The impact of knowledge management practice on the hospital performance in Abu Dhabi

Main Nase Alolayyan; Alalawin, Abdallah Hassan; Alyahya, Mohammad S.; Qama , Ahmad A icle The impac o knowledge managemen p ac ice on he hospi al pe o mance in Abu Dhabi Cogen Business & Managemen P o ided in Coope a ion wi h: Taylo & F ancis G oup Sugges ed Ci a ion: Main Nase Alolayyan; Alalawin, Abdallah Hassan; Alyahya, Mohammad S.; Qama , Ahmad (2020) : The impac o knowledge managemen p ac ice on he hospi al pe o mance in Abu Dhabi, Cogen Business & Managemen , ISSN 2331-1975, Taylo & F ancis, Abingdon, Vol. 7, Iss. 1, pp. 1-17, h ps://doi.o g/10.1080/23311975.2020.1827812 This Ve sion is a ailable a : h ps://hdl.handle.ne /10419/244970 S anda d-Nu zungsbedingungen: Die Dokumen e au EconS o dü en zu eigenen wissenscha lichen Zwecken und zum P i a geb auch gespeiche und kopie we den. Sie dü en die Dokumen e nich ü ö en liche ode komme zielle Zwecke e iel äl igen, ö en lich auss ellen, ö en lich zugänglich machen, e eiben ode ande wei ig nu zen. 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I he documen s ha e been made a ailable unde an Open Con en Licence (especially C ea i e Commons Licences), you may exe cise u he usage igh s as speci ied in he indica ed licence. h ps://c ea i ecommons.o g/licenses/by/4.0/ Full Te ms & Condi ions o access and use can be ound a h ps://www. and online.com/ac ion/jou nalIn o ma ion?jou nalCode=oabm20 Cogen Business & Managemen ISSN: (P in ) (Online) Jou nal homepage: h ps://www. and online.com/loi/oabm20 The impac o knowledge managemen p ac ice on he hospi al pe o mance in Abu Dhabi Main Nase Alolayyan, Abdallah Hassan Alalawin, Mohammad S. Alyahya & Ahmad Qama | To ci e his a icle: Main Nase Alolayyan, Abdallah Hassan Alalawin, Mohammad S. Alyahya & Ahmad Qama | (2020) The impac o knowledge managemen p ac ice on he hospi al pe o mance in Abu Dhabi, Cogen Business & Managemen , 7:1, 1827812, DOI: 10.1080/23311975.2020.1827812 To link o his a icle: h ps://doi.o g/10.1080/23311975.2020.1827812 © 2020 The Au ho (s). This open access a icle is dis ibu ed unde a C ea i e Commons A ibu ion (CC-BY) 4.0 license. Published online: 15 Oc 2020. Submi you a icle o his jou nal A icle iews: 2284 View ela ed a icles View C ossma k da a MANAGEMENT | RESEARCH ARTICLE The impac o knowledge managemen p ac ice on he hospi al pe o mance in Abu Dhabi Main Nase Alolayyan 1 *, Abdallah Hassan Alalawin 2 , Mohammad S. Alyahya 1 and Ahmad Qama 2 Abs ac : This s udy p oposes a concep ual model ha simul aneously in ol es i e ac o s o Knowledge Managemen (KM) and six ac o s o Hospi al Pe o mance (HP), in hei espec i e cons uc s. The signi icance o his model is ha i has logically linked he cons uc s o bo h KM and HP. Explo a o y ac o analysis, eliabili y analysis p ocedu e, and cons uc alidi y p ocedu es ha e been used o e i y and alida e he unde lying dimensions o KM and HP. The ela ionship has been analyzed h ough S uc u al Equa ion Modeling app oaches, in he las s age o he da a analysis, he esul s ound ha only h ee a iables o KM cons uc ha e a signi ican di ec ional impac on he only h ee a iables o HP cons uc e ec s. Fu he , he in-dep h da a analysis has e ealed ha he h ee a iables o KM cons uc ha e a s a is ically signi ican in luence on he h ee a iables o HP cons uc . The s a is ically igo ous and s ong esul s ob ained in his s udy sugges ha his concep ual model can be used as a managemen ool o assess ABOUT THE AUTHOR Main Nase Alolayyan/ Jo dan Uni e si y o Science and Technology (JUST). An assis an p o esso a he Heal h Managemen and Policy Depa men . His a eas o in e es and esea ch encompass: Heal h Knowledge managemen , heal h ope a ions managemen , heal h quali y managemen , ope a ional lexibili y, se ice quali y and managemen , supply chain man- agemen , lean se ice, six sigma, human esou ce managemen , and Small Medium En ep eneu ship. Abdallah Alalawin/ Hashemi e Uni e si y. An Assis an P o esso a he Depa men o Indus ial Enginee ing. His a eas o in e es : Supply Chain managemen and in elligen sys ems. D . Mohammad Alyahya/ Jo dan Uni e si y o Science and Technology (JUST). An associa e p o- esso a he depa men o Heal h Managemen and Policy/Facul y o Medicine. His esea ch in e - es s include Heal h policy, heal h sys ems, p og am and p ojec managemen , change managemen , and Heal h in o ma ics. Ahmad M. Qama / Hashemi e Uni e si y. A ull- ime lec u e in he Depa men o Indus ial Enginee ing. Besides eaching, he is in e es ed in conduc ing esea ch conce ned wi h ope a ions esea ch, and o he indus ial enginee ing applica ions. PUBLIC INTEREST STATEMENT The Majo i y o he new ends in he o ganiza ion managemen sys ems conside knowledge as one o he main asse s hey ha e. How o u ilize his knowledge o imp o e he o ganiza ion’s pe o - mance is a esea chable a ea, whe e o ganiza- ions in es mo e and mo e o ocus on i . The ocus o his pape is o in es iga e he linkage be ween Knowledge Managemen and Hospi al Pe o mance. This esea ch p o ides empi ical e idence o he di ec impac s o Knowledge Managemen on he Hospi al Pe o mance. The sugges ed model can be used as a managemen ool o assess hospi al pe o mance, which can be used o imp o e hospi al pe o mance and e iciency. Alolayyan e al., Cogen Business & Managemen (2020), 7: 1827812 h ps://doi.o g/10.1080/23311975.2020.1827812 Page 1 o 17 Recei ed: 24 Janua y 2020 Accep ed: 18 Sep embe 2020 *Co esponding au ho : Main Nase Alolayyan, Facul y o Medicine, Jo dan Uni e si y o Science and Technology, Jo dan E-mail: [email p o ec ed] Re iewing edi o : Pan ea Fo oudi, MBT, Middlesex Uni e si y, London UK Addi ional in o ma ion is a ailable a he end o he a icle © 2020 The Au ho (s). This open access a icle is dis ibu ed unde a C ea i e Commons A ibu ion (CC-BY) 4.0 license. pe o mance. The signi ican impac o KM on HP has been a gued o be posi i e. The alue o he pape is ha i cla i ies he in luence o KM on HP in Abu-Dhabi hospi als which can be used o imp o e hospi al pe o mance and e iciency. Subjec s: Heal hca e Adminis a ion and Managemen ; Quali y o Li e; Heal h Communica ion; Heal h In o ma ics and S a is ics Keywo ds: Knowledge Managemen (KM); hospi al; pe o mance; Abu-Dhabi; s uc u e equa ion modeling 1. In oduc ion The p ac ice o knowledge managemen (KM) has gained much impo ance in he las ew decades. Knowledge managemen (KM) has become a p ima y ool o o ganiza ions ha seek o ope a e a an op imal le el and mee he maximum sa is ac ion o all cus ome s. Knowledge managemen (KM) is la gely conside ed as a na u al p ocess ha p e ails in all p esen -day mode n o ganiza ions. Fu he , i is an in eg a ed sys em ha signi ican ly combines human esou ces, p ocesses, and s a e o a wi hin an o ganiza ion o achie ing long- e m and sus ainable goals h ough imp o ing o ganiza- ional pe o mance based on lea ning. I is belie ed ha knowledge managemen simul aneously wo ks as a i al esou ce o he o ganiza ion and allows o ganiza ions o be e compe e in he ma ke (Tan & Nasu din, 2011). Imp o ing he knowledge managemen o he inancial sec o has become a main issue o cus ome s, hospi al owne s, go e nmen s, and manage s. Today, knowledge man- agemen has come o ha e a di ec e ec on o ganiza ional pe o mance. An ample body o p e ious li e a u e on he cu en a ea o in e es has e ealed ha KM plays a i al ole in signi ican ly imp o ing o ganiza ional pe o mance, along wi h p o iding a clea answe o he ques ion: “How can he o ganiza ion enhance i s o ganiza ional capabili ies, esul ing in he enhancemen o in e nal pe o mance and ex e nal compe i i eness?” 2. Li e a u e e iew and heo e ical amewo k The e alua ion o KM pe o mance in o ganiza ions has been a main poin o ocus in he p e ious li e a u e. On one hand, s udies such as L.-C. Wu e al. (2008) ha e app oached his issue wi h he concep o using accoun and inance echniques o measu e in ellec ual capi al and/o knowledge asse s, and ha e adop ed he eal op ions me hodology o p oduce a inancial me hod o e alua ing knowledge-based o ganiza ions. On he o he hand, o he s udies in he li e a u e ha e explici ly ocused on he ela ionship be ween KM and o ganiza ional pe o mance using o e all business measu es such as p o i abili y, p oduc i i y, and ma ke pe o mance (Anan a mula & Kanungo, 2006; Gold e al., 2001; Iqbal e al., 2019; Kiessling e al., 2009; Payal e al., 2019). Fo example, Gold e al. (2001) ca ied ou a su ey-based s udy in which hey es ed a model o he ela ionship be ween KM and o ganiza ional capabili ies, including in as uc u e and p ocesses capabili ies and o ganiza ional e ec i eness, Iqbal e al. (2019) es ed he di ec ela ion be ween KM p ocesses and Hospi al pe o mance (HP), hei inding is ha p ocesses in luence di ec ly and indi ec ly h ough inno a ion and in ellec ual capi al, Payal e al. (2019) in es iga ed he dynamic ela ionships KM cons uc s and hei links o HP using a holis ic in eg a ed model, a signi ican posi i e ela ionship is ound. Howe e , i is wo h men ioning ha many o hese s udies ha e ended o o e look he complexi y o he ela ionship be ween KM and business pe o mance and ha e no p o ided p ac i ione s wi h su icien necessa y ou pu o help hem de elop and moni o Knowledge Managemen Assessmen s (KMAs). The e o e, o mo e in-dep h analysis o he phenomenon, o he s udies ha e ins ead ocused on he ela ionship be ween KM and inno a ion, he la e being conside ed a di ec ou come o he o me . Resea che s o such s udies belie e ha knowledge and inno a ion a e in e ela ed (Mu o ec & P odan, 2009) and iew knowledge as a p ima y ac o o inno a ion (Abbas & Sağsan, 2019; B and, 1998; Elmo shidy, 2018; Hassan & Raziq, 2019; Kuma , 2016; Susan y e al., 2019). Fo example, Susan y e al. (2019) ound ha inno a ion pe o mance will dec ease by Alolayyan e al., Cogen Business & Managemen (2020), 7: 1827812 h ps://doi.o g/10.1080/23311975.2020.1827812 Page 2 o 17 compensa ing knowledge imp o emen . On he o he side Hassan and Raziq (2019) ound a posi i e associa ion be ween KM and adical inno a ion. KM can hus be conside ed an o ganiza ional mechanism o he con inual p omo ion and de elopmen o inno a ion (Chang & Chen, 2004). In suppo o he ela ionship be ween knowl- edge and inno a ion, nume ous well-o ganized impe ial s udies ha e e ealed ha knowledge managemen -d i en o ganiza ions end o exhibi highe le els o inno a ion (A ias (A anda & Molina-Fe nández, 2002; Da och, 2003, 2005; Hassan & Raziq, 2019; Iqbal e al., 2019; Singh e al., 2019). Some case-based s udies ha e explo ed his link in inno a ion-d i en business p ocesses such as esea ch de elopmen and new p oduc de elopmen in knowledge-in ensi e businesses such as elecommunica ion (Akeke & Olayiwola, 2019; Gyemang & Emeagwali, 2020; Massey e al., 2002) and IT (Kodama, 2006). On he o he side o he spec um, o he esea che s hold he iew ha he nexus be ween inno a ion and pe o mance managemen is a he simple and di ec han complex. In hei wo k, Jiménez-Jimenez e al. (2008) explici ly s a e ha o many o ganiza ions, being inno a i e is no enough o success. In hei 2005 s udy, Vijande e al. (2005) shed ligh on he ela ionship be ween inno a ion, ma ke o ien a ion (MO), and pe o mance and a gued ha pe o mance needs an o ganiza ional abili y o an icipa e, espond, and signi ican ocus on en i onmen al issues as such is concep ually bound o local en i onmen al s a egy, and Ud iyah e al. (2019) a gue he ela ionship be ween ma ke o ien a ion (MO) and inno a ion wi h business pe o - mance which hey ha e a signi ican di ec and indi ec h ough compe i i e ad an age. Though i is ag eed ha he ela ionship be ween KM and pe o mance is in e wined wi h he use o inno a ion and MO as media ing a iables be ween o ganiza ional lea ning and pe o - mance (Hu ley & Hul , 1998; Jiménez-Jimenez e al., 2008; Ud iyah e al., 2019). MO was no included in his esea ch model. This is because MO places in ensi e ocus on cus ome needs whils g ea ly o e looking o he signi ican en i onmen al changes b ough abou by ac o s such as new echnologies, legal ci cums ances, social de elopmen , me ge s, consolida ions, e c. (Nzewi & Moneme, 2016; O e by e al., 2005). An agili y li e a u e e iew e ealed ha many esea che s iew ha KM has become a undamen al ac o o business p ospe i y. Mode n o ganiza ions a e o ced o deal wi h an inc easingly uns able en i onmen b ough by globaliza ion, ad ances in IT, and ise in li ing s anda ds, inc eased egula ions and co po a e go e nance demands, less cohesion in social alues, and he ise o pos -mode nism (Cai e al., 2019; Nzewi & Moneme, 2016; O e by e al., 2005; Sambamu hy e al., 2003; Wo ley & Lawle , 2010). Cai e al. (2019) in es iga ed how o le e age KM and IT capabili y o build agili y in he con ex o inno a ion. Agili y is a e m used o e e o a i m’s le el o awa eness o compe i i e oppo uni ies and h ea s and i s abili y o use his awa eness in aking inno a i e, compe i i e decisions such as in oducing new p oduc s, making new p ocess imp o emen s, and o ming new alliances (Saha, 2017; Sambamu hy e al., 2003). This awa eness and he esponse o his awa eness a e wo undamen al ac o s ha demons a e he in e - ela edness o agili y and inno a ion (Cai e al., 2019). Do e (1999) de ined “ esponse-abili y” as he physical abili y o ac h ough inno a ions and “sensing abili y” as he KM abili ies equi ed o ind app op ia e ac o s o ac on. Ma hews and Ha is (2006) a gued ha agile o ganiza ions a e usually knowledge d i en. Such o ganiza ions h i e on he abili y o eac apidly o en i onmen al changes by ga he ing necessa y knowledge and asse s and hen making inno a i e changes (Raschke, 2010). P ac i ione s in he ields o KM, IT, and s a egy (Tallon e al., 2019; Van Oos e hou e al., 2006) and academics (Do e, 1999; O e by e al., 2005; Saha, 2017) ha e come o iew agili y as he s a egic pe spec i e ha uly cap u es he signi icance o KM. Thus, in ou cu en s udy, we ha e aken agili y o be he le el a which he o ganiza ion inally links KM o pe o mance. Alolayyan e al., Cogen Business & Managemen (2020), 7: 1827812 h ps://doi.o g/10.1080/23311975.2020.1827812 Page 3 o 17 Finally, e y ew s udies ocus on he ela ion be ween KM and hospi al pe o mance. Najmi e al. (2018) ound ha KM has no signi ican e ec on hospi al pe o mance, and his esul was agains he mos commen esul which indica es ha he e is a signi ican ela ion be ween KM and HP like Liu e al. (2005), Zheng e al. (2010), and Ud iyah e al. (2019), ano he s udy by Tang (2017) and I.-L. Wu and Hu (2012) ound ha KM has a signi ican e ec on hospi al pe o mance, and many o he s udies suppo he same esul in heal hca e sec o . (Achmad & G ace, 2019; J.-L. Chen, 2017; Ka ama e al., 2019) 3. Me hodology In his sec ion, he me hodology o he cu en s udy is discussed in de ail. P ocedu es and p ocesses in ol ed in de eloping and choosing he ins umen used o da a collec ion a e ou - lined. Finally, he alidi y es and eliabili y es es ima es o he ins umen , he p ocedu e o da a collec ion, and he comple e da a analysis p ocess a e explained. 3.1. Resea ch se ing The esea ch se ing e e s o he place ha can be seen as he physical, social, and cul u al si e whe e he da a a e collec ed. This s udy was conduc ed in i e hospi als (p i e and go e nmen ) in Abu Dhabi emi a e, he s a which pa icipa ed in he s udy om many a ious depa men s in he hospi als, he s udy objec i e o de e mine he ela ionship be ween Knowledge managemen p ac ice and hospi al pe o mance. 3.2. Resea ch design A esea ch design is explo a o y esea ch ha esea che s use o conduc a scien i ic s udy. I is he o e all synch oniza ion o iden i ied componen s and da a esul ing in a plausible ou come. A esea ch design is de ined as he gene al main plan o how a esea che will go abou answe ing he esea ch ques ions ha she o he has se (Saunde s e al., 2016). Consequen ly, he esea ch design has wo main unc ions: he i s is o emphasize he impo ance o quali y in hese p ocedu es o ensu e hei alidi y, objec i i y and accu acy, and he second is he iden i i- ca ion and de elopmen o p ocedu es and logis ical a angemen s equi ed o unde ake a s udy (Kuma , 2005). In ou esea ch, quan i a i e esea ch was used by implemen ing expe imen al design esea ch; o his esea ch o allow o es ing o he ela ionship and es ablishing cause and e ec s on he esea ch ques ion (Saunde s e al., 2016). The s udy u ilized his design o iden i y and desc ibe he e ec s o knowledge managemen p ac ice on hospi al pe o mance in Abu Dhabi emi a e hospi als. 3.3. S udy popula ion The popula ion is desc ibed as all membe s o he s udy communi y, as well as any well-de ined ca ego y o people, e en s o hings ha a e allo ed and gene alized abou i , on he o he hand, a sample is de ined as a pa o he popula ion o a small g oup ha is obse ed and iden i ied in a esea ch s udy (Manoha an, 2010). The a ge popula ion in s a is ics is he speci ic popula ion abou which in o ma ion is desi ed. Popula ion s udies also called census a e mo e ep esen a i e because e e yone has an equal chance o be included in he inal sample ha is d awn acco ding o Mugenda (2003), he a ge popula ion o his s udy consis ed o hospi als medical s a and s a om many a ious depa men s. 3.4. Sample and sampling echniques Sampling is de ined as a delica e p ocess o selec ing speci ic membe s o a subse o he o al popula ion o make in e ences and s a is ical s udies om hem and o es ima e gene al cha - ac e is ics o he en i e communi y. Resea che s use all sampling ypes on a social science and ma ke esea ch, so ha hey do no need o s udy all membe s o he popula ion o each gene al judgmen s. I is also a me hod ha has he quali ies o being bo h ime and cos -e ec i e and hus o ms an impo an basis o any esea ch design. Alolayyan e al., Cogen Business & Managemen (2020), 7: 1827812 h ps://doi.o g/10.1080/23311975.2020.1827812 Page 4 o 17 Gy (1992) a gues ha he comp ehensi eness o a s udy sample is undamen al o i s eliabili y, as i allows o he gene aliza ion o he s udy indings. Though sample sizes may di e depending on he ype o esea ch in ques ion, he ideal sample size, i e obse a ions o each independen a iable 5:1 is usually he a io used o de e mine s a is ical powe (sample size) (Hai , 2009). In acco dance wi h he abo e condi ion, he esea che selec ed a mode a e ye app op ia e sample size o 200 espon- den s om he i e hospi als; howe e , only 200 esponses we e e u ned back o analysis. Pa icipan s we e chosen om a lis o he a ge ed popula ion o he s udy using a s a i ied andom sampling echnique (s a i ied andom sampling is a me hod whe e he popula ion can be di ided in o smalle g oups, ha don’ o e lap bu ep esen he en i e popula ion oge he . While sampling, hese g oups can be o ganized and hen d aw a sample om each g oup sepa a ely). The sampling echniques ocused mainly on ce ain demog aphic cha ac e is ics o he esea ch popula ion, namely Gende [Male—122 (61%), Female—78 (39%)]; Age [20–35 y s—170 (85%), 36–50 y s—27 (13.5 %), 51–65 y s—3 (1.5%)]; Le el o Educa ion [Diploma—11 (5.5%), G adua e— 85 (42.5%), Pos g adua e—104 (52)]; P o ession [Manage —2 (1 %), Senio O ice —26 (13 %), Head o Depa men —33 (16.5 %), Supe iso —25 (12.5 %), adminis a o s—83 (41.5 %), Heal h Managemen S a —31 (15.5%)]; and Yea s o Expe ience [2 y s o less han 2 y s—56 (28%), 3–5 y s—66 (33 %), 6–10 y s—63 (31.5 %), and 11–25 y s—15 (7.5 %)]. Table 1 p esen s de ails on he esea ch sample selec ed o his s udy. The s udy sample consis ed o 200 esponden s, 27 (13.5 %) om Al Co niche Hospi al, 85 (42.5%) om Sheikh Khali a Medical Ci y, 33 (16.5 %) om Li eline Hospi al, 30 om (15 %) Al Salam Hospi al, and he emaining 25 (12.5%) om Ma a aq Hospi al. Table 2 p esen s a summa y o he s udy sample size. The olun ee s in ol ed in he esea ch we e s a om he i e hospi als which was selec ed. The i e hospi als we e s ic ly which con o med o he key c i e ia used o sample selec ion in his s udy. Table 1. Sample s a is ics o he esponden s F equency (N) Pe cen age % Gende Male 122 61 Female 78 39 Age (yea s) 20–35 170 85 36–50 27 13.5 51–65 3 1.5 Educa ion le el Diploma 11 5.5 G adua e 85 42.5 Pos g adua e 104 52 P o ession Manage s 2 1 Senio O ice s 26 13 Head o Depa men s 33 16.5 Supe iso s 25 12.5 Adminis a o 83 41.5 Heal h Managemen S a 31 15.5 Expe iences 2 yea s o Less han 2 yea s 56 28 3–5 yea s 66 33 6–10 yea s 63 31.5 11–25 yea s 15 7.5 To al 200 100% Alolayyan e al., Cogen Business & Managemen (2020), 7: 1827812 h ps://doi.o g/10.1080/23311975.2020.1827812 Page 5 o 17 3.5. S udy a iables I was ini ially en isaged ha he only dependen a iable in he s udy was hospi al pe o mance and he independen a iable was knowledge managemen p ac ice. Li e a u e, as well as indings, con i med ha all a iables i.e. knowledge managemen p ac ices and heal h in o ma ion man- agemen a e posi i e in luence on he o ganiza ion pe o mance as gene al, and hospi al pe o - mance as special case. Independen a iables we e con i med o ela e well wi h dependen a iables o p oduce meaning ul esul s. The su ey ool is a ool o he con inuous implemen a ion o a igo ous scien i ic p o ocol o ob ain da a om esponden s in an e icien manne ; he ool includes a ques ionnai e ha p o ides clea and unde s andable ex o p esen a s anda d se o ques ions ela ed o he s udy p oblem as well as answe op ions. The su ey ool con ains ques ions ha add ess speci ic s udy objec i es. The Su ey Tool can also be used o collec demog aphic da a. Ou ques ionnai e was de eloped based on he objec i e se o cla i y he ela ionship be ween knowledge manage- men and hospi al pe o mance in Abu Dhabi emi a e hospi als. A h ee-pa ques ionnai e was used o he collec ion o da a in his s udy. Pa A consis ed o ques ions on he demog aphic cha ac e is ics o he esponden s, pa B on knowledge manage- men p ac ices (KM cons uc s), and pa C on o ganiza ional pe o mance (Hospi al) (HP con- s uc s). The i ems in he h ee pa s we e based on p e ious au hen ic esea ch ela ed o he cu en a ea o in e es . The ollowing pa ag aphs p esen de ails on he numbe s and sou ces o hese i ems. “Pa A” ocused on ce ain demog aphic cha ac e is ics o he esponden s, namely Gende (Male o Female), Age (20–35 y s; 36–50 y s; and 51–65 y s), Le el o Educa ion (Diploma; Bachelo Deg ee; and Pos g adua e), P o ession (Manage ; Senio O ice ; Head o Depa men ; Supe iso ; Adminis a o ; and Heal h Managemen S a ), and Yea s o Expe ience (2 y s o less han 2 y s; 3–5 y s; 6–10 y s; 11–25 y s; and 26 y s and o e ). “Pa B” included 43 i ems [adap ed, modi ied, and used] o measu e KM p ac ices. I ems in pa B we e based on he s udies o Ga cía-Fe nández (2015); Chen and Huang (2009), Kao e al. (2011), and Fuga e e al. (2009). A 7-poin Like ype scale, anging om s ongly disag ee (1) o s ongly ag ee (7), was used o measu emen o he da a. A high numbe o “S ongly Ag ee” sco es indica ed a s ong belie amongs many esponden s in he exis ence o KM p ac ices, whils a high numbe o “S ongly Disag ee” sco es indica ed he opposi e. Table 3 shows in de ail he composi ion o his cons uc . “Pa C” consis ed o 23 s uc u ed i ems adap ed o he hi d pa o he ques ionnai e (Hospi al Pe o mance) and aken om he s udies o Chen and Liang (2011), Chen and Huang (2009), Alolayyan e al. (2013), and Liao and Wu (2009). This sec ion aimed o measu e he pa icipan s’ opinions on he o e all pe o mance and cus ome se ice o hei hospi als. Simila o pa B, answe s o he ques ions in his sec ion we e measu ed on a 7-poin Like scale, anging om s ongly disag ee (1) o s ongly ag ee (7). A high sco e o “S ongly Ag ee” esponses indica ed posi i e pa icipan iews on hospi al pe o mance (speci ically wi h ega d o cus ome se ice), whils a high sco e o “S ongly Disag ee” esponses indica ed he opposi e. Table 4 shows in de ail he make-up o pa C. Table 2. Hospi als names and sample size o each hospi al Hospi al name Sample numbe Pe cen age % Al Co niche Hospi al 27 13.5 Sheikh Khali a Medical Ci y 85 42.5 Li eline Hospi al 33 16.5 Al Salam Hospi al 30 15 Ma aq Hospi al 25 12.5 To al 200 100% Alolayyan e al., Cogen Business & Managemen (2020), 7: 1827812 h ps://doi.o g/10.1080/23311975.2020.1827812 Page 6 o 17 3.6. Me hod o Da a Collec ion Da a collec ion is a p ocess o collec ing in o ma ion om all he ele an sou ces o ind answe s o he esea ch p oblem o achie e esea ch objec i e, es he hypo hesis and e alua e he ou comes. Da a collec ion me hods can be di ided in o wo ca ego ies: seconda y me hods o da a collec ion and p ima y me hods o da a collec ion. In his s udy used p ima y da a, p ima y da a we e ob ained h ough a s uc u ed ques ionnai e. The ques ionnai e, ha d copies we e u ilized as he da a collec ion ool. The ha d copies we e p in ed; a ques ionnai e is a w i en lis o ques ions, he answe s o which a e eco ded by he esponden s (Kuma , 2019), his da a collec ion me hod was u ilized because i was accu a e, con enien o use, inexpensi e and p o ided anonymi y o he esponden s. A well-designed and p e- es ed ques ionnai e was used o ga he da a om pa icipan s on he speci ied a iables. One ad an age o ques ionnai es is ha hey can be used o ga he da a om a la ge numbe o people whils equi ing li le ime, e o , and cos . Fu he , ques ionnai es a e lexible in ha esponden s ha e he eedom o ill hem in hei own ime and o emain anon- ymous, which encou ages hones answe s. Howe e , one disad an age o using w i en ques ion- nai es o da a collec ion is ha he esea che may be equi ed o ake u he s eps o ensu e a sa is ac o y u n-in a e o ques ionnai es by pa icipan s. In he case o ou cu en s udy, he Table 3. Lis o i ems o KM cons uc (KM1: Knowledge Acquisi ion) NA1: Knowledge is ob ained om a cus ome du ing wo k- ela ed in e ac ion. NA2: Knowledge is ob ained om pa ne s du ing wo k- ela ed in e ac ion. NA3: Knowledge is ob ained om an employee du ing wo k- ela ed in e ac ion. KM2: (Knowledge S o age) NS1: Employees end o monopolize knowledge as a sou ce o powe and a e eluc an o sha e i wi h o he employees. NS2: S a u no e does no imply a loss o impo an knowledge o skills o he hospi al. NS3: The i m has p ocedu es o he collec ion o p oposals om employees, which a e hen inco po a ed as knowledge by he i m. NS4: The i m has da abases s o ing expe iences and knowledge o la e use. KM3: (Knowledge C ea ion) KC1: A e ou hospi al has se i s inno a i e goals, hese goals become ixed. KC2: Se ing he hospi al’s inno a i e plans is conside ed impo an and mus mee many people’s iews. KC3: When se ing ou hospi al’s plans, he manage does no limi he ways o discussion. KC4: A e se ing an inno a i e plan, he e can be lexible adjus men s du ing i s execu ion. KC5: A e execu ing ou company’s plans, we do no ca e abou de i ing o he esul s. KM4: (Knowledge Sha ing) KSH1: Du ing wo k, knowledge is sha ed be ween supe iso s and subo dina es. KSH2: Du ing wo k, knowledge is sha ed among colleagues. KSH3: Du ing wo k, knowledge is sha ed be ween uni s. Knowledge Implemen a ion and Gene a ion KIG1 Is isi ing cus ome s’ si es o be e unde s and hei needs encou aged? KIG2 Is ge ing o in ol e in sales ac i i ies encou aged? KIG3 Is ge ing o in ol e in helping o esol e cus ome p oblems encou aged? KIG1 Is isi ing cus ome s’ si es o be e unde s and hei needs encou aged? Alolayyan e al., Cogen Business & Managemen (2020), 7: 1827812 h ps://doi.o g/10.1080/23311975.2020.1827812 Page 7 o 17 The pa ame e loadings o he model all p o ed logical and s a is ically signi ican . The yielded loading coe icien s anged was be ween 0.76 and 0.95, all abo e he accep able h eshold o 0.7 (By ne, 2016; Kline, 2015). Fu he analysis also e ealed he s a is ical and signi ican in e ela ed- ness o he cons uc s, pa icula ly he KM and HP cons uc s, which we e highly s a is ically in e - ela ed gi en ha he C i ical Ra io (CR) alues o each o he in e - a iable ela ionships (By ne, 2016; Kline, 2015) exceeded 1.96 (6.601) ( he absolu e alue), a 0.05% le el o signi icance. This model also p o ed he in e ela edness o he cons uc s. Analysis o he model sugges ed ha KM has a a o able and s a is ically signi ican ela ionship wi h hospi al pe o mance (HP) = 0.92. The e ec es ima es showed o be s a is ically signi ican and logically a ional and me he ypical s anda ds o e idence o di ec (0.2) (By ne, 2016; Kline, 2015). Table 8 p esen s accu a e measu es o he e ec s and ela ionships o he s udied cons uc s. The esul s we e in line wi h p e ious esea ch in he heal hca e sec o which ound ha KM has a posi i e e ec on hospi al pe o mance (Achmad & G ace, 2019; Chen, 2017; Ka ama e al., 2019; Wu & Hu, 2012). Fu he mo e, he esul s we e in line wi h p e ious esea ch which a e ocus on he ela ion be ween KM and HP in gene al (Cai e al., 2019; Nzewi & Moneme, 2016; O e by e al., 2005; Sambamu hy e al., 2003; Wo ley & Lawle , 2010). The esul s we e also suppo ing he new end in he quali y sys em s anda ds and he quali y awa ds o include he KM in hei c i e ia and equi emen s. 6. Conclusion In ou cu en s udy, a se ies o ex ensi e analyses all e ealed he i al ole o KM in imp o ing hospi al pe o mance and cus ome sa is ac ion and encou aging hospi al success. The model employed in ou cu en s udy may be o e icacious use o all hospi als, and Abu Dhabi hospi als, which seek o assess pe o mance in a way ha mee s in e na ional acc edi a ion s anda ds. None heless, he esul s o his s udy lack gene alizabili y, and his is a esul o he small sample size and geog aphical a ea co e ed, he p esence o desi abili y biases in he esponden s answe s, he lack o su icien wo k and hospi al expe ience o he esponden s, and he p esence o common me hod a iance/biases. Ou cu en s udy has been e ec i e in ecognizing he signi icance o KM in imp o ing hospi al pe o mance and cus ome sa is ac ion and has pa ed he way o any u u e wo ks ha wish o u he explo e he complex ye essen ial ole o KM. These days heal hca e sec o in de eloping coun ies is acing many p oblems ela ed o quali y and cos o hei se ices, knowledge managemen as a le e age o imp o e he se ice quali y le el and o educe he se ice cos is he main message which can be concluded om his pape . Fu he mo e, knowledge managemen becomes a e y impo an pa in mos o he quali y managemen sys ems o example, KM is added o ISO9001 and i is one o he main c i e ia o mos o he excellence quali y Awa ds, ha is because he impo ance o i s ule on he o ganiza- ion pe o mance. Hospi als and heal hca e sec o s in de eloping coun ies a e encou aged o de elop hei knowledge managemen ools by ocusing on he ac o s which a e conside ed in his pape o imp o e hei pe o mance. Table 8. Analysis o causal e ec s among he cons uc s De e minan Ou come Di ec Resea ch/ Ques ion Resul KM (HP) .92 Main Resea ch Suppo ed Alolayyan e al., Cogen Business & Managemen (2020), 7: 1827812 h ps://doi.o g/10.1080/23311975.2020.1827812 Page 14 o 17 Funding The au ho s ecei ed no di ec unding o his esea ch. Au ho de ails Main Nase Alolayyan 1 E-mail: [email p o ec ed] Abdallah Hassan Alalawin 2 E-mail: [email p o ec ed] Mohammad S. 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