| Summary: | 博士 === 國立成功大學 === 企業管理學系碩博士班 === 92 === ABSTRACT
Strategies have recognized knowledge as a key source of competitive advantage. No where is it more important than in knowledge-intensive firms like healthcare organizations, where resources are almost exclusively knowledge-based. In another aspect, the uncertainty of medical care, the “school of thought” between physicians and the development of clinical specialties as well as sub-specialties all lead to the variability of medical care, which could hurt medical quality. Consequently, the most imperative issues for healthcare industry are the diffusion and incorporation of medical knowledge into patterns of treatment recommended by physicians. Two models are proposed in this study. The first model reveals the influencing factors of medical knowledge sharing and medical knowledge integration through exploring the barriers of knowledge flow. The second model further discusses the associations between medical knowledge sharing, medical knowledge integration, medical decision-making quality and medical quality.
Since literature regarding these issues is rare, this research is with exploratory and qualitative nature. The study consists of three phases. In Phase I study, literature review and in-depth interviews were conducted to explore medical knowledge flow barriers. In Phase II study, a questionnaire was developed and a case study using a survey approach was employed. It aims to test the model established in Phase I study, and meanwhile to construct an extended model, which integrates the prior model with medical decision making quality and medical quality. In Phase III study, a Delphi method was used for validating and probing the generazability of the extended model.
The results basically support the two proposed models. Medical knowledge flow is composed of five factors including knowledge source, knowledge receiver, knowledge transferred, knowledge flow context and organizational context. These factors are correlated with each other, and they greatly affect medical knowledge sharing, medical
knowledge integration, medical decision-making quality and medical quality. Furthermore, a third model was constructed according to the findings regarding how the individual medical knowledge flow barrier affects other research constructs. Human factors including knowledge source and knowledge receiver largely influence medical decision-making quality, while contextual factors including knowledge flow context and organizational context affect medical quality most. For those healthcare managers who are carrying out knowledge management, our models can be adopted as a tool for examining the implementation performance. For those who are interested in studying or introducing knowledge management in healthcare industry, this research is expected to provide a comprehensive framework and serve as an essential reference for the academy and the practice.
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