Knowledge Management in High-Risk Hospital Environments

An Exploratory Case Study of a Moroccan Intensive Care Unit

Abstract

In intensive care units, knowledge management (KM) is both a technical necessity and an emotional challenge. This case study, conducted in an intensive care unit at a Moroccan hospital, aims to understand how caregivers mobilize, share, and apply their knowledge in an environment marked by urgency, serious illness, and high emotional stress. The main objective is to assess the extent to which KM can contribute to improving hospital performance, while taking into account the daily experiences of professionals confronted with death, the distress of families, and the pressure of critical care. The research is based on a qualitative method combining semi-structured interviews, field observations, and documentary analysis. The data, processed using NVivo 12 software, were analyzed using an inductive and abductive approach. The theoretical framework is based in particular on Bose's (2003) model for KM in healthcare and Donabedian's (1966, 1988) model for hospital performance. The results reveal tensions between the need to structure knowledge and the emotional complexity of end-of-life situations, which hinder the fluidity of exchanges. The KM process is highly dependent on the organizational context, leadership, professional relationships, and technological resources. The study highlights that knowledge management in intensive care is not only a matter of formal systems, but also relies on human, emotional, and collaborative practices that are essential to resilience and performance in healthcare.