Organizational theory can assist in better understanding how changes made in clinical practice can be sustained in healthcare organizations. Organizational learning and knowledge transfer theories were used to develop and test a theoretical model, “Sustaining in Memory” (SIM) model, to explore how organizations disperse or distribute newly transferred knowledge in knowledge reservoirs situated in the organization. Three hypotheses were generated from the theoretical model and tested with data from a cross sectional postal survey of 148 patient/resident care units in one large Canadian province where a CPG on prevention of falls was widely disseminated. Findings confirmed that fall prevention practice knowledge was transferred and embedded in all six knowledge reservoirs; however, there were three specific knowledge reservoirs that were found to be significant predictors of perceived CPG adherence (activities consistent with the CPG recommendations). These were staff, policy and role expectation knowledge reservoirs. There was variation in the adherence to the eight CPG recommendations with greater adherence to recommendations that were mandatory. Additionally, findings showed that the relationship between staff knowledge reservoir and CPG adherence was the only relationship moderated by the practices that helped to prevent/address knowledge loss through various activities designed for reviewing and updating practice knowledge. Interestingly, although CPG adherence was reported significantly greater in LTC resident care units, its association with patient outcomes was much weaker than in hospital patient care units. Hospital units had significantly greater correlation between perceived CPG adherence and all four of the falls prevention outcomes reported by study participants. Lastly, quality management culture as managed by senior leaders in the organization was also found to be a significant predicator of adherence to the CPG. The research study validated key assumptions made in the theoretical model while helping to clarify the distinct influence of different knowledge reservoirs. The SIM model provided an alternate perspective within which to study knowledge transfer and sustainability of clinical practices and has potential to apply to other change initiatives. This study answered the call for greater theoretically driven studies of CPG implementation as well as attention on the organizational influences of CPG implementation and sustainability.

Organizational theory can assist in better understanding how changes made in clinical practice can be sustained in healthcare organizations. Organizational learning and knowledge transfer theories were used to develop and test a theoretical model, “Sustaining in Memory” (SIM) model, to explore how organizations disperse or distribute newly transferred knowledge in knowledge reservoirs situated in the organization. Three hypotheses were generated from the theoretical model and tested with data from a cross sectional postal survey of 148 patient/resident care units in one large Canadian province where a CPG on prevention of falls was widely disseminated. Findings confirmed that fall prevention practice knowledge was transferred and embedded in all six knowledge reservoirs; however, there were three specific knowledge reservoirs that were found to be significant predictors of perceived CPG adherence (activities consistent with the CPG recommendations). These were staff, policy and role expectation knowledge reservoirs. There was variation in the adherence to the eight CPG recommendations with greater adherence to recommendations that were mandatory. Additionally, findings showed that the relationship between staff knowledge reservoir and CPG adherence was the only relationship moderated by the practices that helped to prevent/address knowledge loss through various activities designed for reviewing and updating practice knowledge. Interestingly, although CPG adherence was reported significantly greater in LTC resident care units, its association with patient outcomes was much weaker than in hospital patient care units. Hospital units had significantly greater correlation between perceived CPG adherence and all four of the falls prevention outcomes reported by study participants. Lastly, quality management culture as managed by senior leaders in the organization was also found to be a significant predicator of adherence to the CPG. The research study validated key assumptions made in the theoretical model while helping to clarify the distinct influence of different knowledge reservoirs. The SIM model provided an alternate perspective within which to study knowledge transfer and sustainability of clinical practices and has potential to apply to other change initiatives. This study answered the call for greater theoretically driven studies of CPG implementation as well as attention on the organizational influences of CPG implementation and sustainability.

Organizational memory has significant potential for companies’ competitive advantage, with mentoring considered a particularly effective method of transferring this knowledge. Older workers are often considered ideal mentors because of their experience and alleged willingness to pass on their knowledge. There is an associated assumption that these workers anticipate and experience positive outcomes from mentoring others. This thesis tested if these assumptions hold up in 21st century workplaces - some discriminatory practices towards older workers and a career contract that no longer guarantees employment, may discourage knowledge sharing. An organizational memory scale was constructed to help test the assumptions and an exploratory factor analysis involving 143 employees from eight companies resulted in 21 items and five correlated factors including socio-political knowledge, job knowledge, external network, history, and industry knowledge. Two confirmatory factor analyses, the first involving 287 employees and the second 115 retirees, found support for five correlated first-order factors and a second order factor, organizational memory. In a third study involving 134 employees, support was found for a model of organizational memory and empowerment. Age was found to relate to organizational memory but this relationship was mediated by organizational tenure. In turn, organizational memory was found to relate to psychological empowerment and the frequency with which participants were requested to share knowledge at work. Organizational memory, empowerment and request to train and mentor others also positively related to organization-based self-esteem. In the fourth study, an organizational case study involving 78 employees, support was found for a model of organizational memory and the intention to mentor within the context of an aging workforce. Generativity and the expected cost of the time and effort involved in mentoring mediated the relationship between organizational memory (specifically, socio- political knowledge) and the intention to mentor. Furthermore those participants with high scores on both organizational memory and occupational self-efficacy anticipated more cost in time and effort, and indicated less intention to mentor, than those with high organizational memory but low occupational self-efficacy. These findings challenge the assumption that experienced workers are, as a matter of course, willing to mentor others. In a final study involving 96 retired individuals, there were no significant differences found between retirees with and those without experience as a mentor, in career satisfaction and unwelcome work ruminations. However notably, the study showed that participants did experience unwelcome work ruminations even (as in the case of some) well into retirement. The thesis concludes with a summary of findings as they relate to the assumptions under examination, an outline of the overall implications of the findings for future research and for organizational practice, and closing remarks about the overall research contribution of the thesis.

學校應該學習與組織記憶、組織學習以及體制論相關之知識。其中，組織記憶有助於問題解決與決策制訂（Hanson, 2001），且能協助學校維持不易被模仿、獨特的競爭優勢，並能有效提高組織績效表現及降低成本（Wexler, 2002）。許多組織記憶相關的研究結論顯示，組織成員流動會嚴重影響組織記憶成長（Carley, 1992）。因此，如何有效獲取、保留、維護及存取（retrieve）組織成員的知識，以避免重要的組織記憶消失（Walsh 和 Ungson, 1991;），儼然成為當前組織最需要關切的課題之一（Lahaie, 2005）。本研究整理、分析組織記憶相關文獻，發現藉由中介變項：書面化程度、可接近性、資深知識者角色行為、協同教學行為與知識分享行為以管理組織記憶，可滿足教師的組織記憶存取需求（retrieval demands），維持組織記憶的有效性。 本研究透過問卷調查法，以幼稚園組織中在園年資一年以下與三年以上的教師為研究對象，徵詢教師對組織記憶的存取需求、組織記憶有效性及教師績效知覺三構面的實際感受。總共發出問卷470份，問卷回收率為44.7%，在剔除不適合的問卷後，得到私幼有效樣本161份、公幼有效樣本19份。由於公幼樣本過少，故公幼教師的意見以描述統計方式呈現；私幼樣本則進行組間差異分析、相關分析及迴歸分析，並進行研究假設檢定。 　　研究結果顯示，本研究七項假設皆獲得支持，即幼稚園教師確實具有組織記憶存取需求，且教師在遭遇工作上的困難時，也經常採取實際詢問行為以解決其組織記憶存取需求，且93%的受訪教師認為其獲得的組織記憶具有效性。其次，教師的在園年資與幼教年資愈短，對組織記憶存取需求則愈高。 在中介變項的分析上，受訪教師除了對協同教學行為此變項持有不同認知外，均認為書面化程度、可接近性、資深知識者角色行為與知識分享行為皆有助於組織記憶建構。迴歸分析結果也顯示，無論教師年資之長短，以園長或資深教師擔任諮詢輔導角色，最能維繫組織記憶有效性，也能提升教師績效知覺；其次，增加知識分享行為亦可達到類似結果。故幼稚園組織在處理組織記憶問題時，應讓園長或資深教師擔任資深知識者的角色，並建立教師之間知識分享的機制，讓教師能有效獲取、保留、維護及存取組織記憶，進而促進組織學習、建立競爭優勢並提高教師績效表現。 / Hanson(2001) declared that schools should get insights from the literature regarding organizational memory, organizational learning and institutional theory. Organizational memory can support organizational members to acquire knowledge in problem-solving and decision-making activities (Walsh and Ungson, 1991). Moreover, organizational memory could be viewed as an intangible asset if successfully managed, and it might confer competitive advantages and lower transaction cost (Wexler, 2002). Day (1994) claimed that organizational memory is as a repository for collective memory which lain in policies, procedures, routines, and rules that can be retrieved when organization members needed. Stein and Zwass (1995) defined that organizational memory as “the means by which knowledge from the past is brought to bear present activities, thus resulting in higher or lower levels of organizational effectiveness.” Levitt and March(1996) also mentioned that “the lesson of history are likely to be lost through turnover of personnel (Hanson, 2001).” These statements implied that personnel turnover is the main threat of organizational memory (Stein and Zwass, 1995). This study wants to explore the relationship between teachers’ turnover, retrieval demands and effectiveness of organizational memory and the performance of kindergartens. Moreover, researcher wants to investigate the elements that have the most influence upon organizational memory effectiveness. Drawn from organization memory literature, we found that knowledge externalization, accessibility of organizational memory, senior teachers and principal’s behavior, team-teaching behavior, and knowledge-sharing behavior are determinants of organizational memory effectiveness. / The major finding was that teachers definitely have retrieval demands toward organizational memory, especially new-employed teachers. New teachers need senior teachers and principal’s guidance to help them solve problems and make decisions. The more assistances senior teachers and principal can offer, new teachers are more satisfied with organizational memory. That means new teachers can retrieve organizational memory successfully; moreover, they will be more contented with organizational memory effectiveness and show higher personal performance. As for intervening variables, researcher have detected that senior teachers and principal’s behavior and knowledge-sharing behavior show the primary influence upon organizational memory effectiveness. Consequently, management teams of kindergartens should attempt to create opportunities for teachers to share their knowledge. After knowledge-sharing procedure, teachers’ retrieval demands of organizational memory will be fulfilled, effectiveness of organizational memory will be maintained, and personal performance will be lifted as well.

<p>Nothing has been that consistent as the change is for the knowledge revolution to nourish and cultivate. Different forms of changes are occurring in organizations with the aim to improve the output performances. Health organizations have been more attached to the changes and the consequences that are brought with such changes. Such consequences are primarily connected with concepts of unlearning and learning. Any form of the change if initiated in organization asks for new routines learning, tasks conductions and the organizational cultural revolution. These new routines have been occurring at individual and organizational levels. The unlearning at any level in the organizational culture can be performed through investigating a primary connection between the organizational and individual routines. At the individual level unlearning brings a number of psychological, cognitive, social and moral hurdles. These hurdles at individual level basically help the organizational unlearning to occur. All of the routines occurring at individual level encompass the necessary information that goes from lower levels to upward, strengthening and holding the organizational memory firm.</p><p>This research was about to find how the health organizations unlearn the older practices and learn the new practices in IT change. This research had two streams i) finding whether there had been any connection between the organizational and individual unlearning in the cases of IT change, ii) For unlearning what kind of hurdles had been there at the individual level. Kalmar hospital pediatric department had been chosen for the empirical investigations. The research streams were about how and what parts which helped the researcher to go for the qualitative data gathering techniques.</p><p>The Results showed there had been a very thin connectivity between the organizational and individual unlearning. The results revealed and unfolded that many of the new learning are occurring simultaneously with discarding the older ways of practices. The impression of absorbing the change with respect to the unlearning had been varied from person to person. There had been a numbers of individual hurdles observed at individual level of unlearning. Apart from them, many individual routines (performative tasks) had the primary connectivity with the organizational routines (Ostensive routines) and shaping and reshaping of the organizational memory.</p><p>It is important to understand the unlearning notions with the type of change. In this research each of the interviewee had shared his thoughts of how the things could have been done differently by revealing the consequences with new learning. Literature suggests that for a profound and successful implementation of change more formal and informal trainings, clear strategy for shuffling the older individuals in the camp, more social and cognitive meetings and fast and quick actions in the cases of technical difficulties are to be taken.</p><p><strong> </strong></p><p><strong> </strong></p><p><strong> </strong></p><h1> </h1><h1> </h1><h1> </h1><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p> / Thesis

<p>Nothing has been that consistent as the change is for the knowledge revolution to nourish and cultivate. Different forms of changes are occurring in organizations with the aim to improve the output performances. Health organizations have been more attached to the changes and the consequences that are brought with such changes. Such consequences are primarily connected with concepts of unlearning and learning. Any form of the change if initiated in organization asks for new routines learning, tasks conductions and the organizational cultural revolution. These new routines have been occurring at individual and organizational levels. The unlearning at any level in the organizational culture can be performed through investigating a primary connection between the organizational and individual routines. At the individual level unlearning brings a number of psychological, cognitive, social and moral hurdles. These hurdles at individual level basically help the organizational unlearning to occur. All of the routines occurring at individual level encompass the necessary information that goes from lower levels to upward, strengthening and holding the organizational memory firm.</p><p>This research was about to find how the health organizations unlearn the older practices and learn the new practices in IT change. This research had two streams i) finding whether there had been any connection between the organizational and individual unlearning in the cases of IT change, ii) For unlearning what kind of hurdles had been there at the individual level. Kalmar hospital pediatric department had been chosen for the empirical investigations. The research streams were about how and what parts which helped the researcher to go for the qualitative data gathering techniques.</p><p>The Results showed there had been a very thin connectivity between the organizational and individual unlearning. The results revealed and unfolded that many of the new learning are occurring simultaneously with discarding the older ways of practices. The impression of absorbing the change with respect to the unlearning had been varied from person to person. There had been a numbers of individual hurdles observed at individual level of unlearning. Apart from them, many individual routines (performative tasks) had the primary connectivity with the organizational routines (Ostensive routines) and shaping and reshaping of the organizational memory.</p><p>It is important to understand the unlearning notions with the type of change. In this research each of the interviewee had shared his thoughts of how the things could have been done differently by revealing the consequences with new learning. Literature suggests that for a profound and successful implementation of change more formal and informal trainings, clear strategy for shuffling the older individuals in the camp, more social and cognitive meetings and fast and quick actions in the cases of technical difficulties are to be taken.</p><p><strong> </strong></p><p><strong> </strong></p><p><strong> </strong></p><p><strong> </strong></p><h1></h1><h1></h1><h1></h1><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p> / Thesis

Este trabalho possui como objeto de estudo a gestão de conhecimento dentro das firmas de Serviços Empresariais Intensivos em Conhecimento ou KIBS (Knowledge- Intensive Business Services), empresas especializadas que fornecem serviços para outras firmas ou organizações. Serviços de TI, serviços de P&D, consultoria técnica, consultoria legal, consultoria financeira e consultoria gerencial são típicas empresas KIBS. Dado o grau de especialização dessas empresas, a gestão de conhecimento passa a afetar uma parcela importante do desenvolvimento de suas atividades, bem como as ferramentas ou mecanismos estabelecidos para gerenciar as práticas relativas à criação e transferência do conhecimento. Nota-se, também, que o sistema de gestão de conhecimento nessas empresas se cria e desenvolve de maneira distinta da que ocorre em outras organizações. Portanto, buscou-se entender como as organizações KIBS gerenciam seu conhecimento, em especial a experiência (na forma de conhecimento tácito), investigando os mecanismos que se estabelecem para tal fim; e como a memória organizacional e os processos de socialização específicos são criados e desenvolvidos no interior dessas organizações, tendo como objetivo entender como os Sistemas de Gestão de Conhecimento evoluem através do relacionamento entre esses processos. A metodologia de pesquisa utilizada é qualitativa. Ela foi realizada por meio de um estudo de casos múltiplos em três empresas KIBS. Para tanto, um modelo teórico foi formulado e, posteriormente, avaliado na fase de pesquisa de campo. As observações finais demonstram que o papel dos especialistas dentro das empresas KIBS é fundamental para a evolução do seu Sistema de Gestão de Conhecimento e que os processos de socialização favorecem ou diminuem suas possibilidades de fornecer requisitos de desenvolvimento. / This paper focuses on the study of knowledge management at KIBS (Knowledge- Intensive Business Services), expert companies that provide services to other companies and organizations. IT and P&D service, technical consultancy, law consultancy, financial and management consultancy are all typical KIBS. Given the level of specialization of these firms, management knowledge may play an important part in the development of their activities, as well as the tools, and mechanisms established for managing practices related to the creation and transfer of knowledge. It was noticed in these firms that knowledge management systems (KMS) have been created and developed in a way different from that in other organizations. Consequently, there has been an effort to understand how KIBS firms manage their knowledge, basically expertise in the form of tacit knowledge, by looking into the mechanisms established for that purpose. Additionally, we intend to analyze the creation and development of organizational memory (OM) and particular socialization processes inside these organizations, so that we can learn how KMS evolve through the relationship of such processes. A qualitative research methodology was applied in this project. It was carried out by a multiple case study involving three different KIBS firms. In order to achieve that aim, a theoretic model was devised and forward assessed at the fieldwork stage. Our final observations have proved the essential role experts play inside KIBS firms for the progress of KMS. Likewise, it was found that socialization processes can either increase or reduce the possibilities of supplying development requirements.

Este trabalho possui como objeto de estudo a gestão de conhecimento dentro das firmas de Serviços Empresariais Intensivos em Conhecimento ou KIBS (Knowledge- Intensive Business Services), empresas especializadas que fornecem serviços para outras firmas ou organizações. Serviços de TI, serviços de P&D, consultoria técnica, consultoria legal, consultoria financeira e consultoria gerencial são típicas empresas KIBS. Dado o grau de especialização dessas empresas, a gestão de conhecimento passa a afetar uma parcela importante do desenvolvimento de suas atividades, bem como as ferramentas ou mecanismos estabelecidos para gerenciar as práticas relativas à criação e transferência do conhecimento. Nota-se, também, que o sistema de gestão de conhecimento nessas empresas se cria e desenvolve de maneira distinta da que ocorre em outras organizações. Portanto, buscou-se entender como as organizações KIBS gerenciam seu conhecimento, em especial a experiência (na forma de conhecimento tácito), investigando os mecanismos que se estabelecem para tal fim; e como a memória organizacional e os processos de socialização específicos são criados e desenvolvidos no interior dessas organizações, tendo como objetivo entender como os Sistemas de Gestão de Conhecimento evoluem através do relacionamento entre esses processos. A metodologia de pesquisa utilizada é qualitativa. Ela foi realizada por meio de um estudo de casos múltiplos em três empresas KIBS. Para tanto, um modelo teórico foi formulado e, posteriormente, avaliado na fase de pesquisa de campo. As observações finais demonstram que o papel dos especialistas dentro das empresas KIBS é fundamental para a evolução do seu Sistema de Gestão de Conhecimento e que os processos de socialização favorecem ou diminuem suas possibilidades de fornecer requisitos de desenvolvimento. / This paper focuses on the study of knowledge management at KIBS (Knowledge- Intensive Business Services), expert companies that provide services to other companies and organizations. IT and P&D service, technical consultancy, law consultancy, financial and management consultancy are all typical KIBS. Given the level of specialization of these firms, management knowledge may play an important part in the development of their activities, as well as the tools, and mechanisms established for managing practices related to the creation and transfer of knowledge. It was noticed in these firms that knowledge management systems (KMS) have been created and developed in a way different from that in other organizations. Consequently, there has been an effort to understand how KIBS firms manage their knowledge, basically expertise in the form of tacit knowledge, by looking into the mechanisms established for that purpose. Additionally, we intend to analyze the creation and development of organizational memory (OM) and particular socialization processes inside these organizations, so that we can learn how KMS evolve through the relationship of such processes. A qualitative research methodology was applied in this project. It was carried out by a multiple case study involving three different KIBS firms. In order to achieve that aim, a theoretic model was devised and forward assessed at the fieldwork stage. Our final observations have proved the essential role experts play inside KIBS firms for the progress of KMS. Likewise, it was found that socialization processes can either increase or reduce the possibilities of supplying development requirements.

Nothing has been that consistent as the change is for the knowledge revolution to nourish and cultivate. Different forms of changes are occurring in organizations with the aim to improve the output performances. Health organizations have been more attached to the changes and the consequences that are brought with such changes. Such consequences are primarily connected with concepts of unlearning and learning. Any form of the change if initiated in organization asks for new routines learning, tasks conductions and the organizational cultural revolution. These new routines have been occurring at individual and organizational levels. The unlearning at any level in the organizational culture can be performed through investigating a primary connection between the organizational and individual routines. At the individual level unlearning brings a number of psychological, cognitive, social and moral hurdles. These hurdles at individual level basically help the organizational unlearning to occur. All of the routines occurring at individual level encompass the necessary information that goes from lower levels to upward, strengthening and holding the organizational memory firm. This research was about to find how the health organizations unlearn the older practices and learn the new practices in IT change. This research had two streams i) finding whether there had been any connection between the organizational and individual unlearning in the cases of IT change, ii) For unlearning what kind of hurdles had been there at the individual level. Kalmar hospital pediatric department had been chosen for the empirical investigations. The research streams were about how and what parts which helped the researcher to go for the qualitative data gathering techniques. The Results showed there had been a very thin connectivity between the organizational and individual unlearning. The results revealed and unfolded that many of the new learning are occurring simultaneously with discarding the older ways of practices. The impression of absorbing the change with respect to the unlearning had been varied from person to person. There had been a numbers of individual hurdles observed at individual level of unlearning. Apart from them, many individual routines (performative tasks) had the primary connectivity with the organizational routines (Ostensive routines) and shaping and reshaping of the organizational memory. It is important to understand the unlearning notions with the type of change. In this research each of the interviewee had shared his thoughts of how the things could have been done differently by revealing the consequences with new learning. Literature suggests that for a profound and successful implementation of change more formal and informal trainings, clear strategy for shuffling the older individuals in the camp, more social and cognitive meetings and fast and quick actions in the cases of technical difficulties are to be taken. / Thesis

Nothing has been that consistent as the change is for the knowledge revolution to nourish and cultivate. Different forms of changes are occurring in organizations with the aim to improve the output performances. Health organizations have been more attached to the changes and the consequences that are brought with such changes. Such consequences are primarily connected with concepts of unlearning and learning. Any form of the change if initiated in organization asks for new routines learning, tasks conductions and the organizational cultural revolution. These new routines have been occurring at individual and organizational levels. The unlearning at any level in the organizational culture can be performed through investigating a primary connection between the organizational and individual routines. At the individual level unlearning brings a number of psychological, cognitive, social and moral hurdles. These hurdles at individual level basically help the organizational unlearning to occur. All of the routines occurring at individual level encompass the necessary information that goes from lower levels to upward, strengthening and holding the organizational memory firm. This research was about to find how the health organizations unlearn the older practices and learn the new practices in IT change. This research had two streams i) finding whether there had been any connection between the organizational and individual unlearning in the cases of IT change, ii) For unlearning what kind of hurdles had been there at the individual level. Kalmar hospital pediatric department had been chosen for the empirical investigations. The research streams were about how and what parts which helped the researcher to go for the qualitative data gathering techniques. The Results showed there had been a very thin connectivity between the organizational and individual unlearning. The results revealed and unfolded that many of the new learning are occurring simultaneously with discarding the older ways of practices. The impression of absorbing the change with respect to the unlearning had been varied from person to person. There had been a numbers of individual hurdles observed at individual level of unlearning. Apart from them, many individual routines (performative tasks) had the primary connectivity with the organizational routines (Ostensive routines) and shaping and reshaping of the organizational memory. It is important to understand the unlearning notions with the type of change. In this research each of the interviewee had shared his thoughts of how the things could have been done differently by revealing the consequences with new learning. Literature suggests that for a profound and successful implementation of change more formal and informal trainings, clear strategy for shuffling the older individuals in the camp, more social and cognitive meetings and fast and quick actions in the cases of technical difficulties are to be taken. / Thesis