Epistemic fit and the mobilization of management knowledge in healthcare

This chapter discusses the mobilization of management knowledge in healthcare, drawing on six qualitative case studies in a diverse range of settings. Drawing on theory about management knowledge and practices’ “fit,” and emergent theory about “epistemic stances,” it explains how cultural/institutional, political, and epistemic fit and clashes between the norms, interests, and epistemic stances of different communities affected knowledge mobilization in these settings. It also highlights the key role of knowledge brokers in “fitting” knowledge within contexts as part of their own identity work. Yet it also notes that knowledge brokers’ ability to mobilize and fit knowledge depended on having a senior role or senior level support, and credibility/legitimacy with dominant communities. It suggests that the novel concepts of “epistemic fit” and “fitting” are useful in explaining the process of knowledge mobilization, particularly in complex pluralistic healthcare contexts containing multiple epistemic communities which produce, use, and value knowledge in different ways.