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CONCLUSIONS   237

                            be cognizant of these when overseeing teams and project-based working and
                            recognize that some of the most successful teams and projects in the past may
                            not continue to be so in the future if any of these group dynamics emerge.
                            Regular brief reviews with team or project members (other than the team leader)
                            can often identify when problems are emerging that might hinder knowledge
                            integration as can 360-degree appraisal feedback systems.
                              As with knowledge creation, knowledge integration takes time, as inevitably
                            at the outset there will be different perspectives on the nature of the problem
                            and the route to solve the problem. In order for a shared perspective to emerge
                            the team or project needs the time and opportunity to interact either face-to-
                            face or virtually. The Midlands Hospital case in Chapter 8 highlighted that it
                            took around six months for the team working together to develop the necessary
                            trust and social capital to agree on a way forward in re-designing the cataract
                            procedure. Despite its success in Midlands Hospital, the innovative new proce-
                            dure did not diffuse to other hospital trusts. This was in part because teams in
                            other hospitals had not developed the same shared perspective on the problem
                            and how it could be solved.


                            Sharing knowledge
                            Chapter 4 highlighted the important role that trust also plays in knowledge shar-
                            ing. The development of trust in teams and projects is recognized as one of the
                            most important aspects of an enabling context for collaborative work although
                            companion trust may also militate effective team-working as the Research Team
                            case highlighted. Trust takes different forms and it was highlighted that each
                            form – companion, competence and commitment – has particular strengths and
                            weaknesses. For example, competence trust can be extremely useful in terms of
                            sharing knowledge but is relatively more fragile than either companion or com-
                            mitment trust and may quickly dissipate if competence is not manifest in practice.
                            Trust clearly emerges organically in teams and projects and the development of
                            trust clearly cannot be ‘managed’. Nevertheless it does serve as a major integrat-
                            ing mechanism that helps to overcome knowledge boundaries and so on.
                              The development of trust, and a shared identity and common agreed perspec-
                            tives on the nature of the problem are most apparent in communities. Sharing
                            knowledge within these contexts is less problematic from the outset, compared
                            to formally appointed teams and projects. Chapter 8 highlighted that emergent
                            communities are generated by shared social practices and the socialization of
                            newcomers. In principal knowledge boundaries are minimal in these contexts as
                            community members have typically developed a set of shared meanings deriv-
                            ing from common experiences. Unlike teams and projects they are informal and
                            individuals self-select which communities they participate in. Communities have
                            long been recognized as important sights of innovation. Low knowledge bound-
                            aries and the ease by which knowledge is shared clearly promotes innovation.
                              More recently organizations have attempted to exploit the benefits of com-
                            munities by cultivating ‘managed’ communities but there has been little research









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