医疗保健中的知识共享和创新工作行为英文文献和中文翻译(4)
PCOsare service organizations with professionalexpertise where innovation is enacted pri-marily by doctors and nurses (Hanks et al.,2010). Professional service contexts are privi-leged settings for amicro-level investigation ofinnovation. In these contexts, innovationdepends heavily on the involvement ofemployees who stand at the front-line and‘know best’ what should be innovated andhow (Abbott, 1988; Freidson, 1988). Theirinvolvement in innovative behaviours,however, cannot be mandated or taken forgranted, but depends on inpidual andorganizational antecedents (e.g., Kessel,Hannemann-Weber & Kratzer, 2012; Kessel,Kratzer & Schultz, 2012; Reuvers et al., 2008).The link between knowledge sharing andIWB is also especially salient in these contexts.Professional employees are expected to beknowledge workers who regularly mobilizeand transform their knowledge, and yet theyrarely do so (Newell et al., 2009). In PCOs, inparticular, professionals need to constantlyinnovate to adapt their care to never-the-same,highly complex cases, and share knowledge tosupport interdisciplinary practices. However,employees struggle to do so because of thecomplex and elusive nature of the knowledgethey have to handle (Martin, Currie & Finn,2009). This knowledge, which concerns howhealth deterioration and treatment decisionsshould translate into clinical pathways(Faulkner, 1998), is mostly tacit and, in particu-lar: (i) complex, because it integrates clinical,technical and psychological elements; (ii) case-specific, because different patients require dif-ferent communication and clinical strategies;and (iii) experiential, because professionals areinfluenced by their training, role and pastexperiences (Freidson, 1988).To test the proposed hypotheses we collecteddata through a survey of four PCOs, all widelyrecognized by peers as high-quality providers.They are all located in the north-west of Italyand are comparable in terms of size (numberof beds and enrolled healthcare professionals)and organizational structure. This allowed thedata collected fromeach PCO to be pooled intoa single dataset. All the surveyed PCOs arenot-for-profit organizations and provide bothhome-based and hospice-based care. Healthprofessionals rotate continuously between thetwo types of services to promote sharing ofknowledge and best practices.Since our unit of analysis was inpidualprofessionals, all the data came from primarysources. Control variables were also collectedfrom respondents, and subsequently double-checked using secondary sources of informa-tion. The professionals involved in the surveyincluded physicians, psychologists, physio-therapists, nurses and other healthcare opera-tors. Members of administrative staff were notincluded in this survey because they do notparticipate in PCO core activities. We thusidentified a total of 226 professionals to whomthe questionnaires were subsequently sent. Ofthe returned questionnaires, 150 were consid-ered usable, resulting in a 66 per cent responserate. Table 1 reports the characteristics of oursample.MeasuresWe designed a questionnaire to measure sixconstructs: motivation, opportunity, ability,knowledge sharing behaviour, knowledgereciprocation and innovative work behaviour.All constructs were measured using multiple-item scales that were adapted from previousrelated studies (see theAppendix). To elicit thebehavioural, normative and control beliefsof respondents, we conducted a series of face-to-face interviews with personnel fromone of the organizations involved. Thisallowed us to better understand the context inwhich the constructs were being investigated,and refine the wording of our questions(items). We then pilot-tested our measureswith 48 inpiduals from the same organiza-tion to (i) test the clarity of questions and (ii)assess the ability of our scales to capture thedesired information. Feedback from the pilot-test was used to refine the scales. The resultantfinal questionnaire consisted of six multiple-item scales, for a total of 22 items, each meas-ured on a 7-point Likert scale anchored at 1(‘I totally disagree’) and 7 (‘I totally agree’).The MOA variables were drawn from theliterature and adapted to the healthcarecontext. Motivation was developed drawingfrom Bock et al. (2005) and Hsu et al. (2007).