=Paper=
{{Paper
|id=Vol-2544/paper1
|storemode=property
|title=Contribution of Knowledge Management to the Optimization of Healthcare Settings’ Performance in Cameroon
|pdfUrl=https://ceur-ws.org/Vol-2544/paper1.pdf
|volume=Vol-2544
|authors=Martin Tchoukoua,Jean Robert Kala Kamdjoug
|dblpUrl=https://dblp.org/rec/conf/irehi/TchoukouaK18
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==Contribution of Knowledge Management to the Optimization of Healthcare Settings’ Performance in Cameroon ==
https://ceur-ws.org/Vol-2544/paper1.pdf
Contribution of Knowledge Management to the
Optimization of Healthcare Settings’ Performance in
Cameroon
Martin Tchoukoua Jean Robert Kala Kamdjoug
FSSG, GRIAGES, Université Catholique d’Afrique FSSG, GRIAGES, Université
Centrale Yaoundé, Cameroon Catholique d’Afrique Central Yaoundé, Cameroon
tchoukoua.martin@gmail.com jrkala@gmail.com
I. INTRODUCTION II. THEORETICAL DEVELOPMENT
Public health issues are priority issues for any government. Druker [4] argued that knowledge is "the only significant
According to WHO, health is a complete state of mental, resource" in business today. The resource-based enterprise
physical and social well-being and not just the absence of vision has acquired a new dimension in the theory of
disease or infirmity. In other words, a person with a balanced knowledge. It can be viewed as a strategic asset of an
combination of mental, physical and social conditions is organization that must to be managed [5]. Thus, based on the
considered healthy. One of the core challenges of the current literature around the theory of knowledge, we defined a
modern-day environment is the quality or the shortage of structural model made of five concepts for this research:
human resources. More than ever, it has stood at the centre of technology capacity, organizational culture, knowledge
concerns in all countries, albeit with some acuteness in transfer, process innovation, and organizational performance.
developing countries. However, while healthcare centres and
hospitals around the world have striving to have performant A. TECHNOLOGY CAPABILITY
human resources, they are expected to do the same in terms of
knowledge management and sharing. The sharing of Researchers such as Davenport and Prusak [6], Gupta and
experiences plays a key role in optimizing the performance of Govindarajan [7] found that computing is a key element for
health practitioners. And this inevitably entails a structured knowledge creation. Indeed, IT is extensively used to connect
management of knowledge generated by the daily practice of people with reusable coded knowledge, and it facilitates
the various health structures. conversations geared toward creating new knowledge [8]. In
this regard, Mills and Smith [9] argue that information
Performance remains one of the overarching goals of technology enables not only the incorporation of information
income-generating enterprises, including healthcare and knowledge into a company, but also the creation, transfer,
institutions. Given the challenges faced by health information storage and retention of the company's knowledge asset. A
systems, maximizing organizational performance is still an well-developed technology integrates fragmented streams of
ideal. In the health sector like in other industries, identifying, knowledge, which has the potential of removing obstacles to
accumulating and encoding knowledge are efforts that should communication between the different departments of the
be followed by a sound knowledge management for informed organization. Therefore, we have formulated the following
and improved clinical decision-making. hypothesis:
The aim of this article is to investigate the role of effective H1: Technological capacity positively influences the
knowledge management in selected hospital structures of transfer of knowledge within an healthcare setting.
Yaoundé and even in other areas of Cameroon. To accomplish
this goal, we will try to answer the following big question: Can B. ORGANISATIONAL CULTURE
we achieve an optimal level of performance in a hospital
structure following a successful practice of knowledge Culture is defined as the system of beliefs, values, customs,
management? To answer this question, our research model, behaviours and artefacts that are used by stakeholders of a
which is based on the models by Darroch[1], Slavković and humanity to face their world and interact, and which are
al.[2] and the model of Theriou and al.[3], was defined and transmitted from generation to generation through learning.
tested. Only constructs were used in our study, but they [10]. However, the biggest obstacle to knowledge management
adequately emphasized the link between the effective practice may be the organizational culture [11].
of knowledge management and organizational performance. Generally, culture enhances knowledge, helps its creation,
sharing and application while promoting an open climate for
the free flow of ideas [12]. As a result, we set forth the
following assumption:
Copyright © 2019 for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0)
IREHI 2018 : 2nd IEEE International Rural and Elderly Health Informatics Conference
H2: The better the organizational culture within a III. METHODOLOGY
healthcare setting, the more its staff will be able to transfer To analyse the aforementioned hypotheses, we have opted
knowledge. for a research methodology based on a hypothetico-deductive
approach whose process follows a number of steps, including
C. KNOWLEDGE TRANSFER the elaboration of the questionnaire using a seven-level Likert
Researchers and academics have not yet reached a scale, and data collection and analysis (with a choice of the
consensus on the definition of knowledge transfer, as this sample size, the administration of the questionnaire, and the
concept is being interpreted from different perspectives, collection and processing of data). Regarding the questionnaire
especially from the perspective of the interaction of knowledge development phase and the choice of the sample size, it should
[13]. However, different members of a group with different be noted that our questionnaire had exactly 78 questions on all
ideas and experience create new knowledge by communicating the different items of research models. The questionnaire was
and sharing. So knowledge transfer can be viewed as the then adapted to our research environment, and pre-test was
dissemination of individual knowledge in an organization [14]. carried out by 11 people (10 students from the Management
Gloet and Terziovski [15] believe that human resources can be and Information System (MSI) at the Catholic University of
considered a strategic lever to create a competitive advantage Central Africa, and 1 medical staff.) In addition, the software
through the value of knowledge process. It is through the use of GPower3 and the method of calculation of Hair and Al[21]
knowledge that the assimilated knowledge can be changed allowed us to have a clear idea about the minimum sample size
from a potential capacity into a achieved capacity that affects to be considered in our work.
organizational performance. [9]. Considering such findings, we The administration of the questionnaire was done using a
make the following assumptions: door-to-door approach and paper forms. A pilot phase
H3: Knowledge transfer within a healthcare organization consisting in analyzing remarks from 30 medical respondents
reinforces the process innovation of knowledge. had been conducted beforehand in order to ensure the
reliability of our constructs and the stability of our research
H4: Knowledge transfer has a positive influence on model. The 400 administered questionnaires yielded only 131
organizational performance in health care. usable observations, which were collected and recorded on an
Excel file to initiate the data processing process. The data
D. PROCESS INNOVATION processing was conducted by means of ADANCO, version
2.0.1, which is a software application for analysing structural
Process innovations are those that occur in the technical
equation models based on the PLS partial least squares method
parts of an organization and are directly linked to the main
[22]. It should be noted that at the end of this phase of analysis
work activity of that organization. They may be a work in
and data processing, we did not record any missing data.
progress, or the introduction of new elements into the
production or service operations of an organization [16].
IV. DATA ANALYSIS AND RESULTS
The demographic profile of our 131 respondents is shown
in Table 1 below:
TABLE I. DEMOGRAPHIC CHARACTERISTICS OF THE POPULATION
Profile Description Number Frequency
Gender M 64 48,85%
F 67 51.15%
Age Less than 25 years 14 10,68%
26-30 38 29,01%
31-40 47 35,87%
Fig. 1. Research model
Organizational performance is about how every groups is 41-50 26 19,84%
organized to reach its targets and how it manages to achieve Over 50 years 6 4,60%
them [17]. Literatures reveal that organizational innovation is
important for better performance [18]. For Calantone and Work Less than 5 years 55 41,98%
al.[19], innovation capacity is the most important determinant experience
of a company's performance.[18]. So innovation can cause 5-10 45 34,35%
faster organizational performance in all the areas it agrees with 11-15 20 15,26%
[20]. As a result, we formulate the following hypothesis:
H5: The higher the process innovation capacity of a 16-20 6 04,58%
healthcare structure, the better its performance. Over 20 years 5 03,83%
We note from Table 1 above that our 131 respondents were Organizati
made up of 64 men and 67 women and that most of them were Technolo Process Knowled
Organization onal
Construct gy Innovati ge
aged between 31 and 40. In addition, about 65.08% of this al Culture Performan
Capacity on Transfer
population had at least 5 years of work experience. ce
Culture
With regard to the validity of our research hypotheses, the
stability of our research model and the quality of our Process
0,7773 0,8140
Innovation
constructs, we would like to recall some theoretical standards.
The elimination of overt variables is not a game of chance. Knowledge
0,5373 0,8134 0,7210
Hair and al. [23] point out that overt variables with an outer Transfer
loading of less than 0.4 should be removed, and that those with Organizational
0,6693 0,8253 0,8326 0,7810
an outer loading value between 0.4 and 0.7 should be retained Performance
only if they represent a latent variable with an AVE greater Structural Model. The use of the bootstrapping method
than 0.50 and if all manifest variables with an outer loading enabled us to test the significance of both the relationship
greater than 0.7 are retained. Moreover, reliability of the between model constructions (through the interpretation of t-
constructs and the stability of the research model are being statistics) and the correlation between these constructs (by
confirmed by the quality of our items, which depends on the looking deeply at the values of the correlation coefficient). The
values of both the composite reliability and Crombach alpha t-statistic must be greater than 1.96 to express a
being theoretically greater than 0.7 [23]. significance[24]. Table 4 below summarizes these values:
As indicated in Table 2, the Cronbach’s alpha values and TABLE IV. STRUCTURAL MODEL TESTING HYPOTHESIS USING
the Composite Reliability values are above the 0.7 threshold, BOOSTRAPPING.
thereby suggesting that our constructs are reliable and have Original Standard P-
good internal consistency. In addition, the Average Variance Hypothesis T-value
coefficient error value
Extracted (AVE) values are greater than the threshold of 0.5, Technology Capacity
which is evidence of a convergent validity for the measurement 0,03
->Knowledge 0,1379 0,0670 2,0588*
indicators of each construct. 96
Transfer
TABLE II. CONSTRUCT RELIABILITY AND VALIDITY Organisational
0,00
Culture - 0,5196 0,0808 6,4295***
00
Construct Cronbach’s Composite Average >Knowledge Transfer
alpha Reliability Variance Process Innovation -
(CR) Extracted(AVE) 0,00
>Organisational 0,4185 0,0725 5,7756***
00
Performance
Technology
0,8910 0,9138 0,6034
Capacity Knowledge Transfer - 0,00
0,4474 0,0725 6,1686***
>Process Innovation 00
Organisational
0,8884 0,9130 0,6011
Culture Knowledge Transfer -
10,2258** 0,00
>Organisational 0,393 0,0568
Knowledge * 00
0,8060 0,8732 0,6328 Performance
Transfer
***P < 0.001; **P < 0.01; *P < 0.05;
Process Innovation 0,7399 0,8531 0,6616 Table 4 above shows results obtained by means the version
2.01 of ADANCO boostrapping. It clearly appears that all our
Organisational research hypotheses (H1, H2, H3, H4, and H5) are verified and
0,8833 0,9072 0,5508
Performance supported. Table 5 below shows the various results from the
Based on Table 3, we can conclude that there is good testing of hypotheses.
discriminant validity of our constructs since all HTMT values TABLE V. HYPOTHESIS TESTING RESULTS
are well below the threshold of 0.85 or 0.9. So our assumptions
consist of constructs that are distinct from each other. Indeed, Hypothesis P-value Decision
the HTMT ratio is an estimate of the correlation between the H1 : Technology Capacity -> Verified
constructs, its measurement allows us to see whether there is a 0,0396*
Knowledge Transfer hypothesis
lack of discriminant validity or not; or more specifically, to
know if the constructs are distinct from each other.[24]. H2 : Organisational Culture Verified
0,0000***
TABLE III. HETEROTRAIT-MONOTRAIT RATIO (HTMT)
-> Knowledge Transfer hypothesis
Organizati H3 : Knowledge Transfer -> Verified
Technolo Process Knowled 0,0000***
Organization onal Process Innovation hypothesis
Construct gy Innovati ge
al Culture Performan
Capacity on Transfer
ce H4 : Knowledge Transfer -> Verified
Technology 0,0000***
Organisational Performance hypothesis
Capacity
Organisational 0,5835
Hypothesis P-value Decision
H5 : Process Innovation - Verified
0,0000***
>Organisational Performance hypothesis
***P < 0.001; **P < 0.01; *P < 0.05;
As indicated in this table, the different influences between
our constructs are analyzed as follows:
THE INFLUENCE OF TECHNOLOGICAL CAPACITY
From the results obtained, following the analysis of the data
and those contained in the table above, we observe that for a
level of significance equal to 99.9%, the technological capacity
does not have a significant influence on the transfer of
knowledge. This could mean that managers or leaders of urban
Cameroonian health centers or hospitals do not necessarily
have to invest heavily in technological capacity for efficient
knowledge transfer. This result is also consistent with that Fig. 2. Research model obtained by ADANCO 2.0.1
highlighted by researchers such as N. Theriou, D. Maditinos,
It would therefore be wiser for decision-makers to invest
and G. Theriou [3], who demonstrated that technological
heavily in their ability to develop industry processes as well as
capacity plays a minor role in the effectiveness of knowledge
for the quality of care provided in their field of competence, for
management and does not significantly influence it.
highly improved health care performance. This result is in
THE INFLUENCE OF ORGANIZATIONAL CULTURE contradiction with the one obtained by Darroch [25], but
Our study shows that organizational culture significantly remains very strong in the literature, including studies by M.
influences the transfer of knowledge. This may mean that Slavković and V. Babić [2], N. Theriou, D. Maditinos, and G.
governments or hospital officials need to increase investment Theriou [3].
in education and cultural change in this sector. This influence
holds true for researchers such as N. Theriou, D. Maditinos, V. CONCLUSION, DISCUSSIONS AND LIMITATIONS
and G. Theriou [3], who studied the influence of organizational This work aimed at demonstrating the major impact of
culture on the effectiveness of knowledge management and knowledge management through knowledge sharing on the
concluded that the organizational culture reinforces and organizational performance of health structures; it appears that
encourages knowledge and knowledge creation, sharing, and all the assumptions made have been verified. This indicates
application, while promoting an open climate for the free flow how interesting our research model may be in terms of
of ideas. contribution to an effective and formal practice of knowledge
THE INFLUENCE OF KNOWLEDGE TRANSFER management in the health structures of Cameroon. Indeed, our
study shows that organizational culture significantly influences
Our study shows that knowledge transfer significantly knowledge sharing. This may mean that governments or
influences organizational performance and has a direct and hospital officials need to increase investment in education and
positive effect on innovation. As a result, it could mean that cultural change in this sector. Because this influence remains
any improvement on knowledge management processes (such true for researchers like N. Theriou, D. Maditinos, and G.
as knowledge transfer) also encourages innovation and implies Theriou [3] who, in studying the influence of organizational
that investing in this process in health care could lead to a culture on the effectiveness of knowledge management, have
significantly improved organizational performance in the shown that organizational culture enhances knowledge,
health sector. This result has been proved by several other encourages its creation, sharing, application and promotes an
researchers, including M. Slavković and V. Babić [2], Darroch open climate for the free movement of ideas and knowledge.
[25], N. Theriou, D. Maditinos, and G. Theriou [3].
This study shows that knowledge sharing significantly
THE INFLUENCE OF INNOVATION influences organizational performance and has a direct and
Based on the results obtained, it is clear that although positive effect on process innovation. This could mean that any
innovation may be a partial mediating effect in the relationship improvement in knowledge-sharing processes also encourages
between knowledge transfer and organizational performance, it innovation and implies that investing in the development of
has a significant influence on organizational performance in the knowledge management in health care can lead to improved
public health domain. organizational performance in the health sector. It is clear that
process innovation is a partial mediator of the relationship
between knowledge sharing and organizational performance,
but it significantly influences organizational performance in the
public health domain. It would therefore be wise for decision-
makers in hospital structures to invest heavily in capacity
building, non-retention and proper dissemination of
knowledge, so as to improve the quality of care provided while
maximizing their chances for sustained organizational
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innovation and knowledge management on organisational performance in
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