The Implementation of Knowledge Management in Health and Social Care Organisations as Assessed by Managers: A Descriptive Cross‐Sectional Study

ABSTRACT

Purpose

To describe the implementation of knowledge management in health and social care organisations, as assessed by managers.

Design/Methodology/Approach

A descriptive cross‐sectional study was used. Data were collected from all eligible managers of six Finnish public health and social care organisations (N = 649) using an electronic version of the Managers' Competence in Knowledge Management (MCKM) instrument in February and August 2022. The data included responses from 116 managers and were analysed using descriptive statistical methods.

Findings

Almost half of the managers reported that their organisations did not allocate sufficient resources to knowledge management or systematically map and assess staff competence, even though knowledge development was mentioned in almost all of the organisations' strategies. The results indicated a statistically significant difference between the work area and the clear definition of responsibilities in knowledge management and the utilisation of data to assess staff competence. In addition, a statistically significant difference was observed in the health and social care sector and between organisations' allocation of sufficient resources to knowledge management, the clear definition of responsibilities in knowledge management, and the systematic mapping of staff competences. The most used staff competence development methods included student mentoring, discussions, and familiarisation, while the least used were peer evaluation and study circles.

Originality/Value

The results help identify weaknesses in the implementation of knowledge management, enabling more efficient resource allocation and competency development to improve organisational performance and ensure success.

1. Introduction

Health and social care organisations are complex systems where effective knowledge management can enhance productivity, resource use, and coordination [1, 2, 3]. Prior research indicates that knowledge management has a positive impact on management, patient care, quality, safety, staff satisfaction, and organisational culture [4, 5]. However, knowledge management is often inadequately implemented in public sector organisations, and empirical research, particularly from integrated welfare models such as Finland's, remains limited [5, 6]. This study addresses this gap by examining how knowledge management is implemented, based on responses from managers. It offers theoretical and practical insights into how knowledge management is implemented, its relationship with contextual factors, and the development of staff competence in health and social care organisations. The findings are expected to reveal key strengths and weaknesses, supporting more effective management and strategic knowledge management in complex public health and social care systems.

This study aims to describe the implementation of knowledge management in health and social care organisations, as assessed by managers. The study addresses three key questions: (1) How are the various aspects of knowledge management implemented in health and social care organisations? (2) How are background variables (area of work, health and social care setting) associated with the implementation of knowledge management in health and social care organisations? (3) What kinds of methods are used to develop staff competence in health and social care organisations?

2. Literature Review and Hypothesis Development

Theoretical and practical definitions of knowledge management are not well established and can be influenced by the specific study area in which they are applied [7]. Furthermore, this ambiguity is compounded by the challenging nature of the phenomenon itself [2, 8]. In the context of health and social care, KM is understood as a systematic and dynamic process that encompasses how organisations manage knowledge throughout their lifecycle [3]. It is typically seen as a combination of internal expertise and external standards [9], and its successful implementation depends on the alignment of core organisational elements such as people, infrastructure, and technology [10]. Organisational culture has been identified as a particularly influential factor in KM implementation, even more so than organisational structure [10]. Managers play a critical role in this process by acting as role models, promoting a modern approach to KM, valuing intellectual capital, and fostering a learning culture [1, 2].

In this study, knowledge management implementation is defined as a set of organisational activities aimed at addressing competence challenges in health and social care organisations [5, 6, 11, 12]. These activities include anticipation, definition, mapping, development, and assessment. The concept of anticipation refers to an organisation's ability to prepare for unforeseen events, forecast short‐ and long‐term competence needs, innovate, and envision future challenges [13, 14]. Competence definition involves identifying the competence required for various tasks within an organisation or unit [15]. The current state of competence mapping involves the systematic evaluation of employees' competence levels, typically carried out on an annual basis [13, 16]. Competence development refers to enabling staff to grow their skills through effective models and methods [13, 17], while competence assessment focuses on the organisation's ability to assess and demonstrate its expertise [13, 16]. Together, these dimensions shape the landscape of knowledge management in health and social care organisations.

Previous research has shown that knowledge management benefits both staff and organisations. For staff, it supports systematic development of competence and enhances well‐being [4]. For organisations, it contributes to workplace attractiveness and employee retention [2, 6]. However, knowledge management implementation is influenced by several factors, including organisational culture, information technology, leadership, structure, and performance evaluation [6, 10]. Barriers to implementation include rigid schedules, political decision‐making [7], unclear roles and processes [14], lack of support for staff training, insufficient funding [6], and limited competence in evidence‐based practice [3].

Maintaining high‐quality and efficient health and social care services requires continuous competence development in a rapidly changing environment. Managers should actively create opportunities for staff to enhance their skills [2]. Although managerial evaluations often highlight the difficulty of promoting behavioural change among staff [14], various strategies have proven effective, including training events, workshops, mentoring, role modelling, and meetings [3, 17]. Additionally, tools such as e‐learning modules, orientation programmes, and secondments have been identified as practical knowledge management methods in the health and social care organisations [9].

Although the importance of knowledge management in improving organisational performance has already been recognised [4], few studies have specifically addressed the effects of the implementation of knowledge management in health and social care organisations. It is difficult to distinguish these effects from other management functions studied in the context of health and social care [5]. One reason for this is that knowledge management remains an unfamiliar management model in the health and social care context [9]. In addition, it is challenging to conduct research comparing different health and social care units and organisations because each facility possesses unique characteristics and goals [3, 8] (Karamitri et al. 2017).

3. Methods

3.1. Design

This study had a descriptive cross‐sectional design [18], and its reporting adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE: Data S1) checklist to bolster the reporting of observations [19].

3.2. Survey Description

The data for this study were collected using the Managers' Competence in Knowledge Management (MCKM) instrument, which consists of 15 background questions and 43 items designed to assess the competence of health and social care managers in knowledge management [20]. The 15 background questions include 12 questions related to the sociodemographic characteristics of managers, of which six were presented in this study. In addition, three of the 15 questions were dedicated to exploring the implementation of knowledge management in organisations.

We present findings based on six questions on demographic characteristics, including age, working experience in health and social care management positions, gender, highest education level, area of work, and the health and social care setting. In addition, questions pertaining to the implementation of knowledge management are discussed. Managers were asked to rate the implementation of knowledge management in health and social care organisations using response options such as ‘yes’, ‘no’, or ‘can't say’. The assessment involved rating 11 statements, the first five of which assessed the implementation of knowledge management in organisational aspects, while the remaining six assessed aspects related to staff. Furthermore, managers provided evaluations of the methods employed by health and social care organisations for the competence development of their staff. It is noteworthy that all background questions in the instrument were meticulously developed by a collaborative research group. This research group consisted of instrument development specialists, nursing and rehabilitation professionals, management experts, and experienced management educators.

3.3. Samples and Participants

The data were collected from six public health and social care organisations in Finland. These included one public university hospital offering specialised medical care, two public primary health and social care organisations, and three hospital districts. In Finland, these public organisations play a crucial role in providing essential public health and social care to the residents of their respective areas. The range of services typically includes medically and dentally justified disease prevention, disease diagnosis tasks, examinations, treatment, and rehabilitation [21].

Convenience sampling was used to select the organisations [18]. The inclusion criteria encompassed all eligible managers at all levels, including first‐line, middle, and top managers, with roles in social, health, and rehabilitation units or organisations. Conversely, managers with roles in information management, technical services, logistics, and environmental health care were excluded from the study. Nurses were the largest professional group in these organisations.

3.4. Data Collection

The data were collected electronically using Webropol software over two periods. Initially, in February 2022, the designated contact persons of the organisations sent emails to all 235 eligible managers working in one public university hospital and two public primary health and social care organisations. Due to the low response rate (18%, n = 42), the data collection was expanded, and in August 2022, the organisations' contact persons sent emails to all 414 eligible managers working in three public hospital districts. During the second period, 74 managers responded to the survey, resulting in a response rate of 18%.

Overall, the survey achieved a response rate of 18% (N = 649, n = 116) over a four‐week data collection period. Managers were given access to an anonymous survey, with a reminder email sent 2 weeks later to encourage participation. The decision to use an online survey was driven by its cost‐effectiveness and potential efficiency compared to paper surveys [22].

3.5. Data Analysis

The data collected from different organisations was combined and checked. There were no missing data because all questions were mandatory for the respondents. The data were analysed using descriptive statistical methods and IBM SPSS software (version 27.0; IBM, Armonk, NY, USA).

Participant characteristics were analysed using minimum and maximum values, means, and standard deviations. Background variables are described as percentages and frequency distributions. Associations were assessed using the chi‐squared test and the Fisher's exact test. Managers' responses regarding the use of staff competence development methods in organisations are described using percentages and frequencies. Statistically, a p‐value of < 0.05 was considered the threshold of significance [18].

3.6. Ethical Considerations

The entire research process adhered to Finnish research integrity guidelines [23]. Permission for the study was obtained from the six participating organisations and did not require ethics committee approval due to its nature, since it did not involve minors, direct or indirect physical or physiological harm to the participants, or clinical trials (Medical Research Act 488/1999, [24]). The use of the MCKM instrument did not require permission because the research group had previously developed it. Participants were informed via email, participation was voluntary, and informed consent was implied by completing questionnaires. No personally identifiable information was collected, and the data were securely stored. Individual respondents were kept anonymous in accordance with TENK guidelines. The study also adhered to European Union data protection laws, including the General Data Protection Regulation 2016/679, during data collection and processing.

4. Results

4.1. Characteristics of Managers

Most of the participants were female (83%). On average, the respondents were aged 50.2 years and had 11.9 years of work experience in management positions. Of the participants, 61% held a master's degree, and 35% held a bachelor's degree. Nearly all managers worked in either the health care area (70%) or the social care area (21%), and the remaining 9% worked in various other roles, such as support services and rehabilitation services. In addition, 90% were employed in public primary health and social care or public specialised medical care (Table 1).

TABLE 1.

Participants' characteristics (n = 116).

Characteristics	Min	Max	Mean	SD
Age (years)	31	65	50.2	8.8
Working experience in health and social care management position (years)	0.4	41.7	11.9	9.2
			n	%
Gender
Female			96	83
Male			19	16
Other			1	1
Highest education level
Doctoral degree			5	4
Master's degree			70	61
Bachelor's degree			41	35
Area of work
Health care			81	70
Social care			25	21
Other (e.g., support service, rehabilitation services)			10	9
Health and social care setting
Public primary health and social care (e.g., health clinic)			49	42
Public specialised medical care (e.g., university hospital)			55	48
Other (e.g., prehospital care, disability services)			12	10

4.2. The Implementation of Various Aspects of Knowledge Management in Health and Social Care Organisations

Nearly half of the managers (49%) felt that their organisations were not allocating sufficient resources for knowledge management. However, almost all (97%) reported that their organisation's strategy mentioned organisational competence development, and 77% reported that their top management supported the development of organisational competence. Additionally, a substantial portion of managers (45%) stated that their organisation did not systematically map the current state of staff competence or utilise statistical data to assess it. One in five managers (20%) did not say whether the competence of staff had been defined, and almost the same number (19%) could not say whether the competence of managers in knowledge management was systematically developed (Table 2).

TABLE 2.

The implementation of various aspects of knowledge management in health and social care organisations, as assessed by managers (n = 116).

	In my organisation	Yes	No	Can't say
		% (n)	% (n)	% (n)
Organisations aspect	Sufficient resources have been allocated for knowledge management in organisations.	40 (46)	49 (57)	11 (13)
	The development of organisation competence is mentioned in the strategy.	97 (113)	2 (2)	1 (1)
	Top managers support the development of organisation competence.	77 (89)	7 (10)	15 (17)
	The responsibilities related to knowledge management are clearly defined.	45 (50)	40 (46)	17 (20)
	Managers' competence in knowledge management is systematically developed.	45 (52)	39 (45)	19 (19)
Staff aspect	Anticipation of staff competence is done in a planned manner.	58 (67)	31 (36)	11 (13)
	The competence of the staff is defined.	52 (60)	28 (33)	20 (23)
	The current state of staff competence is systematically mapped.	40 (47)	45 (52)	15 (17)
	Staff competence is developed in a planned manner.	65 (75)	25 (29)	10 (12)
	Various methods are used to develop the competence of staff.	54 (63)	30 (35)	16 (18)
	Various statistical data are utilised to assess the competence of staff.	39 (43)	45 (54)	18 (21)

4.3. The Association Between Background Variables (Area of Work, Health, and Social Care Setting) and the Implementation of Knowledge Management

Statistically significant differences were found between the area of work and health and social care setting background variables and allocating sufficient resources for knowledge management, clearly defining responsibilities, mapping the current state of competence, and using statistical data for competence assessment. Sufficient resources were allocated to knowledge management in public primary health and social care organisations (39%) compared to public specialised medical care (35%). In the social care sector, 60% of organisations were inclined to have clearly defined staff responsibilities in knowledge management—a notably higher percentage than in the health care sector, where it is only 40%. A similar pattern emerged when comparing public primary health and social care, where 51% exhibited this characteristic, with public specialised medical care, which stood at 35%. Furthermore, public specialised medical care demonstrated a stronger tendency (47%) to systematically map the current state of staff competence than primary health and social care, where only 31% followed this practice. Additionally, the use of statistical data for staff competence evaluation was more common in social care (40%) than in health care (33%) (Table 3).

TABLE 3.

The association between background variables (area of work, health and social care setting) and the implementation of knowledge management (n = 116).

In my organisation		Total	Yes	No	Can't say	p
		n	% (n)	% (n)	% (n)
Organisations aspect
Sufficient resources have been allocated for knowledge management in organisation.
Area of work	Health care	81	33 (27)	56 (45)	11 (9)
	Social care	25	48 (12)	35 (9)	16 (4)	0.113 a
Health and social care setting	Public primary health and social care	49	39 (19)	47 (23)	14 (7)
	Public specialised medical care	55	35 (19)	58 (32)	7 (4)	0.048 a
The development of organisation competence is mentioned in the strategy.
Area of work	Health care	81	96 (78)	3 (2)	1 (1)	1.00 b
	Social care	25	100 (25)	0 (0)	0 (0)
Health and social care setting	Public primary health and social care	49	96 (47)	2 (1)	2 (1)
	Public specialised medical care	55	98 (54)	2 (1)	2 (1)	0.734 b
Top managers support the development of organisation competence.
Area of work	Health care	81	73 (59)	11 (9)	16 (13)
	Social care	25	76 (21)	0 (0)	16 (4)	0.252 b
Health and social care setting	Public primary health and social care	49	80 (39)	6 (3)	14 (7)
	Public specialised medical care	55	73 (40)	13 (7)	14 (8)	0.534 a
The responsibilities related to knowledge management are clearly defined.
Area of work	Health care	81	40 (32)	46 (37)	15 (12)
	Social care	25	60 (15)	16 (4)	24 (6)	0.030 a
Health and social care setting	Public primary health and social care	49	51 (25)	27 (13)	22 (11)
	Public specialised medical care	55	35 (19)	54 (30)	11 (6)	0.012 a
Managers' competence in knowledge management is systematically developed.
Area of work	Health care	81	42 (34)	42 (34)	26 (13)
	Social care	25	56 (14)	24 (4)	20 (5)	0.287 a
Health and social care setting	Public primary health and social care	49	43 (12)	39 (19)	18 (9)
	Public specialised medical care	55	44 (24)	46 (25)	11 (6)	0.575 a
Staff aspect
Anticipation of staff competence is done in a planned manner.
Area of work	Health care	81	52 (42)	36 (29)	12 (10)
	Social care	25	76 (19)	16 (4)	8 (2)	0.112 a
Health and social care setting	Public primary health and social care	49	51 (25)	35 (17)	14 (7)
	Public specialised medical care	55	58 (32)	33 (18)	9 (5)	0.645 a
The competence of the staff is defined.
Area of work	Health care	81	48 (39)	32 (26)	20 (16)
	Social care	25	52 (13)	20 (5)	28 (7)	0.446 a
Health and social care setting	Public primary health and social care	49	55 (27)	29 (14)	16 (8)
	Public specialised medical care	55	49 (27)	33 (18)	18 (10)	0.834
The current state of the staff competence is systematically mapped.
Area of work	Health care	81	37 (30)	50 (49)	24 (11)
	Social care	25	44 (11)	36 (9)	20 (5)	0.476 a
Health and social care setting	Public primary health and social care	49	31 (15)	49 (24)	20 (10)
	Public specialised medical care	55	47 (26)	47 (26)	6 (3)	0.043 a
Staff competence is developed in a planned manner.
Area of work	Health care	81	62 (50)	31 (25)	7 (6)
	Social care	25	86 (17)	12 (3)	20 (5)	0.068 a
Health and social care setting	Public primary health and social care	49	61 (30)	27 (13)	12 (6)
	Public specialised medical care	55	69 (38)	27 (15)	4 (2)	0.305 b
Various methods are used to develop the competence of the staff.
Area of work	Health care	81	52 (42)	34 (28)	14 (11)
	Social care	25	50 (15)	20 (5)	20 (5)	0.357 a
Health and social care setting	Public primary health and social care	49	47 (23)	29 (14)	25 (12)
	Public specialised medical care	55	56 (31)	35 (19)	9 (5)	0.124 a
Various statistical data are utilised to assess the competence of the staff.
Area of work	Health care	81	33 (27)	52 (42)	15 (12)
	Social care	25	40 (10)	24 (6)	36 (9)	0.020 a
Health and social care setting	Public primary health and social care	49	35 (17)	45 (22)	20 (10)
	Public specialised medical care	55	36 (20)	53 (29)	11 (6)	0.429 a

Note: Bold values denote statistical significance at the p < 0.05 level.

^a Chi–square test.

^b Ficher's exact test.

4.4. The Use of Staff Competence Development Methods in Health and Social Care Organisations

According to the managers, the most frequently used methods for developing staff competence in health and social care organisations, with usage rates of up to 90%, were student mentoring, development discussion, familiarisation, work substitution, teamwork, continuing education, and projects. In contrast, peer evaluation was the least used method, at 25%, followed by study circles, which were employed by only 11% of the respondents. More than one in five managers did not know if their organisations used peer evaluation (25%) or study circles (22%) to develop staff competence (Table 4).

TABLE 4.

The use of staff competence development methods in health and social care organisations, as assessed by managers (n = 116).

Competence development methods	Yes	No	Can't say
	% (n)	% (n)	% (n)
Student mentoring	99 (115)	1 (1)	0 (0)
Development discussion	99 (115)	0 (0)	1 (1)
Familiarisation	98 (114)	1 (1)	1 (1)
Work substitution	91 (105)	4 (5)	4 (5)
Teamwork	91 (105)	4 (5)	5 (6)
Continuing education	91 (105)	7 (8)	3 (3)
Projects	90 (104)	8 (8)	2 (3)
Work rotation	83 (97)	14 (16)	3 (3)
Special work	78 (91)	9 (10)	13 (15)
Pair work	71 (82)	16 (19)	13 (15)
Guided visits	66 (76)	24 (28)	10 (12)
Mentoring	65 (75)	28 (33)	7 (8)
Conferences and seminars	63 (73)	24 (28)	13 (15)
Peer learning	62 (72)	22 (26)	16 (18)
Competence survey	54 (63)	34 (39)	12 (14)
Degree‐oriented education	51 (59)	32 (37)	17 (20)
Peer evaluation	25 (29)	63 (61)	25 (26)
Study circle	11 (13)	67 (78)	22 (25)

5. Discussion

In this study, we analysed findings from 116 managers working at different management levels in six public health and social care organisations to describe the implementation of knowledge management. Almost half of the managers mentioned that their organisations did not allocate sufficient resources to knowledge management. These findings are consistent with previous research, suggesting that, from the managers' perspective, the scarcity of time, human, and financial resources has been a significant obstacle to effective knowledge management [6, 25]. Furthermore, as assessed by the managers, more resources are allocated for knowledge management in public primary health and social care compared to specialised medical care. This result is concerning because, as Ayatollahi and Zeraatkar [10] found in their study, hospitals' resource support, together with colleagues' attitudes and users' participation, significantly impacts professionals' willingness to utilise knowledge management in a hospital unit.

Knowledge management was mentioned in the strategies of almost all organisations, as reported by the managers. This finding contrasts with earlier research, which has indicated that the absence of strategic guidelines and the lack of clarity regarding roles and responsibilities in knowledge management have hindered effective implementation [25]. However, it is in line with Ikonen [7] study, which found that knowledge management was often a widely echoed mantra across organisations despite the lack of a shared and well‐defined understanding of its meaning. Moreover, it is advisable for organisations to systematically incorporate various elements into their knowledge management strategies [10], especially in primary care [11]. This includes implementing simple mechanisms, such as training programmes and seminar series, as methods for competence development; using technology; using frameworks or process‐based models (including concept mapping); and engaging communities of practice to capture and share knowledge [10, 12].

One notable finding of our study is that almost three out of four managers reported receiving active support from top managers in developing organisational competence. This finding is consistent with previous studies highlighting the critical importance of top managers actively supporting middle‐ and first‐line managers in their leadership roles [6, 9]. Therefore, it is essential for organisations to recruit top managers with the right personalities and competence to establish a participative and supportive leadership style [1]. Consequently, recruiting individuals with the right qualifications for top management positions can act as a catalyst for the effective implementation of knowledge management in health and social care organisations.

A significant portion of respondents reported that the responsibilities related to knowledge management are clearly defined within their organisations. The result contradicts previous research, which found that the lack of defined roles and unrealistic job expectations in knowledge management hinders managers' work [14, 25]. Additionally, the results show that the area of work and the health and social care setting are associated with clearly defined knowledge management responsibilities. Notably, responsibilities are better defined in social care than in health care, and they are also better defined in primary health and social care than in specialised care. A clear definition of these responsibilities stands as a critical factor for the successful implementation of knowledge management, as it necessitates managers to engage in long‐term planning, continuous monitoring, and robust support [10].

Our results show conflicting views on how managers' knowledge management competence was systematically developed. A large proportion of respondents believed that managers' knowledge management competence was systematically developed, while another large group held a contrary view. Previous studies have suggested that managers' knowledge management competence can be identified through their solid foundation in degree and can be maintained and nurtured through continuous training and guidance [6]. However, our findings provide a more positive outlook compared to the study by Miltner et al. [14], in which none of the 20 hospital managers from the US reported receiving adequate management development opportunities. Furthermore, in this study, one in five respondents answered ‘can't say’ when asked if knowledge management competence was systematically developed. This suggests potential issues with the definition of knowledge management. Organisations need to ensure that their employees understand knowledge management in the same way and, therefore, understand the efforts being made to develop managers' competence in this area.

Our findings underscore that only slightly more than half of managers reported that their organisations anticipated and defined staff competence. In addition, one in five assessed that they ‘can't say’ whether staff competence was defined. This aligns with one previous study in which a few managers discussed proactive management strategies to enhance unit performance [14]. On the other hand, our number is higher compared to Lunden et al.'s [13] study, in which only 30% of nurses reported that their managers anticipated their competence. The weak anticipation and definition of competence can be influenced, for example, by the perception among managers that they often lack agile knowledge management tools [9]. Therefore, in the future, organisations should provide tools, structures, processes, methods, and information systems for managing competence, which can streamline the entire process [17].

We found that competence mapping was more systematic in specialised medical care than in primary health and social care. In addition, managers estimated that only one in three organisations used statistical data to assess staff competence and that assessments were less common in health care than in social care. According to previous studies, assessing staff performance is one of the most important success factors for knowledge management in health and social care organisations [9, 10]. This is because it enables organisations to better understand the competency strengths and weaknesses of their staff [4] and, consequently, allows them to provide additional support only to those staff who need it to ensure the required competency [16]. Despite this importance, less than half of the managers reported that their organisation mapped the current state of staff competence. This finding supports the previous observation that managers only minimally address nurses' inadequate qualifications [13]. The results therefore suggest that there is a clear skills gap and that by investing in mapping and assessing competence, organisations can make their knowledge management more effective.

We found that competence mapping takes place more systematically in specialised medical care than in primary health and social care. Additionally, only one out of three organisations utilised statistical data to assess staff competence, and assessments were less frequent in health care than in social care. A previous study identified the assessment of staff performance as one of the most important success factors in knowledge management within health and social care organisations [9, 10]. This is because it enables organisations to gain a better understanding of their staff's competence strengths and weaknesses [4], consequently allowing them to allocate additional support only to staff who need it to ensure the necessary competence [16]. Despite this importance, less than half of the managers stated that their organisations mapped the current state of staff competence. This outcome aligns with prior findings indicating that managers only minimally address nurses' inadequate qualifications [13]. Based on the results, it can be recognised that a clear skill gap has been identified, and thus, there is the possibility that by investing in mapping and evaluation of competence, organisations can make their knowledge management more efficient.

Based on our results, two out of three managers confirmed that staff competence development was planned systematically. This finding contradicts previous research, which has highlighted that systematic and goal‐oriented competence development within organisations is often limited [26], even though systematic competence development among staff in health and social care organisations is critical to the success of the knowledge management process [10].

In our study, only half of the participants mentioned using different methods for competence development. The most frequently used methods for developing staff competence were student mentoring, development discussions, and orientation, which were implemented in almost all organisations. In contrast, peer evaluations and study circles were the least favoured methods, according to the managers. Notably, all 18 competence development methods examined were used in at least some health and social care organisations. Similar findings have been reported in previous research, which emphasises that a diverse range of methods is crucial for an organisation's learning capacity and ongoing development [27]. For instance, Karamitri et al. (2017) showed that adopting teamwork methods can enhance organisational performance, while Kosklin et al. [5] highlighted the importance of education and training as fundamental drivers of sustainable growth in healthcare.

6. Limitations

This study has several limitations. First, convenience sampling may limit the generalisability of the results because private sector organisations, for example, were omitted from the research. Although the results provide valuable insights into the implementation of knowledge management, caution is advised in generalising them. Second, the data collection coincided with staff strikes and Finland's largest health and social care reform, potentially affecting managers' participation and response rate (18%). Despite this, the adequacy of the sample size supports the validity of the analyses and the generalisability of the study findings. The suitability of the sample is supported by the fact that the respondents were managers directly involved in the relevant health and social care organisations, ensuring that the data appropriately reflect the study context. Third, the results rely on inherently subjective self‐assessments. Self‐reported answers may be influenced by social desirability bias [28]. Fourth, the survey participants may have been particularly interested in the implementation of knowledge management. In contrast, managers who were not interested in this or whose work did not include the implementation of knowledge management may not have responded to the survey. Lastly, the study's focus on Finnish public health and social care managers may limit the study's geographic and cultural scope.

7. Further Research

In the future, it would be useful to conduct a more comprehensive knowledge management study that compares the differences in knowledge management implementation across various health and social care systems and settings. In addition, it is important to consider that case or qualitative studies, for example, could provide important insights into effective practices and methods for developing organisational knowledge management. Gathering feedback from health and social care staff on their experiences of implementing knowledge management in different health and social care settings is also crucial, as is understanding their expectations and aspirations. It is also important to conduct longitudinal studies of knowledge management, which have greater evidential value than cross‐sectional studies and intervention studies, which offer the possibility of generating information on the effectiveness of interventions in developing managers' knowledge management competence.

8. Conclusion

There is variability in the implementation of knowledge management within health and social care organisations, and optimal execution is not consistent across them. Despite the inclusion of knowledge management in organisational strategies and top management's support for staff competence development in many organisations, the allocation of resources for its implementation falls short. Moreover, in primary health and social care, resources and responsibilities are likelier to be adequately provided through knowledge management than in specialised medical care. However, when systematically mapping staff competence, the trend is reversed. Additionally, social care organisations tend to define responsibilities and use statistical data in staff competence assessments more than their counterparts in health care.

In terms of competence development, health and social care organisations often use methods such as student mentoring, development discussions, and familiarisation. However, peer evaluation and study circles are less commonly employed. In the future, health and social care organisations should engage in more discussions about knowledge management. This would facilitate the creation of a shared common understanding and strategic alignment of knowledge management within organisations. Additionally, standardising knowledge management practices and processes through these discussions could contribute to making operations more efficient in health and social care organisations.

9. Implications for Practice

For health and social care organisations, it is important to identify the status of the organisation's knowledge management, including its weaknesses and strengths, and to pinpoint areas for development. This facilitates meaningful discussions when exploring the potential of organisations to manage knowledge and competence effectively. It is crucial for organisations in the future to develop effective and structured models, methods, and practices that foster and systematise the implementation of knowledge management. Organisations should also share information and knowledge with stakeholders and, together with them, develop knowledge management processes in their operational area. The results of this study can be utilised to develop these models, methods, and practices.

In addition, managers should allocate more resources to the implementation of knowledge management, with a specific focus on systematically mapping the current state of staff competence and utilising statistical data to assess staff competence. Top managers should systematically ensure that first‐line managers are acquainted with a variety of staff competence development methods. This prerequisite would enable first‐line managers to choose practical and tailored staff competence development methods from a broad pool for each specific situation.

Author Contributions

E.K., M.M., K.K., A.‐M.T. and O.K.: made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; involved in drafting the manuscript or revising it critically for important intellectual content; given final approval of the version to be published. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content; agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Ethics Statement

An ethics committee statement was not required, according to Finnish legislation, as the research did not involve minors, cause direct or indirect physical or physiological harm to the participants, or entail clinical trials (Medical Research Act 488/1999).

Consent

By completing the questionnaires, managers were considered to have provided informed consent.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Data S1: scs70122‐sup‐0001‐DataS1.doc.

Karsikas E., Meriläinen M., Koivunen K., Tuomikoski A.‐M., and Kanste O., “The Implementation of Knowledge Management in Health and Social Care Organisations as Assessed by Managers: A Descriptive Cross‐Sectional Study,” Scandinavian Journal of Caring Sciences 39, no. 3 (2025): e70122, 10.1111/scs.70122.

Data Availability Statement

Research data are not shared.