Rumizen's book1 bills itself on the premise that knowledge management (KM) is an important field fundamental for success in the new economy. In a digital world with rapidly expanding knowledge requirements, what people know and how they use what they know are key to patient care quality, safety, and competitive advantage. Rumizen's catchy book title should not imply any dilution of the book's substance; rather the title suggests the author's talent at cutting through the complex lingo that litters the KM field. In fact, if one types "knowledge management" into a Web-based search engine such as Google, the term KM would yield 316,000,000 hits. A comparable search in Amazon.com would yield 1,373 books. In the crowded field of KM resources, Rumizen's book stands out for its simplicity and the author's ability to relate KM concepts to practice in different industries. Using her years of experience as an expert KM practitioner combined with her scholarly credentials, Rumizen has produced a KM user-friendly text that can serve as a primer for nurse leaders new to the KM field.

Overview

Rumizen's book is written in 6 parts and is sequenced in a logical order. Each part is titled using a catchy name that draws the reader into each content section. Within each part are various chapters, each beginning with an overview of the content to be presented and ending with a clearly delineated section labeled "the least you need to know" about the topic just presented. Keeping with the theme of using creative and unusual titles, the author includes the equivalent of computer screen "pop-ups" using light bulb images throughout each chapter. These light bulbs are positioned strategically to reinforce content and appear labeled in 4 ways: know these, know nos, know how, and didn't know. The know these light bulbs represent a reiteration of a definition the reader should know. Know nos instruct readers on things not to do. Know how light bulbs expand upon the author's lessons learned regarding the topic. Didn't know represent trivia points meant to inform the reader of interesting literature, history, or facts related to the topic in the chapter. The didn't know light bulbs also work to captivate readers and keep them reading.

Exploring the Oxymoron

Part 1, "Exploring the Oxymoron," provides a definition of KM as the systematic processes by which knowledge needed for an organization to succeed is created, captured, shared, and leveraged. Knowledge, the most important asset in organizations today, is emphasized. Early on, the concept of communities of practice (COP) is presented as an essential component of KM. The importance of knowledge workers as "minds, not hands" is emphasized with KM presented within the context of learning organizations and as the vehicle to engage employees for long-term career development and sustained organizational success. Part 1 also includes an in-depth discussion of the chief knowledge officer (CKO), a role determined to be a critical factor to the success of a KM initiative. Part 1 ends with examples of KM success stories in business and industry.

Getting Started

Part 2, "Getting Started," offers a step-by-step guide for implementing a KM strategy. The author cautions that for KM to be successful, it must be rooted in organizational strategy. In promoting a KM strategy, senior executive sponsorship connected at the highest levels and canny in the ways of the organization is deemed important. Keys to successful implementation of KM are presented, including the need to start small (pilots are preferable), operate from a steering committee framework, and pursue "gee whiz" projects with high impact and visibility.

In deciding where within the organization to place KM, the author indicates that there is no right answer for where KM belongs. A stand-alone department reporting to the chief executive officer and positioned organizationally with other senior executives in information technology (IT), human resources, finance, and operations, however, seems to be advocated. Clearly, the role of CKO is not a stand-alone role, but rather a collaborative one requiring the ability to connect people. Although the CKO is "in charge" of implementing the KM strategy, other key roles of knowledge stewards, knowledge researchers, knowledge brokers, and knowledge sharers are equally important.

Communities of Practice

The book includes an expanded discussion of COP, referred to as "the killer application" for KM. A COP is thought to help drive strategy, transfer knowledge and best practices, build core capabilities, and increase innovation. A clear distinction, however, is made between what a COP is and is not. For example, a COP is neither a team nor a workgroup appointed by management. Instead, a COP represents a voluntary entity distinguished by passion for a common cause and lasting as long as the members want the COP to last. A COP cycles in 5 stages (planning, start-up, growth, sustainment, and closure), with social activities representing a value-creating thread throughout the COP life cycle.

The community coordinator represents the most important critical success factor in a COP. Fulfilling the duties of the community coordinator requires coordinators to commit 15% to 25% of their total time to each community. In addition to the community coordinator position, at a minimum, additional allocation of resources is needed to include the services of a librarian, secretarial support, and release time for employees to participate in the COP. Because resources are valuable in all organizations, the author advocates the need to allocate resources based on the principle of the vital few. This implies that 20% of the most important causes (those that bring approximately 80% of the problems) are most vital to the organization and are thus the causes that should receive more critical emphasis. The principle of the vital few is a key one to follow to align the interests of the COP with organizational strategy and allocation of resources.

Can't Live With It: Can't Live Without It

Part 3, "Can't Live With IT: Can't Live Without IT," reinforces the notion that the CKO should be well connected with the organization's chief information officer. Both the CKO and chief information officer, to have influence within the organization, must consistently show value for the organization. Understanding this dynamic is important because both the KM and IT functions in organizations are regarded as cost centers, not profit centers. Part 3 also provides an extensive discussion about the various nets (Internet, intranet, and extranet) and an explanation of the various applications used to find electronic information (e-mail, databases, and search engines).

Culture Is You, Me and Everybody Else

Part 4, "Culture Is You, Me and Everybody Else," supplements the KM information presented in parts 1 and 2 and emphasizes the importance of understanding organizational culture throughout all phases of a KM strategy. Because implementing a KM strategy effectively represents change, the power of culture must never be underestimated. Importantly, leaders should recognize that culture can blindside KM efforts. Rumizen provides good advice and perspective regarding organizational culture by indicating that

No matter how insanely idiotic you think some aspect of culture is, keep that opinion to yourself. Whether you're an insider or an outsider, your job is to understand the culture with its strengths and weaknesses and to work within it. Open contempt will alienate the people you need to learn from.

The author cautions that organizational culture may serve as either a "wild card" or "trump card" for a change. Certain organizational cultures may be seen as healthy (learning organizations), whereas others that are too "in grown" may be deemed as unhealthy. Clearly, the health of the organizational culture is a key factor in the success of a KM strategy. Important to the organizational culture is the presence (or absence) of strong social networks that contribute a sense of the social capital in an organization's culture. The author defines social capital as the sum of connections between people and the associated norms of trust and behavior that create social cohesion.

Keeping Score

Part 5, "Keeping Score," goes into the measurement aspects of KM. This section is key because it provides a framework for evaluating the success of KM and in documenting its value. A key piece of advice that this section offers is the need to combine numbers (quantitative) with the stories (qualitative) behind the numbers. This reinforces the premise that both tacit and explicit knowledge have value within the context of people pursuing a KM strategy. The author advocates for producing actionable measures, not measuring everything, using existing measurement systems when possible, and for crafting communication strategies that keep the designated measures and strategies in the forefront. Important to the integrity of the measurement system is the use of valid and reliable measures that should be displayed in a variety of ways with enough context to explain them.

Measurement approaches for KM are presented, with emphasis given to the more frequently used balanced scorecard. The balanced scorecard links an organization's mission and strategy to the measures that represent financial performance as well as 3 additional perspectives: customers, internal business processes, and learning and growth. Although used to a lesser extent, the author introduces measures of intellectual capital using a typology of 4 types of measures: direct intellectual capital method, market capitalization method, return on assets method, and scorecard method.

The direct intellectual capital method estimates the value of intangible assets by first identifying their various components and then quantifying them either alone or together. The market capitalization method, a somewhat volatile measure, focuses on the perceived value of an organization in the marketplace by looking at the difference between the company's market capitalization and its stockholder's equity. The return on assets method focuses on an average earning from intangible assets. Calculating the return on assets involves dividing the company's pre-tax earnings by the average tangible assets and then comparing with the industry average.

The scorecard method for intellectual capital is similar to the balanced scorecard previously described. When focusing exclusively on measuring intellectual capital, however, various components of intangible assets are assessed. An example of an intangible asset scorecard represents the work by Karl-Erik Sveiby, a pioneer in KM. Sveiby2 focuses on human competence (values, experience, social skills, and educational background), external structure (trademarks, brand name, and image), and internal structure (databases, processes, models, and documentation).

Settling in for the Long Haul

Part 6, "Settling in for the Long Haul," represents a kaleidoscope of issues that may be useful to those implementing a KM strategy. For example, the author suggests the importance of not equating KM to IT, provides caution regarding the need to establish realistic deadlines (5 years seems to be the norm for full KM implementation), and emphasizes the importance of accommodating differences yet not fully sacrificing standardization. Furthermore, the author pulls from her military background to reiterate the value of debriefing (particularly after the pilot phase) using timely after-action reports and implementing precision-driven changes resulting from the lessons learned.

The 315-page book ends with 3 appendices inclusive of a brief glossary, a list of useful Web sites, and a reference list of pertinent books and articles. The book is thoroughly indexed to assist the reader in finding topics of interest. Missing, however, is a detachable table that would summarize the "least you need to know" sections of the book into a useable poster suitable for mounting.

Evaluation

Overall, the book does an outstanding job of itemizing fundamental KM information. Parts 1, 2, and 5 provide answers to 3 key questions about KM:

1. What is KM and what can it do for an organization?

2. How is a KM strategy started?

3. How is the success of KM evaluated?

The book's primary distinctive feature is its ability to convey KM information with the author not becoming lost in the complex lingo of KM. The book reinforces more in-depth KM content typically presented in an academic course or in a scholarly text.

Using what could be described as a rather simplistic description of organizational culture (an element that helped in parts 1, 2, and 5), part 4 presents a discussion on culture that works within this context and serves to complement the "pure" KM information in parts 1, 2, and 5. If nothing else, part 4 underscores the importance of organizational culture as a factor that can either facilitate or derail a KM strategy. Recognizing the significance of culture and learning from the culture could prove to be an incomparable strategy to enhance the likelihood of success when implementing KM.

The part 3 discussion regarding IT may be said to be so elementary that even a technology "non-geek" would find it useless. The author may have aimed the technology discussion to the novice IT user, incorrectly assuming that lack of KM knowledge equates to lack of IT knowledge. This observation is particularly interesting given that the book makes a clear distinction that KM is not IT. In reality, either omitting part 3 or replacing it with a section on KM exemplars in the healthcare industry (one industry not referenced) would have added more value. In any event, a recommendation for future readers of this book would be to skip over part 3 in what otherwise is a most informative book.

Part 6, much like part 3, did not seem to "fit" as a distinct section. Unlike part 3, which is deemed useless, part 6 provided a hodgepodge of helpful tidbits that could have been more efficiently incorporated into the most valuable sections of the book (parts 1, 2, and 5).

In reviewing this book, the section on COP defined as a "killer strategy for KM" truly lived up to the title and raised the most reflective questions:

1. Why, if a COP is deemed to be so valuable in other industries, is the concept of COP not prevalent in the healthcare setting?

2. How could the content presented in this book be applied in a nursing health systems context?

The answer to question 1 consists of 4 elements crucial to the success of COP. First, for COP to thrive, this requires an investment in resources and supportive structures. Second, success in COP and KM requires a long-term focus rather than emphasis on immediate and tangible results. Third, a COP seems to imply the acceptance of some slack in systems to facilitate innovation. Fourth, a COP is seen predominantly in learning organizations, particularly in those with healthy organizational cultures that value social capital. Given these 4 required elements for success in COP (elements often lacking in many healthcare settings), it becomes understandable why COP are not the norm in the healthcare workplace. Clearly, COP do not prevail in healthcare because of an inadequate commitment to funding these types of efforts, a lack of a long-term focus, zero slack time in systems precluding release time for staff to participate, and lastly, frenetic work environments that either do not value social capital or have no internal reward systems for cultivating it.

Although question 1 presents the problem, question 2 points to the solution. In this reviewer's opinion, a solution rests with nurses leveraging their knowledge base and positioning the profession at the forefront of the current knowledge economy. Clearly, a well-planned and well-executed KM strategy tapping into the creation of valuable COP combined with a well-educated, experienced, energetic, and savvy nurse at the CKO helm could make nursing's contribution quite visible and of high impact. With the current push for Magnet cultures and the need to operationalize evidence-based practice, KM is at a crucial tipping point. Aligned with KM's value in promoting organizational strategy and documenting results, the nursing profession could emerge as institutionalizers of innovation and facilitators of knowledge transfer for competitive advantage and acceleration of performance improvement. Capitalizing on a KM strategy now would be particularly significant given that only a limited number of healthcare institutions currently use a KM strategy.3 Furthermore, successful implementation of KM takes a long lead time, suggesting that the sooner an organization starts KM, the sooner that organization may be likely to reap the benefits of early adoption.

Conclusion

Rumizen's book lives up to its billing as a basic KM text that provides step-by-step instructions on how to implement the concept. The book is replete with tips and tricks of the trade needed for KM success and sustainability. The book is presented in an easy-to-read format that informs and keeps the reader engaged. Overall, this user-friendly book represents a must-have primer for those entering the KM field. The interesting points raised and the valuable appendices provided offer suggested readings for those seeking KM mastery. Overwhelmingly, the book dispels any myths that KM is a fad and presents a strong argument why KM should be a valuable organizational strategy for the future.

References