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Social networks enable knowledge to flow between groups and organizations. There are two major theoretical approaches to such networks. The first one underlines the role of network as channels for the flow of knowledge. The benefits of this network are the connectivity It provides between Individuals and organizations. The second one sees social networks as communities and emphasizes the quality of relationships within them. Communities may develop from informal interactions within a particular social group; these are named as emergent communities.

Managed communities are formally defined groups by organizations. Finally, online communities are built up through on-line interactions within their members. The Midlands Hospital case describes the development of an innovative procedure for the treatment of cataracts. The process began with the creation of a community of different specialists involved in diagnosing and treatment. This type of “managed community’, In the form of project team, leads the change process. Through the time and through working together, trust developed among team members.

Trust Is a necessary condition for cooperative behaviors; It encourages sharing knowledge and knowledge creation. The social network contributed positively to the Innovation process breaking down the knowledge boundaries between different specialists with different professional backgrounds. Inside this community different professionals worked together sharing understanding and attitudes to knowledge formation and knowledge sharing. This enabled an agreed analysis of the diagnosing and treatment problems.

Moreover, this community of practice link shared identities to learning amongst community members. Each member brought and shared inside the community his/her experience and knowledge, but also used personal network to expand the community knowledge and understanding. The flow of information within and outside the community was supported also by a structured network made of detailed forms filled by the specialists with specific Information about the patient and self-diagnostic questionnaires that each patient was required to fill out.

Finally, post-operation feedbacks were collected through telephone calls. The Midlands case is a perfect example of how communities can effectively operate as agent of change. The team members shared their experienced and knowledge interacting each other so that there has been a deep and real change in the cataract treatment. ) The project team format has been the basis for the development of the new network. The project team brought together representatives from the whole range of groups Involved in diagnosing and treatment.

However, putting together individuals with different backgrounds will not automatically and Inevitably generate the synergy that will result In knowledge creation because there are powerful knowledge boundaries that exist. At the beginning also In Midlands Hospital case there have been conflicts and mistrust within team members. But through time and working increasing the awareness of the competencies and skills of the various groups involved. The project team became a community of practice where people with different knowledge could interact every day and share their mental space in terms of personal experiences and ideas.

The community of practice highlights the importance of relationships, face-to-face interactions, shared understandings and attitudes to knowledge formation and knowledge sharing. 3) Boundary spanners are people who enjoy membership of different groups and hence are able to span the boundaries of social networks. The have a very important role in knowledge integration. In Midlands Hospital the project team was formed by representatives from the whole anger of groups involved in diagnosing and treatment.

This included the head nurse in the eye unit, a hospital administrator, general practitioners, a set of optometrists from the local community, and a surgical consultant. The consultant was the main boundary spanner because he had the necessary hierarchical status to be able to span the boundaries of the different medical and non-medical groups involved in re- design the cataract process. However, each representative had a an important role as boundary spanner in translating his/her own personal experiences or the experiences of the group who represented in a language that everyone inside the community could understand.

Moreover, each team member used his/her personal network to expand the knowledge boundaries of the community and find out what was happening in other hospital. The aim of these boundary spanners was to collect knowledge from outside the network and look for “best-practices” that could be use as a basis for their work. 4) The redesign cataract process was highly successful but there was little spread from Midlands Hospital to other sites. This can be explained starting from the basic incept that knowledge cannot be transferred between people or organizations in any straightforward way.

Knowledge cannot be viewed as a cognitive resource as described by the “epistemology of possession” approach. It is not a possession that can be captured and transferred easily across people, place and time. Sharing knowledge requires individuals who are willing to change and who are homogeneous in terms of common practices, understanding and attitudes. Also the type and the degree of the relationships within individuals are important. Translating the experience of a project team into approaches that would work in other contexts is official.

Moreover, as in the case of the other hospitals, people and particularly knowledge workers are often reluctant to change. They are worried to loose their power changing the traditional division of tasks between them. Information alone is not enough to overcome this resistance. There is a need to share practices. In doing this, social networks have a critical role. For instance, in the Midlands Hospital the community helped the development of a share perspective on the problem and on how it could be solved. Social networks must be created in a way to share not Just knowledge but learning.

The limited spread of the innovation in cataract treatment to other hospitals was probably linked also to the extent to which social networks and welcome new knowledge. The quality of the relationships both, within and outside the community is extremely important. Without boundary spanners maintaining effective relationships with other communities and learning from them become nearly impossible. Finally, in the other hospitals the necessary shared perspective on the problem did not exist and therefore there was a very little value placed on the knowledge made available by the Midlands Hospital.