机会)的影响。转移障碍包括(管理支持不足、团队和员工支持不足、员工高流动率、董事会与经理优先级不一致、缺少技术专长、长期罢工、负面政治和沟通不畅)。建议包括(以需求为导向的课程、资源的有效分配和利用、适当的优先级、有效的沟通、纵向辅导和工作团队招聘)。

结论

研究结果表明,除非培训干预措施是根据定制的以实际工作团队为基础的需求驱动课程,否则潜在的知识和技能转移可能会受到阻碍。

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