Modeling the Pathways of Knowledge Management Towards Social and Economic Outcomes of Health Organizations
Abstract
:1. Introduction
- RQ1.
- What is the impact of the KM process on organizational-level outcomes in the healthcare context?
- RQ2.
- What is the mechanism through which the KM process is able to enhance the quality of care and social and economic outcomes of health organizations?
2. Theoretical and Empirical Background
2.1. Knowledge Management Process and Organizational Performance
2.2. Healthcare Perspective on Knowledge Management
3. Research Hypotheses and Conceptual Model
4. Materials and Methods
4.1. Participants and Procedure
4.2. Measures
4.3. Data Screening
4.4. Data Analysis
5. Results
5.1. Measurement Model Assessment
5.2. Structural Model
5.3. Testing Research Hypotheses
5.4. Importance Performance Matrix Analysis
6. Discussion and Conclusions
6.1. Theoretical and Practical Implications
6.1.1. Quality of Healthcare
6.1.2. Social Outcomes
6.1.3. Economic Outcomes
6.2. Limitations and Directions for Future Research
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Concept | Variable | Item | References |
---|---|---|---|
KM process | Within the organization… | ||
Knowledge acquisition | KAch1 | New sources of information and knowledge are constantly being identified | [18,21,30,34] |
KAch2 | New information and knowledge are acquired through participation at medical conferences and congresses | ||
KAch3 | New information and knowledge are acquired by studying relevant literature | ||
KAch4 | New information and knowledge are acquired by attending training or specialization courses | ||
KAch5 | New information and knowledge are acquired from high-quality medical centers | ||
Knowledge sharing | KSha1 | Information and knowledge are frequently shared with department colleagues | [21,25,30,34] |
KSha2 | Information and knowledge are frequently shared with younger/less experienced colleagues | ||
KSha3 | Information and knowledge are frequently shared with colleagues from other departments | ||
KSha4 | Information and knowledge are frequently shared with colleagues from other health organizations | ||
KSha5 | Information and knowledge are frequently shared by means of formal communication (e.g., meetings) | ||
KSha6 | Information and knowledge are frequently shared by means of informal communication | ||
Knowledge utilization | KUti1 | Information and knowledge are cherished for their true value | [21,25,34] |
KUti2 | Information and knowledge are considered as the organization’s valuable assets | ||
KUti3 | Different sources of information and knowledge are effectively used within medical practice | ||
KUti4 | Medical staff knowledge is effectively applied within their medical practice | ||
KUti5 | In providing medical care, there are effectively used medical protocols, procedures, and instructions existing within the organization | ||
KUti6 | The information and knowledge existing within the organization are accessible to those who need it | ||
Quality of health services | |||
QHS1 a | The organization has a highly skilled medical staff | [56,57,58] | |
QHS2 a | The medical services provided are accessible in terms of location, price, and waiting time | ||
QHS3 | Patients positively appreciate the quality of medical services in terms of interpersonal relationships | ||
QHS4 | Continuity in medical care is ensured | ||
QHS5 | The medical services provided are efficient | ||
QHS6 | The medical services provided are considered effective by patients and healthcare professionals | ||
QHS7 | There are no risks associated with the process of granting medical care | ||
QHS8 | Patients are provided free choice in terms of medical care | ||
Social-related outcomes | |||
Employees satisfaction | ESat1 | The organization frequently measures employee perception of motivating factors | [51,59,60,61] |
ESat2 | The organization frequently measures employees’ perception of demotivating factors | ||
ESat3 | Employee satisfaction has, overall, an increasing tendency | ||
ESat4 | Employee satisfaction is, overall, superior to that recorded in similar organizations | ||
Health status and quality of life improvement | HStat1 | Medical services provided contribute to improving patient health status | [51,61] |
LQual1 a | Medical services provided contribute to increasing patient quality of life | ||
Patient satisfaction | PSat1 | Patient satisfaction with medical services/products is constantly assessed through surveys | [51,59,60,61] |
PSat2 | Patient satisfaction has, overall, an increasing tendency | ||
PSat3 | Patient satisfaction is, overall, superior to that recorded in similar organizations | ||
Economic-related outcomes | |||
Competitiveness | Comp1 | Evaluation of organization’s competitiveness… … compared with that of the main competitors | [60,61] |
Comp2 | … compared to five years ago | ||
Comp3 | … compared with its set objectives | ||
Economic performance | EPerf1 | Evaluation of organization’s competitiveness… … compared with its set objectives | [60,61] |
EPerf2 | … compared with that of the main competitors | ||
EPerf3 | … compared to five years ago |
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Variable | N/Mean | SD (%) | |
---|---|---|---|
Profession | Physician | 99 | 21.569 |
Pharmacist | 115 | 25.054 | |
Medical staff with higher education (other than physician) | 24 | 5.229 | |
Nurse | 101 | 22.004 | |
Nonmedical staff | 95 | 20.697 | |
Others | 25 | 5.447 | |
Managerial position | Yes | 66 | 14.379 |
No | 393 | 85.621 | |
Seniority within organization (years) | 5.538 | 4.412 | |
Type of healthcare | Specialized medical care | 141 | 30.719 |
Hospital | 190 | 41.394 | |
Pharmacy | 128 | 27.887 | |
Organization size (employees) | <10 | 87 | 18.954 |
10–49 | 40 | 8.715 | |
50–249 | 144 | 31.373 | |
>250 | 188 | 40.959 |
Latent Construct (First-Order/Second-Order; Reflective/Formative) | Items | Loadings | SD | t | α | Rho_A | CR | AVE |
---|---|---|---|---|---|---|---|---|
KAch—Knowledge acquisition | KAch1 | 0.788 *** | 0.019 | 40.497 | 0.870 | 0.871 | 0.906 | 0.658 |
(first-order; reflective) | KAch2 | 0.841 *** | 0.016 | 53.782 | ||||
KAch3 | 0.833 *** | 0.018 | 47.596 | |||||
KAch4 | 0.811 *** | 0.016 | 50.852 | |||||
KAch5 | 0.780 *** | 0.021 | 37.084 | |||||
KSha—Knowledge sharing | KSha1 | 0.788 *** | 0.021 | 37.647 | 0.805 | 0.816 | 0.860 | 0.507 |
(first-order; reflective) | KSha2 | 0.686 *** | 0.031 | 22.183 | ||||
KSha3 | 0.717 *** | 0.026 | 27.842 | |||||
KSha4 | 0.664 *** | 0.034 | 19.548 | |||||
KSha5 | 0.648 *** | 0.033 | 19.528 | |||||
KSha6 | 0.760 *** | 0.021 | 35.571 | |||||
KUtil—Knowledge utilization | KUti1 | 0.773 *** | 0.022 | 35.005 | 0.831 | 0.842 | 0.877 | 0.545 |
(first-order; reflective) | KUti2 | 0.637 *** | 0.039 | 16.383 | ||||
KUti3 | 0.807 *** | 0.018 | 44.961 | |||||
KUti4 | 0.711 *** | 0.028 | 25.318 | |||||
KUti5 | 0.691 *** | 0.032 | 21.806 | |||||
KUti6 | 0.795 *** | 0.016 | 49.245 | |||||
QHS—Quality of health services | QHS3 | 0.550 *** | 0.051 | 10.883 | 0.820 | 0.838 | 0.870 | 0.531 |
(first-order; reflective) | QHS4 | 0.743 *** | 0.029 | 25.704 | ||||
QHS5 | 0.810 *** | 0.021 | 39.429 | |||||
QHS6 | 0.808 *** | 0.019 | 43.494 | |||||
QHS7 | 0.703 *** | 0.031 | 22.830 | |||||
QHS8 | 0.725 *** | 0.029 | 25.022 | |||||
SOut—Social-related outcomes | ESat1 | 0.794 *** | 0.019 | 41.999 | 0.869 | 0.875 | 0.898 | 0.527 |
(first-order; reflective) | ESat2 | 0.779 *** | 0.024 | 32.619 | ||||
ESat3 | 0.835 *** | 0.014 | 61.671 | |||||
ESat4 | 0.746 *** | 0.024 | 31.178 | |||||
HStat1 | 0.588 *** | 0.040 | 14.578 | |||||
PSat1 | 0.690 *** | 0.027 | 25.625 | |||||
PSat2 | 0.709 *** | 0.025 | 28.317 | |||||
PSat3 | 0.634 *** | 0.030 | 21.377 | |||||
EOut—Economic-related outcomes | Comp1 | 0.727 *** | 0.022 | 32.810 | 0.845 | 0.849 | 0.885 | 0.564 |
(first-order; reflective) | Comp2 | 0.781 *** | 0.020 | 39.030 | ||||
Comp3 | 0.772 *** | 0.023 | 33.777 | |||||
EPerf1 | 0.808 *** | 0.016 | 49.829 | |||||
EPerf2 | 0.747 *** | 0.023 | 32.156 | |||||
EPerf3 | 0.662 *** | 0.031 | 21.079 | |||||
KMP—Knowledge management process | KAch | 0.896 *** | 0.011 | 84.809 | 0.907 | 0.914 | 0.889 | 0.727 |
(second-order; reflective) | KSha | 0.820 *** | 0.021 | 39.973 | ||||
KUtil | 0.840 *** | 0.014 | 58.747 |
Construct | EOut | KAch | KSha | KUtil | QHS | SOut |
---|---|---|---|---|---|---|
EOut | 0.751 | |||||
KAch | 0.431 | 0.811 | ||||
KSha | 0.318 | 0.676 | 0.712 | |||
KUtil | 0.528 | 0.606 | 0.493 | 0.738 | ||
QHS | 0.488 | 0.276 | 0.135 | 0.571 | 0.728 | |
SOut | 0.671 | 0.518 | 0.36 | 0.631 | 0.592 | 0.726 |
Endogenous Construct | R2 | Relationship | f2 | Decision |
---|---|---|---|---|
QHS | 0.164 *** | KMP → QHS | 0.203 *** | Medium |
EOut | 0.479 *** | KMP → EOut | 0.033 | Small |
QHS → EOut | 0.024 | Small | ||
SOut | 0.511 *** | KMP → SOut | 0.334 *** | Large |
QHS → SOut | 0.299 *** | Medium |
Hypothesis | Relationship | β | SE | t | 95% BC CI | Supported (Yes/No) | |
---|---|---|---|---|---|---|---|
CIlow | CIhigh | ||||||
H1 (+) | KMP → QHS | 0.407 *** | 0.040 | 10.149 | 0.340 | 0.471 | Yes |
H2 (+) | KMP → SOut | 0.439 *** | 0.030 | 14.747 | 0.390 | 0.488 | Yes |
H3 (+) | KMP → EOut | 0.156 ** | 0.047 | 3.332 | 0.079 | 0.233 | Yes |
H4 (+) | QHS → SOut | 0.414 *** | 0.038 | 10.817 | 0.349 | 0.476 | Yes |
H5 (+) | QHS → EOut | 0.131 ** | 0.054 | 9.278 | 0.051 | 0.214 | Yes |
Hypothesis | Relationship (Effect Type) | β | SE | t | 95% BC CI | Mediation | Supported (Yes/No) | |
---|---|---|---|---|---|---|---|---|
CIlow | CIhigh | |||||||
H6 | KMP → SOut (Direct Effect) | 0.439 *** | 0.030 | 14.747 | 0.390 | 0.488 | Simple complementary mediation | Yes |
KMP → QHS → SOut (Indirect Effect) | 0.168 *** | 0.023 | 7.390 | 0.131 | 0.206 | |||
KMP → SOut (Total Effect) | 0.607 *** | 0.026 | 23.646 | 0.560 | 0.646 | |||
H7a–H7c | KMP → EOut (Direct Effect) | 0.156 ** | 0.047 | 3.332 | 0.079 | 0.233 | Multiple complementary mediation | Yes |
KMP → EOut (Total Indirect Effect) | 0.358 *** | 0.028 | 12.888 | 0.309 | 0.400 | |||
KMP → QHS → EOut (Specific Indirect Effect) | 0.053 * | 0.020 | 2.585 | 0.022 | 0.090 | |||
KMP → SOut → EOut (Specific Indirect Effect) | 0.220 *** | 0.027 | 8.069 | 0.176 | 0.267 | |||
KMP → QHS → SOut → EOut (Specific Indirect Effect) | 0.084 *** | 0.015 | 5.625 | 0.062 | 0.111 | |||
KMP → EOut (Total effect) | 0.513 *** | 0.039 | 13.160 | 0.443 | 0.573 |
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Popa, I.; Ștefan, S.C. Modeling the Pathways of Knowledge Management Towards Social and Economic Outcomes of Health Organizations. Int. J. Environ. Res. Public Health 2019, 16, 1114. https://doi.org/10.3390/ijerph16071114
Popa I, Ștefan SC. Modeling the Pathways of Knowledge Management Towards Social and Economic Outcomes of Health Organizations. International Journal of Environmental Research and Public Health. 2019; 16(7):1114. https://doi.org/10.3390/ijerph16071114
Chicago/Turabian StylePopa, Ion, and Simona Cătălina Ștefan. 2019. "Modeling the Pathways of Knowledge Management Towards Social and Economic Outcomes of Health Organizations" International Journal of Environmental Research and Public Health 16, no. 7: 1114. https://doi.org/10.3390/ijerph16071114