Knowledge and culture influences on quality of care: A mixed methods approach

Concerns about the quality of care provided to patients have been recently revisited in the healthcare management literature, driven by the aftermath of the COVID-19 pandemic. Quality of care is a complex measure of healthcare performance that relies on optimizing healthcare knowledge. Knowledge management initiatives and practices in healthcare remain difficult to implement and develop – presenting a managerial challenge that must coexist in a competitive environment. This paper aims to study the contribution of knowledge-management systems, knowledge-sharing behavior, and competitive culture to the quality of care provided to patients. We use a mixed-methods approach to explore a research model in a sequence of two studies. Research data comes from a sample of 323 healthcare professionals in Portuguese healthcare organizations. Quantitative results show that both knowledge-management systems and a competitive culture positively influence the quality of care. Results also show a positive influence of knowledge-sharing behavior on the quality of care. Complementarily, qualitative results reveal two configurations leading to quality of care. The first highlights the role of knowledge-management systems alone as sufficient to provide quality of care. A second configuration involves cumulative contributions of competitive culture and individual knowledge sharing, leading to quality of care. Theoretical and practical implications are discussed, and a model for quality of care creation is offered. Limitations are acknowledged and future work directions are presented.