title: The effects of knowledge management on surgeon behavior.
abstract: Knowledge management is an important process for health care researchers and administrators. The way we manage and transfer knowledge in an organization can have a substantial impact on behavior and performance. In this article, we examine the behavioral effects of transferring performance-efficiency knowledge to a group of hospital-based surgeons. We observe the way the knowledge transfer impacts their sense of professional accountability and practice patterns for a limited set of diagnoses. We defined performance efficiency for a surgeon as the deviation from expected average length of inpatient hospital stay, and from expected average hospital charges (adjusted for risk and outcomes) for three of the most frequently performed and most costly surgical procedures in our subject hospital. We communicated knowledge of their performance efficiency to the group of hospital-based surgeons, along with benchmarked professional best practices, and included an identification of dimensions where performance could be improved. We then measured and compared their performance efficiency one year later. We did observe differences in performance efficiency, but not in consistent directions, and not in statistically significant magnitudes. Also, surgeons who initially had low levels of efficiency continued to have low levels of efficiency one year later. Within a professional accountability system, transfer of performance-efficiency knowledge alone did not provide sufficient motivation to induce consistent, significant change in practice behaviors among the group of surgeons. We conclude that medical opinion leaders and individualized strategies for surgeon motivation may have greater promise for improving performance efficiency if linked to the knowledge transfer system.
authors.affiliation: Department of Surgery at Greater Baltimore Medical Center, Baltimore, MD, USA.
authors.forename: Clifford F
authors.initials: CF
authors.lastname: Melick
authors.forename: Dale
authors.initials: D
authors.lastname: Buchbinder
authors.forename: David P
authors.initials: DP
authors.lastname: Coll
authors.forename: Sylvia
authors.initials: S
authors.lastname: Moore
authors.forename: Chih-Chen
authors.initials: CC
authors.lastname: Lee
authors.forename: Krishnamurthy
authors.initials: K
authors.lastname: Surysekar
authors.forename: Te-Wei
authors.initials: TW
authors.lastname: Wang
authors.forename: Dana A
authors.initials: DA
authors.lastname: Forgione
mesh_terms: D003953:Diagnosis-Related Groups; D013502:General Surgery; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010820:Physicians / Q000523:psychology*; D012941:Social Responsibility; D014481:United States; D000078329:Workforce