Eintrag in der Universitätsbibliographie der TU Chemnitz
Pflugfelder, Nina
Pawlowsky, Peter (Univ.-Prof. Dr. rer. pol. habil. em.) ; Edvinsson, Leif (Adjunct Professor Emeritus) (Gutachter)
Managing and measuring knowledge-based value creation in ambulatory healthcare
Kurzfassung in englisch
Purpose/ Background The key resource for value creation in ambulatory healthcare is knowledge. Providers of ambulatory care are faced with knowledge-related challenges: Increasingly complex disease patterns and rapid medical innovation overwhelm their capacity to identify, generate, integrate, modify, diffuse and apply relevant knowledge. This results in reduced quality of care. Nevertheless, knowledge-based value creation has not been widely explored in ambulatory healthcare. Several research gaps explain: There are few publications regarding tools and methods for the management of knowledge resources in this context. Furthermore, the causal links between knowledge and organizational outcomes has not been theorized. A third major gap in the literature is the non-existence of frameworks for measuring knowledge-induced ambulatory healthcare performance. Against this backdrop, this dissertation attempts to answer the following overarching question: How can knowledge-based value creation be managed and measured in ambulatory healthcare? Design/ Methodology/ Approach This cumulative dissertation adopts a mixed-methods approach, i.e., each of the four included publications adopts a methodological approach appropriate to its topic and research question. The first publication narratively reviews major developments in Intellectual Capital (IC) and Knowledge Management theory. It benchmarks the new industry standard on Knowledge Management Systems (ISO 30401) against the previous literature by means of document analysis. Thereby it summarizes the state of research and practice regarding knowledge-based value creation. The second publication takes the form of a systematic literature review. In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, it summarizes the literature on Knowledge Management and performance in ambulatory healthcare. It compiles an overview of Knowledge Management practices which have been studied in the literature. Furthermore, it lists the indicators used to measure the impact of Knowledge Management on ambulatory healthcare performance and assesses their usefulness for further research and practice. The third publication explores the Knowledge Management-performance relationship by means of qualitative data analysis. Based on interviews with stakeholders from the ambulatory healthcare context, a toolbox of human-centered Knowledge Management methods and technical Knowledge Management tools for ambulatory healthcare is compiled. A conceptual model of the causal links between knowledge and organizational value creation is derived. The fourth and final publication uses social network analysis to measure Relational Capital in referrer networks of medical specialists in ambulatory settings. Using inferential statistics, it correlates Relational Capital with the economic performance of healthcare providers. Findings The first publication shows that the “ISO 30401:2018 Knowledge Management Systems” standard successfully integrates the broad and heterogenous extant literature on Intellectual Capital and Knowledge Management. The standard creates a common language for this research field and provides guidelines for Knowledge Management Systems across geographical, industry and organizational settings. As it is intentionally neutral with regards to concrete Knowledge Management tools and methods, the challenge lies in the implementation of the standard in practice. The second publication is a systematic literature review on Knowledge Management and its effects on the performance of ambulatory healthcare providers. It reveals that the previous literature is narrowly focused on 6 types of Knowledge Management practices, namely Electronic Health Records, Health Information Systems, Clinical Decision Support Systems, Trainings, Communities of Practice and bundles of firm-specific Knowledge Management initiatives (“multi-faceted interventions”). In previous publications, these tools and methods were mostly studied in relation to healthcare quality, while other outcomes like financial performance, staff engagement and patient satisfaction were neglected. The third publication, an interview-based conceptual study, paints a different picture than the literature review. Practitioners use a much broader range of Knowledge Management initiatives than those studied in the literature. Specifically, self-learning tools such as apps and podcasts as well as immersive training sessions are used by ambulatory healthcare providers. Also, technical gadgets for speech recognition and automated data processing are used. Sector stakeholders also relate Knowledge Management initiatives to a much wider set of outcome dimensions than the academic literature. Financial performance, staff engagement and client (patient/ referrer) satisfaction were named as distal outcomes. According to the interviewees in the study, Knowledge Management initiatives have direct causal connections with these outcomes as well as indirect connections mediated by quality and efficiency. The fourth publication shows that Relational Capital in social-professional networks of medical specialists can be measured by social network metrics (degree, density, relative betweenness centrality, referrer concentration). Furthermore, empirical support for the relationship between the Relational Capital and economic performance of medical specialist offices is provided. Originality/ Value In summary, this thesis makes three key contributions to research: Firstly, it provides an overview of human-centered Knowledge Management methods and technical Knowledge Management tools for the ambulatory healthcare context. Secondly, it sheds light on the causal links between knowledge resources and value/performance delivered by ambulatory healthcare providers. Thirdly, it develops a measurement framework for Relational Capital. Finally, it points out a range of research questions worth exploring.
| Universität: | Technische Universität Chemnitz | |
| Institut: | Professur BWL I - Betriebswirtschaftliche Steuerlehre und Wirtschaftsprüfung | |
| Fakultät: | Fakultät für Wirtschaftswissenschaften | |
| Dokumentart: | Dissertation | |
| Betreuer: | Pawlowsky, Peter (Univ.-Prof. Dr. rer. pol. habil. em.) | |
| URL/URN: | https://nbn-resolving.org/urn:nbn:de:bsz:ch1-qucosa2-853298 | |
| Quelle: | 2023. - 236 S. | |
| SWD-Schlagwörter: | Intellektuelles Kapital , Gesundheitswesen , Wissen , Wertschöpfung | |
| Freie Schlagwörter (Englisch): | Ambulatory Healthcare , Intellectual Capital , Knowledge Management , Organizational Performance , Value Creation | |
| DDC-Sachgruppe: | 658.303 | |
| Sprache: | englisch | |
| Tag der mündlichen Prüfung | 01.06.2022 |
