The influence of HR practices upon knowledge brokering in professional organizations for service improvement: Addressing professional legitimacy and identity in health care

• Author: Dimitrios Spyridonidis,Graeme Currie,Eivor Oborn
• Published date: 01 July 2020
• DOI: http://doi.org/10.1002/hrm.22001
• Date: 01 July 2020

ORIGINAL ARTICLE

The influence of HR practices upon knowledge brokering

in professional organizations for service improvement:

Addressing professional legitimacy and identity in health care

Graeme Currie | Dimitrios Spyridonidis | Eivor Oborn

Warwick Business School, University of

Warwick, Coventry, UK

Correspondence

Graeme Currie, Warwick Business School,

University of Warwick, Coventry CV4 7AL,

UK.

Email: graeme.currie@wbs.ac.uk

Abstract

Drawing upon sociology of professions, our study extends insight into the specific

HR practices that shape the microdynamics of knowledge-sharing behaviors among

professionals. Empirically, we examine the influence of Human Resource

(HR) practices on enactment of a knowledge-brokering role by doctors to drive ser-

vice improvement in health care. Our study shows, first, HR practices influence pro-

fessional identity, which is predicated on jurisdictional autonomy and client interest.

Second, HR practices influence the legitimacy of any role and associated activities,

with professionals valuing collegial leadership and evidence-based practice. Our

study highlights it is employee perceptions of the effect of HR practices upon their

legitimacy and identity that shape their attitudes and behavior toward knowledge

sharing. Thus, different HR practices have different effects on knowledge sharing.

Further, the same HR practice may be perceived differently even within the same

cadre of professionals, depending upon their relative status and career interests.

1|INTRODUCTION

Within professional organizations, there is a global drive toward

evidence-basedservice improvement (Dopson& Fitzgerald, 2005). This

is particularlyprevalent in health care, where there is a so-called“trans-

lational gap”between “what we know and what we do”:thatis,

between what researchstudies generate in the form of evidence about

clinical effectiveness and what frontline professionals deliver in clinical

practice (Currie, El Enany, & Lockett, 2014). For example, research evi-

dence may extolthe benefit for patients of early intervention preventa-

tive services delivered in the community for chronic obstructive

pulmonary disorder, but clinical service may remain hospital-based,

delivered in responsive mode when the patient is acutely ill (Currie &

Spyridonidis,2019). A panacea for the translationalgap in health care is

the introduction of “knowledge brokers”drawn from the ranks of clini-

cal practitioners, defined as those “who get the right knowledge, into

the right hands, at the right time”(Bartunek, 2007; Currie & White,

2012; Hargadon,2002; Verona, Prandelli, & Sawhney, 2006). To ensure

service improvement, clinical practitioners broker knowledge into

researchers' co mmunities to ens ure contextual k nowledge about p rac-

tice informs the development of the research, but also broker knowl-

edge from research to practice to ensure its impact (Barrett & Oborn,

2018). However,the panacea of knowledge brokering has not delivered

on its promise. Commentators highlightlack of attention to the profes-

sionalized context of health care (Baker et al., 2009; Currie & White,

2012; Dobbins et al., 2009), and note the hybrid character of the

knowledge brokering role that crosses managerial and professional

domains may render it unattractive to clinicians (Currie, Burgess, &

Hayton, 2015). Nonetheless, scholars suggest HR practices may have a

significant part to play to ensure knowledge brokering delivers service

improvementin health care (Rycroft-Malone & Bucknall, 2011).

The suggestion from those researching knowledge brokering in the

health care context to examine the HR challenges chimes with more

generic interest in the influence of HR policies and practices upon knowl-

edge sharing (Collins & Clark, 2003; Foss, Minbaeva, Pedersen, &

Reinholt, 2009; Kang, Morris, & Snell, 2007; Kang, Snell, & Swart, 2012;

Krausert, 2014; Minbaeva, Foss, & Snell, 2009; Sung & Choi, 2018).

Knowledge sharing behaviors require individual networking and

DOI: 10.1002/hrm.22001

Hum Resour Manage. 2020;59:379–395. wileyonlinelibrary.com/journal/hrm © 2019 Wiley Periodicals, Inc. 379

relationship building behaviors, upon which HR practices can have a posi-

tive effect (Collins & Clark, 2003; Lepak, 1999; Prieto & Pilar Pérez San-

tana, 2012; Yan, Marie Francesco, Zhang, & Chen, 2013). However,

within extant literature, first there is an absence of studies about how

HR practices, such as performance management, training and develop-

ment, job design, and shape knowledge brokering specifically. Compared

with the more general phenomenon of knowledge sharing, around which

homophilic actors interact, commonly, knowledge brokers work in a more

purposeful and strategic way across heterogeneous domains and dispa-

rate actors (Currie & White, 2012; Fernandez & Gould, 1994; Verona

et al., 2006). Second, professional organizations represent a distinctive

context, within which professionals are concerned about the legitimacy

of knowledge brokering roles and whether a knowledge brokering role

aligns with preexisting identity (Currie et al., 2015). Yet few studies con-

sider this distinctive context to examine how HR practices support

knowledge brokering (Kang et al., 2012). With these two research gaps in

mind, our study seeks to answer the research question: How do HR prac-

tices address concerns about professional legitimacy and identity to influ-

ence knowledge brokering in professional organizations for service

improvement?

Our empirical example is the National Health Service in England,

within which we consider how a regional R&D unit (“Metro”) engages and

supports doctors to act as knowledge brokers to drive evidence-based

service improvement. There is growing interest in Human Resource Man-

agement (HRM) within health care contexts, as evidenced by a special

issue of Human Resource Management (Cooke & Bartram, 2015). Thus far,

however, analysis of the health care context has remained at the empirical

level. There has been little theoretical analysis derived from a more socio-

logical perspective that focuses upon professional organization and its

underpinning dimensions relating to legitimacy and identity (Abbott,

1988; Freidson, 1988). Then, there are calls for HRM scholars to engage

more deeply with issues of professional organization and identity in health

care settings (Kessler, Heron, & Dopson, 2015). Our longitudinal study,

carried out over 5 years, addresses such a call, and encompasses 139

semistructured interviews with the Metro leadership team and doctors

enacting a knowledge brokering role, complemented by 56 hr of observa-

tion of educational workshops in which our interviewees participated.

Foreshadowing our theoretical contribution, our study provides

much needed sociological insight into how HR practices influence under-

pinning dimensions of professional organization, specifically professional

legitimacy and identity, so that those professionals entrusted with the

hybrid role of knowledge brokering for evidence-based service improve-

ment, enact the role effectively. In so doing our study makes a more spe-

cific contribution to HRM in health care organizations, associated with

which are lessons for HR managers concerning HR practices around per-

formance management, job design, training, and development.

2|HUMAN RESOURCE PRACTICES AND

KNOWLEDGE BROKERING

The HRM literature considers “knowledge sharing”more generally,

rather than knowledge brokering specifically, although its empirical

interrogation of how HR policies and practices support knowledge

sharing can be applied to knowledge brokering. There are frequent

overlaps in the literature between HR policies and HR practices. HR

policies frame the enactment of HR practices on the ground; for

example, Delery and Doty's (1996) definition of HR practices as a set

of internally consistent policies and practices designed and

implemented to ensure that a firm's human capital contribute to the

achievement of business objectives. Our specific concern, however,

lies with HR practices, that is a set of practices used by the organiza-

tion to manage human resources through facilitating the development

of competencies that are firm-specific, produce complex social rela-

tions, and generate organizational knowledge to sustain competitive

advantage (Minbaeva, 2005). We focus upon HR practices

implemented at the local level, as perceived by employees and that

directly affect their attitudes and behaviors. In this light, we recognize

different practices may be perceived in different ways by employees

(Bos-Nehles & Veenendaal, 2017; Kehoe & Wright, 2013).

In considering HR practices, the focus of HRM study has been on

an individual level of analysis, notably on how to enhance motivation

of individuals for knowledge sharing (Foss et al., 2009;Gagné, 2009 ;

Minbaeva et al., 2009), specifically the role of training and develop-

ment, performance management, reward, and job design (Gagné,

2009; Minbaeva et al., 2009). First, employee motivation for knowl-

edge sharing can be enhanced through training (Kang et al., 2007;

Minbaeva et al., 2009; Patel, Messersmith, & Lepak, 2013; Prieto &

Pilar Pérez Santana, 2012; Youndt, Subramaniam, & Snell, 2004). Sec-

ond, HR practices can reward knowledge sharing, not so much

through extrinsic incentives for so doing (Espedal, Gooderham, &

Stensaker, 2013; Kang et al., 2007, 2012; Lepak, 1999; Minbaeva

et al., 2009; Minbaeva, Pedersen, Björkman, Fey, & Park, 2003; Yan

et al., 2013), but where the incentive is intrinsic, derived from per-

sonal values and norms (Foss et al., 2009; Gagné & Deci, 2005). Third,

HR practices in the domain of job design engender opportunity for

knowledge sharing (Foss et al., 2009; Gagné, 2009).

Individuals are likely to share knowledge more easily within their

peer group rather than across professional groups (Bednall & Sanders,

2016). However, knowledge sharing represents a double-edged

sword. On the one hand, it may be valued by the organization and

enhance individual status and career opportunities, particularly where

members of a collective share the belief that it is safe to do so

(Edmondson, 1999). On the other hand, knowledge sharing may ren-

der employees vulnerable in a competitive labor market (Yang, van

Rijn, & Sanders, 2018).

Some HRM studies have moved beyond the individual level anal-

ysis, toward greater consideration of the group level (Kase, Paauwe, &

Zupan, 2009; Minbaeva et al., 2009). HR practices in the areas of job

design (Kang et al., 2007; Kase et al., 2009; Minbaeva et al., 2009) and

training and development (Kase et al., 2009) are significant in their

effect upon development of social networks, specifically in knowledge

intensive firms (Kase et al., 2009). Where training and development

encompasses a diverse range of actors, HR practices encourage devel-

opment of social capital and accompanying collaborative behaviors

and actions that support knowledge sharing across boundaries,

380 CURRIE ET AL.