Knowledge sharing and institutionalism in the healthcare industry

Is knowledge liberating? The role of knowledge behaviors and competition on the workplace happiness of healthcare professionals

PURPOSE

The purpose of this paper is to highlight the joint impact of competitive culture and knowledge behaviors (sharing, hoarding and hiding) on workplace happiness among healthcare professionals. It addresses a literature gap that critiques the development of happiness programs in healthcare that overlook organizational, social and economic dynamics. The study is based on the Social Exchange Theory, the Conservation of Resources Theory and the principles of Positive Psychology.

DESIGN/METHODOLOGY/APPROACH

The study analyzes a linear relationship between variables using a structural equation model and a partial least squares approach. The data are sourced from a survey of 253 healthcare professionals from Portuguese healthcare organizations.

FINDINGS

The data obtained from the model illustrate a positive correlation between competitive culture and knowledge hoarding as well as knowledge hiding. Interestingly, a competitive culture also fosters workplace happiness among healthcare professionals. The complex relationship between knowledge behaviors becomes evident since both knowledge hoarding and sharing positively affected these professionals' workplace happiness. However, no direct impact was found between knowledge hiding and workplace happiness, suggesting that it negatively mediates other variables.

ORIGINALITY/VALUE

This research addresses a previously identified threefold gap. First, it delves into the pressing need to comprehend behaviors that enhance healthcare professionals' workplace satisfaction. Second, it advances studies by empirically examining the varied impacts of knowledge hiding, hoarding and sharing. Finally, it sheds light on the repercussions of knowledge behaviors within an under-explored context - healthcare organizations.

A Systematic Literature Review of Health Information Systems for Healthcare

Health information system deployment has been driven by the transformation and digitalization currently confronting healthcare. The need and potential of these systems within healthcare have been tremendously driven by the global instability that has affected several interrelated sectors. Accordingly, many research studies have reported on the inadequacies of these systems within the healthcare arena, which have distorted their potential and offerings to revolutionize healthcare. Thus, through a comprehensive review of the extant literature, this study presents a critique of the health information system for healthcare to supplement the gap created as a result of the lack of an in-depth outlook of the current health information system from a holistic slant. From the studies, the health information system was ascertained to be crucial and fundament in the drive of information and knowledge management for healthcare. Additionally, it was asserted to have transformed and shaped healthcare from its conception despite its flaws. Moreover, research has envisioned that the appraisal of the current health information system would influence its adoption and solidify its enactment within the global healthcare space, which is highly demanded.

Knowledge sharing behaviour among head nurses in online health communities: The moderating role of knowledge self-efficacy

BACKGROUND

Head nurses are vital in understanding and encouraging knowledge sharing among their followers. However, few empirical studies have highlighted their contribution to knowledge-sharing behaviour in Online Health Communities (OHCs). In addition, scant literature has examined the moderating role of knowledge self-efficacy in this regard.

PURPOSES

This study examines the moderating role of self-efficacy between the association of four selected individual factors of head nurses (i.e., Trust, Reciprocity, Reputation, and Ability to Share) and their knowledge-sharing behaviour in OHCs in Jordan.

METHOD

The data were obtained by using a self-reported survey from 283 head nurses in 22 private hospitals in Jordan. A moderation regression analysis using a structural equation modelling approach (i.e. Smart PLS-SEM, Version 3) was utilised to evaluate the study's measurement and structural model.

RESULTS

Knowledge self-efficacy moderates the relationship between the three individual factors (i.e., Trust, Reciprocity, and Reputation) and knowledge-sharing behaviours. However, self-efficacy did not moderate the relationship between the ability to share and knowledge-sharing behaviours.

IMPLICATIONS

This study contributes to understanding the moderating role of knowledge self-efficacy among head nurses in online healthcare communities. Moreover, this study provides guidelines for head nurses to become active members in knowledge sharing in OHCs. The findings of this study offer a basis for further research on knowledge sharing in the healthcare sector.

An emerging knowledge management framework adopted by healthcare workers in China to combat COVID ‐19

This study examines elements of knowledge management (KM) applied during the treatment of the coronavirus disease 2019 (COVID‐19) and proposes a KM framework that can be applied to respond quickly to a new virus outbreak. Following a content analysis of the press conferences held in China, this study found that various elements of KM, including strategic KM, the knowledge codification strategy vs. the knowledge personalization strategy, a knowledge‐friendly culture, knowledge‐based leadership, KM‐based human resource management, and KM‐related information technologies, were widely used by Chinese authorities and healthcare workers to improve treatment effectiveness for COVID‐19 patients. This paper provides a unique case study on how KM helps the government and the healthcare workers to respond to an unexpected public hygiene crisis.ⁱ

A Novel Framework for Extracting Knowledge Management from Business Intelligence Log Files in Hospitals

This paper proposes a framework to extract knowledge-management elements from business systems in healthcare organizations. According to results of in-depth interviews with experts in the field, a framework is defined, and software was developed to generate log files. Following the application of the Bag of Words (BoW) method on log files of 455 days for feature extraction, the k-means algorithm was used to cluster the feature vectors. The framework was tested with queries for confirmation. The developed framework successfully clustered the generated reports at operational, tactical, and strategic levels to extract knowledge-management elements. This study provides evidence for the knowledge-management pyramid by finding that the generated reports are reviewed mostly at the operational level, then tactical, and then the least at the strategic level. Our framework has the potential to be used not only in the health sector, but also in banking, insurance, and other businesses using business intelligence, especially in accordance with the organization’s goals at operational, tactical, and strategic levels of the knowledge-management pyramid.

Institutional isomorphism in collaborative, cross-cultural, project-based development work: an inquiry into the knowledge sharing behaviour of volunteers

Purpose

Using an institutionalist lens, this study aims to identify factors that influence the knowledge sharing behaviour of volunteers engaged in collaborative, cross-cultural and project-focussed development work.

Design/methodology/approach

Following an inductive research design, the authors conducted a thematic analysis of interviews with volunteers to explore the practicalities of knowledge sharing in the context of development aid projects and to examine contributing factors, such as personality, motivations, experience and variations in team members’ understanding of the nature and objective of projects.

Findings

Through exploring the experiences of volunteers working on cross-cultural development aid programmes, the authors identify and discuss the ways in which the preparation of volunteers and the structuring of project work is shaped by managerialist modes of thinking, with an emphasis on the creation of an environment that is conducive to sustainable knowledge sharing practices for all stakeholders involved.

Originality/value

The examination of volunteer development work tendency towards institutional isomorphism is a novel contribution intersecting the areas of knowledge sharing in the project, volunteer-led and culturally diverse environments.

The Challenge of Employee Retention in Medical Practices across the United States: An Exploratory Investigation Into the Relationship between Operational Succession Planning and Employee Turnover

Employee turnover is a growing challenge for health-care providers delivering patient care today. US population demographics are shifting as the population ages, which leaves the field of health care poised to lose key leaders and employees to retirement at a time when patient care has grown more complex. This means health care will lose its core of key employees at a time when skilled leadership and specialized knowledge is most needed and directly impacts health care's ability to deliver quality care. Operational succession planning (OSP) may be one solution to manage this looming challenge in health care, as the process identifies and develops the next generation of leadership. Thus, this exploratory national study used a quantitative and cross-sectional design to examine the relationship between OSP and employee turnover. Demographic and 10-point Likert scale data were collected from n = 66 medical practices, using an online survey instrument. Data were analyzed using various descriptive and inferential statistical methods. Distribution (frequency and chi-square) analyses of the study sample, one-way analysis of variance (ANOVA), and regression analyses were performed across seven demographic characteristics of the medical practices: Specialty, Ownership Structure, Number of full-time equivalent (FTE) Physicians, Number of FTE Clinical Employees, Number of FTE Nonclinical Employees, Number of FTE Employees Left Position, and Region. Study results provided statistically significant evidence to support the relationship between OSP and employee turnover, highlighting that OSP was associated with lower employee turnover. The finding suggests that OSP can serve as an effective mechanism for increasing employee retention.

Towards safer healthcare: qualitative insights from a process view of organisational learning from failure

OBJECTIVES

This study adopted a process view of organisational learning to investigate the barriers to effective organisational learning from medical errors.

METHODS

Qualitative data were collected from 40 clinicians in high and low performing hospitals. The fit between the organisational learning process and socio-technical factors was investigated systematically from a pre-reporting stage to reporting and post-reporting stages.

RESULTS

The analysis uncovered that the major stumbling blocks to active learning lie largely in the post-reporting stages and that they are rooted in social rather than technical issues. Although the experience of the higher-performing hospital provides valuable pointers in terms of creating more trusting environment and using the potential of small failures towards ways in which the organisational learning process in the lower hospital might be improved, due to lack of local mangers' proactive engagement in integrating changes into practice the active learning takes place in neither of the hospitals.

CONCLUSIONS

To ensure that the change solutions are firmly incorporated into the culture and routine practice of the hospital, we need to focus on fostering an organisational culture that encourages positive cooperation and mutual interactions between local managers and frontline clinicians. This process will lead to double-loop learning and an increase in system safety.

Rural healthcare providers coping with clinical care delivery challenges: lessons from three health centres in Ghana

Background

Rural settings in low- and middle-income countries are bedeviled with poverty and high disease burden, and lack adequate resources to deliver quality healthcare to the population. Drug shortage and inadequate number and skill-mix of healthcare providers is very common in rural health facilities. Hence, rural healthcare providers have no choice but to be innovative and introduce some strategies to cope with health delivery challenges at the health centre levels. This study explored how and why rural healthcare providers cope with clinical care delivery challenges at the health centre levels in Ghana.

Methods

This study was a multiple case studies involving three districts: Bongo, Kintampo North, and Juaboso districts. In each case study district, a cross-sectional design was used to explore the research question. Purposive sampling technique was used to select study sites and the study participants. The authors conducted 11 interviews, 9 focus group discussions (involving 61 participants), and 9-week participant observation (in 3 health centres). Transcription of the voice-recordings was done verbatim, cleaned and imported into the Nvivo version 11 platform for analysis. Data was analysed using the inductive content analysis approach. Ethical clearance was granted by the Ethics Review Committee of the Ghana Health Service.

Results

The study found three main coping strategies (borrowing, knowledge sharing and multi-tasking). First, borrowing arrangements among primary health care institutions help to address the periodic shortage of medical supplies at the health centres. Secondly, knowledge sharing among healthcare providers mitigates skills gap during service delivery; and finally, rural healthcare providers use multi-tasking to avert staff inadequacy challenges during service delivery at the health centre levels.

Conclusion

Borrowing, knowledge sharing, and multi-tasking are coping strategies that are sustaining and potentially improving health outcomes at the district levels in Ghana. We recommend that health facilities across all levels of care in Ghana and other settings with similar challenges could adopt and modify these strategies in order to ensure quality healthcare delivery amidst delivery challenges.

Collaborative interdepartmental teams: benefits, challenges, alternatives, and the ingredients for team success

Radiology practices often employ collaborative interdepartmental teams to address complex projects. These teams benefit from their diversity of viewpoints and the potential for innovative, high-quality solutions. However, collaborative interdepartmental teams also suffer from challenges: interpersonal conflicts, team member mistrust, competing individual priorities, and obstructive turf concerns. When tackling projects, radiologists should consider alternative group models such as single department teams, two-person partnerships, and small workgroups. Each of these group models has strengths and weaknesses relative to collaborative interdepartmental teams and may be more efficient in some scenarios. Finally, when radiologists launch collaborative interdepartmental teams, four key ingredients should be optimized to improve team performance: right goal, right culture, right leadership, and right people.

Information technology and knowledge sharing for better health care: an emerging economy context

Purpose

The present study aims to explore “what” type of knowledge is shared, “how” it is shared and what information and communication tools are used to share knowledge among health-care professionals in the context of emerging “digital laggard” country in the South-Eastern European region (i.e. Bosnia and Herzegovina [B&H]).

Design/methodology/approach

This study applies the qualitative research methodology and thematic analysis for collecting, analysing and interpreting data. Primary data is collected using semi-structured interviews (n = 9). Key informants are employees of the main primary health-care institution in the capital of B&H.

Findings

The results indicate that knowledge sharing among primary health-care practitioners is the interplay of formal and informal exchange of knowledge, facilitated by both traditional communication media (face-to-face interaction) and ICT-based tools. In regards to ICT tools, our findings suggest that instant messing applications (predominantly Viber) are viewed as common media for sharing tacit knowledge within a community of practice.

Research limitations/implications

This study is limited to one emerging digital laggard country; thus, future research regarding ICT-based knowledge sharing in other emerging digital laggard countries is welcomed.

Originality/value

In the context of “digital laggard”, societies, informal, spontaneous and dynamic system of social interactions can be a successful substitute for ICT-based formalised and structured system of knowledge sharing.

Mobile technology to give a resource-based knowledge management advantage to community health nurses in an emerging economies context

Purpose

Knowledge is a key success factor in achieving competitive advantage. The purpose of this paper is to examine how mobile health technology facilitates knowledge management (KM) practices to enhance a public health service in an emerging economies context. Specifically, the acceptance of a knowledge-resource application by community health workers (CHWs) to deliver breast cancer health care in India, where resources are depleted, is explored.

Design/methodology/approach

Fieldwork activity conducted 20 semi-structured interviews with frontline CHWs, which were analysed using an interpretive inductive approach.

Findings

The application generates knowledge as a resource that signals quality health care and yields a positive reputation for the public health service. The CHW’s acceptance of technology enables knowledge generation and knowledge capture. The design facilitates knowledge codification and knowledge transfer of breast cancer information to standardise quality patient care.

Practical implications

KM insights are provided for the implementation of mobile health technology for frontline health-care professionals in an emerging economies context. The knowledge-resource application can deliver breast cancer care, in localised areas with the potential for wider contexts. The outcomes are valuable for policymakers, health service managers and KM practitioners in an emerging economies context.

Social implications

The legacy of the mobile heath technology is the normalisation of breast cancer discourse and the technical up-skilling of CHWs.

Originality/value

First, this paper contributes three propositions to KM scholarship, in a public health care, emerging economies context. Second, via an interdisciplinary theoretical lens (signalling theory and technology acceptance model), this paper offers a novel conceptualisation to illustrate how a knowledge-resource application can shape an organisation’s KM to form a resource-based competitive advantage.

Building intellectual structure of knowledge sharing

Purpose

This study aims to build the intellectual structure of knowledge sharing (KS) research by objectively and systematically capturing and sketching the content of research papers published in the KS research area.

Design/methodology/approach

This study uses a systematic literature review for data collection, and content analysis and bibliometric techniques of citation and co-citation analysis for data analyses and interpretation.

Findings

Based on the study, the intellectual structure of KS research consisting of five themes has emerged. The five themes identified are: models, frameworks and understanding for KS, the behaviour-oriented perspective of KS, technology-oriented perspective of KS, KS barriers and KS and firm’s performance.

Research limitations/implications

This study has used published literature extracted from selected journals using the web of science database. More journals and databases may be included in future studies.

Practical implications

This study will give future researchers a comprehensive understanding of KS discipline and serve as a quick reference and resource for those interested in KS research. It identifies major areas of KS for the practitioners to enable them to focus and apply various organizational interventions to derive a competitive advantage. The identified themes in the intellectual structure of KS will also provide a holistic view and give multiple perspectives to practitioners so that they can better manage KS in their organizations.

Originality/value

This is among early studies aiming to extract the intellectual structure of KS in the broad area of knowledge management research.

Leader identity development in healthcare: an existential-phenomenological study

PURPOSE

The purpose of this study is to take an existential-phenomenological perspective to understand and describe the experienced leader identity development of healthcare leaders working in dual roles. Leader identity development under the influence of strong professional identities of nurses and doctors has remained an under-researched phenomenon to which the study contributes.

DESIGN/METHODOLOGY/APPROACH

Existential-phenomenology serves as a perspective underpinning the whole research, and an existential-phenomenological method is applied in the interview data analysis.

FINDINGS

The study showed leader identity development in healthcare to be most strongly influenced and affected by clinical work and its meanings and followers' needs and leader-follower relationships. In addition, four other key categories were presented as meaningful in leader identity development; leader identity development is an ongoing process occurring in relations of the key categories.

ORIGINALITY/VALUE

The existential-phenomenological approach and analysis method offer a novel way to understand leader identity development and work identities as experienced.

Relationship between team culture and team performance through lens of knowledge sharing and team emotional intelligence

Purpose

The purpose of this study is to investigate the relationship between team culture and team performance through the mediating role of knowledge sharing and team emotional intelligence.

Design/methodology/approach

The study advocated that team culture influences the knowledge sharing behavior of team members and the development of emotional intelligence skill at the team level. Further, it is hypothesized that knowledge sharing and team emotional intelligence positively influence team performance. By adopting a quantitative research design, data were gathered by using a survey questionnaire from 535 respondents representing 95 teams working in private health-care institutions.

Findings

The findings significantly indicated that knowledge sharing and team emotional intelligence influence team working. Furthermore, this study confirms the strong association between team culture and team performance through the lens of knowledge sharing and team emotional intelligence.

Practical implications

This investigation offers observational proof to health-care services to familiarize workers with the ability of emotional intelligence and urge them to share knowledge for enhanced team performance. The study provides in-depth understanding to managers and leaders in health-care institutions to decentralize culture at the team level for endorsement of knowledge sharing behavior.

Originality/value

This is amongst one of the initial studies investigating team members making a pool of knowledge to realize potential gains enormously and influenced by the emotional intelligence. Team culture set a platform to share knowledge which is considered one of the principal execution conduct essential for accomplishing and managing team adequacy in a sensitive health-care environment.

From social network to firm performance

Purpose

The purpose of this study is to develop a structural equation model to explain the complex relationship between social network and firm performance by introducing the mediating role of trust, selling capability and pricing capability.

Design/methodology/approach

The research model with hypothesis development was derived based on the literature. To provide empirical evidence, this study carried out a survey in which the data were equated with a list of questionnaires with a random survey of 380 small and medium enterprises (SMEs) in the Indonesian context.

Findings

This study indicates that the use of social media in management process will not affect the increasing firm performance, unless the firms build trust upon social networks. The social network with trust allows the firms to gain a pricing capability and a selling capability, which brings a positive impact on firm performance. The results also show that the selling and the pricing capabilities become essential following the utilizing the social media, which concerns on trust building.

Research limitations/implications

This study focused on the small-to-medium context, which has conventionally provided an exemplary site for the development of social capital theory but raises issues of generalizability across different contexts.

Practical implications

To the managers, it is advisable to encourage their employees to consciously exploit the selling capability by enhancing the business networks via social media to achieve the firm performance.

Originality/value

This paper contributes to the social capital theory by explaining the mediating role of trust in the complex relationship between social network and firm performance. This study provides evidence that trust plays a pivotal role in social networks, which enable the observed firms to achieve the performance.

Investigating the impact of information systems on knowledge sharing

Purpose

Knowledge is the key factor and the strategic resource for acquiring assets and intangible organizational capabilities, which can lead to further growth and development, creation of value and the advantage of competitiveness. The purpose of this paper is to investigate the impact of information systems (ISs) on knowledge sharing.

Design/methodology/approach

The statistical society and the intended population of this study were the experts of the registry office in Tabriz, East Azerbaijan Province, Iran. A questionnaire was used as the instrument for collecting data. Also, SMART-partial least square was used for testing the hypotheses of the study.

Findings

The results gained in this study revealed that IS dimensions, i.e. service quality, system quality and technology, play a significant role in sharing knowledge among the personnel of an organization.

Practical implications

Nowadays, knowledge is regarded as a notable component of knowledge management process, which contributes to the growth and development of organizations. Sharing knowledge can be considered as a vital phenomenon in managing organizational knowledge. One of the remarkable tasks of ISs is to share information as a key factor. Sharing information can result in fast information distribution and efficient and effective organizational operations and enhanced internal and external performance of the organization.

Originality/value

This paper is aimed at introducing and presenting functional dimensions for optimizing the efficacy of ISs. Implementing an effective IS can accelerate the speed of information exchange among the personnel and the improvement of their capabilities.

Factors affecting Web 2.0 adoption: exploring the knowledge sharing and knowledge seeking aspects in health care professionals

Purpose

This research aims to explore the factors that affect the adoption of Web 2.0 among knowledge workers. The research specifically investigated the role of factors related to both knowledge seeking and knowledge sharing, in the context of Web 2.0 use by health care professionals.

Design/methodology/approach

For this research, a cross-sectional survey design was adopted. The data were analyzed using the partial least square-structural equation modeling.

Findings

The results confirmed that the intention to adopt Web 2.0 depends upon both the knowledge-seeking and the knowledge-sharing attitudes. However, between the two, it is knowledge-sharing factors that are more important. Health care professionals tend to share knowledge driven by intrinsic motivators rather than by extrinsic motivators. On the other hand, knowledge-seeking attitude was determined by usefulness of knowledge and was not affected by the effort involved.

Research limitations/implications

All the respondents were health care professionals from India, and convenience sampling was used to reach them. This may limit the generalizability of the findings.

Practical implications

This research provides useful insights on implementing Web 2.0-based knowledge management systems, specifically for health care professionals. Particularly, it emphasizes the need to focus on reinforcing intrinsic motivators like self-efficacy and the joy of sharing.

Originality/value

It is perhaps the first study that integrates the factors related to knowledge sharing and seeking in a single theoretical model, thereby presents and tests a more realistic model of knowledge management.

The impact of TQM practices and KM processes on organisational performance

Purpose

The purpose of this paper is to investigate the impact of total quality management (TQM) practices in terms of leadership, strategic planning, customer focus, teamwork, process management, information, and analysis on organizational performance in Jordanian telecommunications companies. In addition, the mediating effect of knowledge management (KM) processes is tested.

Design/methodology/approach

A survey instrument was used to gather empirical data, and it was distributed to all managerial and non-managerial employees. A total of 477 questionnaires were valid for analysis, resulting in a response rate of (97 percent). Factor analysis and multiple regression analyses were used to test the study’s hypotheses.

Findings

Customer focus and process management were found to have an insignificant impact on organizational performance, while teamwork had the strongest impact on KM processes. The results also revealed that only knowledge sharing and application processes had a significant impact on organizational performance. More importantly, KM processes fully mediated the impact of TQM practices on organizational performance, except for teamwork, which had a partial mediating effect.

Research limitations/implications

This study was limited to a survey of the headquarters of three telecommunication companies: Zain, Orange, and Umniah, in Amman City.

Originality/value

Originality of the paper lies in testing the influence of TQM practices on organizational performance in a novel context, where most TQM initiatives fail for one reason or another.

Patient-centered knowledge sharing in healthcare organizations: Identifying the external barriers

OBJECTIVE

This paper reports on a research study, which aims to identify, qualify, and theorize the external barriers that prevent and hinder the exercises and activities of patient-centered knowledge sharing (KS) in healthcare organizations.

METHODS

The project adopted a qualitative secondary analysis approach as the overarching methodology to guide the analysis of data collected in a previously completed research study. Specifically, 46 semi-structured interview data were included and analyzed using a thematic analysis approach.

RESULTS

The secondary analysis showed that healthcare KS is strongly influenced and hindered by five external barriers: social belief and preference, cultural values, healthcare education structure, political decisions, and economic environment and constraints. Moreover, the research findings suggest that these external barriers cannot be overlooked in KS implementation and operation in healthcare organizations and should be carefully assessed beginning in the early stages of KS design and strategic planning.

DISCUSSION AND CONCLUSIONS

Based on the secondary analysis, this paper proposes a conceptual model, which will contribute to the development of hypotheses in the future for building a generalized knowledge. The case study used is Chinese healthcare, but the KS problems studied can be shared across international borders.

Mental health knowledge management: critical success factors and strategy of implementation

Purpose

This paper aims to recommend implementation of the knowledge management (KM) strategy for a mental health organisation, an area that has, to date, limited attention in literature based on the factors that influence KM success.

Design/methodology/approach

A mixed-methods research was conducted to identify the organisational culture, resources, enablers and the influential factors of mental health knowledge management (MHKM). The data were collected in five referral mental hospitals and were analysed using quantitative, qualitative and triangulation methods.

Findings

The organisational culture has become a great barrier. Forty-three influential factors were identified. Otherwise, based on culture, resources, enablers and strengthen, weakness, opportunities and threaten (SWOT) analysed were adopted to propose ten of the critical success factors and were recommended into an implementation strategy.

Research limitations/implications

The paper has proven that KM is a new and emerging discipline in Indonesia, especially on mental health care. This will contribute to the governmental policy of KM implementation and enforce the quality of services.

Practical implications

This result has the potential to leverage interdisciplinary KM research. It supports a mental health organisation in applying KM.

Originality/value

This study is probably the first to analyse factors that are of influence in an MHKM initiative programme.

How does the knowledge environment shape procurement practices for orthopaedic medical devices in Mexico?

Background

In organisational theory there is an assumption that knowledge is used effectively in healthcare systems that perform well. Actors in healthcare systems focus on managing knowledge of clinical processes like, for example, clinical decision-making to improve patient care. We know little about connecting that knowledge to administrative processes like high-risk medical device procurement. We analysed knowledge-related factors that influence procurement and clinical procedures for orthopaedic medical devices in Mexico.

Methods

We based our qualitative study on 48 semi-structured interviews with various stakeholders in Mexico: orthopaedic specialists, government officials, and social security system managers or administrators. We took a knowledge-management related perspective (i) to analyse factors of managing knowledge of clinical procedures, (ii) to assess the role of this knowledge and in relation to procurement of orthopaedic medical devices, and (iii) to determine how to improve the situation.

Results

The results of this study are primarily relevant for Mexico but may also give impulsion to other health systems with highly standardized procurement practices. We found that knowledge of clinical procedures in orthopaedics is generated inconsistently and not always efficiently managed. Its support for procuring orthopaedic medical devices is insufficient. Identified deficiencies: leaders who lack guidance and direction and thus use knowledge poorly; failure to share knowledge; insufficiently defined formal structures and processes for collecting information and making it available to actors of health system; lack of strategies to benefit from synergies created by information and knowledge exchange. Many factors are related directly or indirectly to technological aspects, which are insufficiently developed.

Conclusions

The content of this manuscript is novel as it analyses knowledge-related factors that influence procurement of orthopaedic medical devices in Mexico. Based on our results we recommend that the procurement mechanism should integrate knowledge from clinical procedures adequately in their decision-making. Without strong guidance, organisational changes, and support by technological solutions to improve the generation and management of knowledge, procurement processes for orthopaedic high-risk medical devices will remain sub-optimal.

Public sector knowledge management: a structured literature review

Purpose

– This paper aims to review and critique the public sector knowledge management (KM) literature, offers an overview of the state of public sector KM research and outlines a future research agenda.

Design/methodology/approach

– Articles published in KM journals are analyzed using a structured literature review methodology. The paper analyzes 180 papers published within ten journals specializing in the field of KM.

Findings

– Public sector KM is a research area of growing importance. Findings show that few authors specialize in the field and there are several obstacles to developing a cohesive body of literature. Low levels of international cooperation among authors and international comparisons mean that the literature is fragmented. Some research topics and some geographical areas within the public sector theme are over-analyzed, while others are under-investigated. Additionally, academic researchers should re-think their methodological approach if they wish to make significant contributions to the literature and work toward developing research which impacts practice in conjunction with practitioners.

Originality/value

– The paper presents a comprehensive structured literature review of the articles published in KM journals. The paper’s findings can offer insights into future research needs.

Mechanisms to motivate knowledge sharing: integrating the reward systems and social network perspectives

Purpose

– The purpose of this study is to develop a theoretical model that integrates two different mechanisms to explain knowledge sharing. First, adapted from traditional reward systems, the calculative-based mechanism (CBM) serves as the benchmark. Second, the relational-based mechanism (RBM) plays a complementary role. RBM is founded on social interaction and consists of two social network constructs: relational deposits (i.e. network and valued network centralities) and withdrawals (i.e. network and valued network densities).

Design/methodology/approach

– This study collected survey data in collaboration with a health-care organization. The data collected from 180 respondents were tested against the research model using a partial least squares analysis.

Findings

– This study found the CBM to be beneficial for knowledge sharing. The findings support the RBM prediction of a positive relationship between the deposit construct and knowledge sharing, but fail to support the RBM prediction on the withdrawal construct. The RBM explained about 15 per cent more of the variance than the CBM. In addition, the withdrawal construct of the RBM predicts respondents’ beliefs in reciprocal obligation.

Research limitations/implications

– RBM does not as strongly associate with economic benefits as the CBM, but it still plays a noteworthy role in increasing the possibility of an individual knowledge sharing.

Originality/value

– The study is the first to propose the concepts of relational deposits and withdrawals. The authors use a roster-based sociometric approach to collect the social network data and to benchmark the effect of RBM with that of CBM on individual knowledge sharing and his/her beliefs in reciprocal obligation.

Organisational Structure, Community of Practice and Patient Safety

Knowledge sharing has been proposed as one of the most effective ways to reduce medical errors, yet research on knowledge sharing with regard to patient safety is sparse. Because employees' knowledge behaviours are enabled or constrained by organisational structures, knowledge sharing can be nurtured or suppressed by organisational structures such as rules and policies. As such, this study integrated organisational structure into the concept of community of practice (CoP) and holistically investigated knowledge sharing with regard to patient safety in the healthcare industry.