CHARM as Activity Model to Share Knowledge and Transmit Procedural Knowledge and its Application to Nursing Guidelines Integration

Japan is no exception among developed countries facing healthcare system problems due to aging and low birthrate as the number of possible patients increases and health care worker numbers shrink. The introduction of high tech medicine has increased the amount of knowledge to be learned by novice nurses. Although vast amounts of implicit knowledge have accumulated among nursing practitioners, this knowledge needs to be communicated when hospitals train younger generations of nurses and integrate nursing guidelines among multiple hospitals. In this paper, the authors have proposed an activity model called CHARM – the Convincing Human Action Rationalized Model. CHARM was developed to resolve the diverse needs of hospitals. CHARM explicates multidimensional purpose-oriented procedure relations often existing as implicit knowledge. For this reason, CHARM supports the training and education of novice nurses. CHARM also is used as a tool to integrate different knowledge and work procedures tacitly existing among different organizations. We developed CHARM models according to nursing guidelines of hospitals and applied them to the integration of nursing procedures at two hospitals. Based on these CHARMmodels, 12 differences were found among the two guidelines covering the same procedure for different hospitals. CHARM is being evaluated at these hospitals and positive responses are coming from nurses.