**3.2 Data collection**

A qualitative approach was used in this case study [34, 35]. The qualitative case study approach is a strategy often used in studies of the use of information systems and KM within organizations [36, 37]. The case study produces context-dependent knowledge and experience without any attempt to make generalizations based on the collected data [38]. The study focuses on the planning and control of the production and capacity within the hospital health care as the case. Since the study focuses on a specific work practice, it is of great importance to use a methodological strategy that is adapted for research of the applied nature of the empirical setting [39]. The approach was to interpret the social phenomena in order to show what is socially constructed by the health professionals in their natural work practice.

Data were collected through qualitative interviews that focused on views and experiences expressed by people [37]. What types of managerial actions were performed within planning and control of hospital health care and how the work was conducted were of interest in this study. The data collection focused on

acquiring a deep insight into the planning and control of production and capacity of the health care provided at the hospital. A semi-structured interview guide was constructed based on a literature review of OM as well as the knowledge and experience that one of the authors has gained from her ordinary work practice of OM at the hospital.

Eleven interviews were held with 11 chief executive officers (CEOs) and their respective production controllers. The interviews lasted for about 2 hours each. Each CEO is responsible for one health-care service unit at the hospital, and they all collaborate with a production controller. Each production controller works at about four to five different health-care service units, and each health-care service unit consists of several departments. The 11 CEOs were chosen from units that need to cooperate with other units in some way. In total, six more CEOs work at the hospital, but their activities are less extensive, and a few have no direct contact with patients. By collecting data through interviews, it was possible to maximize the exploration of different perspectives and activities within the planning and control of production and capacity. The interviews were used as the primary data source. In addition, internal documents used in the planning and control of production and capacity were requested and used as a secondary data source. Both authors conducted all the interviews, which were tape-recorded and afterwards transcribed verbatim.

in different ways. **Figure 1** shows the OM planning process where knowledge

order to be able to take appropriate actions if the situation starts to be worse, instead of saying the following day that: "oh well, now this was damn crazy yesterday". It should be possible to follow up and document lead times at the triage work, if it is going up and down. This is now just recognized based on experience of the staff. Thus, there is a prevalent culture where the staff adapts to changes in the admission of patients. Moreover, knowledge of how to match the schedule to the needs is important and it makes the planning much smoother. Knowledge and experience of where there are shortcomings and what needs to be changed in the planning saves a lot of resources. However, professionals need a lot of education to acquire such knowledge. The departments also have whiteboards for planning and following up on the daily management. The resource utilization can also be reassessed if anyone anticipates changes in the workload. Moreover, oral analyses are made at the departments on a daily basis. These analyses focus on what worked and what did not work, deviations and so on, and aim at learning and creating knowledge for the future operations and capacity planning at the department. These oral analyses are however not documented and deeper analyses are sometimes needed. Moreover, the results from the previous day are sometimes more or less obvious. There is a desire at the hospital to work with, and follow up, based on real-time data, instead of using data from the day before, in order to learn and create more appropriate knowledge, and be able to put in efforts a little earlier. A suggestion is to have a visual and real-time based monitor that shows the inflow, the

operations, and outflow of the hospital as support for the daily planning. Since the operations at the emergency department cannot be planned in advance, resources are allocated based on historical numbers of patients. It is somewhat unclear how many patients the emergency department can handle, as there is no defined assignment. The professionals work toward a goal of shortening the waiting times at the emergency department based on requirements from the regional level. Forecasts are dependent on whether someone discovers changed patterns in an ad hoc basis. It is difficult to compare outcomes since there have been

A certain number of operating rooms with staff and other resources must be available at the hospital. The planning of resources is not directly related to which operating activities will be conducted in these operating rooms. Instead, the operating rooms with staff and other resources are prepared for immediate use. The number of prepared operating rooms is measured in retrospect, based on how much the operating rooms were actually used at a specific time, or a specific day. The

so many changes at the hospital during the last years.

Middle managers would like to have data about the performance in real time, in

mechanisms have to be in place for a smooth work.

**4.1 Learning and knowledge creation culture**

*Schematic view of OM for health-care planning at the hospital.*

*Operations Knowledge Management in Health Care DOI: http://dx.doi.org/10.5772/intechopen.93793*

**Figure 1.**

**257**

#### **3.3 Data analysis**

Thematic analysis was used for the qualitative analysis of the collected data [40]. This method was used to interpret the various aspects of KM mechanisms in the infrastructure of the health-care organization and its OM. By using a deductive thematic analysis, different codes were found in the empirically collected data. Then, a detailed analysis of the specific data that mapped to the aim of the study was conducted. Since the analysis focused on the specific theoretical aspects of the collected data, there is a clear connection between the analysis method and the theoretical perspective [39]. The aim was to analyze the collected data in depth as the data contain meanings that the respondents expressed as their experiences of the work practice rather than measure data quantitatively.

The coding process aimed to fit the theoretical preconception of the study. As such, the coding was theory driven, as we searched in the transcripts for codes within the predefined theory-based themes. The analysis resulted in codes at both a semantic and a latent level. Codes were identified both in the explicit meanings of the data and in the underlying ideas and assumptions. The latent codes are thus based on interpretations of the data during the analysis [40]. The analysis was inspired by a constructionist perspective since it was assumed that meanings and experiences are socially constructed within the context.

Based on the aim of the study, three different KM mechanisms were analyzed in the collected data: (1) learning and knowledge creation culture, (2) organizational architecture for adaptive and exaptive capacity, and (3) "business model" for knowledge capitalization and value capture.

#### **4. Results**

The health care provided at the hospital is based on needs, forecasts, and the division of resources between the departments. The operations at each of the three areas at the hospital affect each other. Different activities, together with the culture and infrastructure, affect the outcomes of the OM, and knowledge is thus managed *Operations Knowledge Management in Health Care DOI: http://dx.doi.org/10.5772/intechopen.93793*

acquiring a deep insight into the planning and control of production and capacity of the health care provided at the hospital. A semi-structured interview guide was constructed based on a literature review of OM as well as the knowledge and experience that one of the authors has gained from her ordinary work practice of

*Operations Management - Emerging Trend in the Digital Era*

Eleven interviews were held with 11 chief executive officers (CEOs) and their respective production controllers. The interviews lasted for about 2 hours each. Each CEO is responsible for one health-care service unit at the hospital, and they all collaborate with a production controller. Each production controller works at about four to five different health-care service units, and each health-care service unit consists of several departments. The 11 CEOs were chosen from units that need to cooperate with other units in some way. In total, six more CEOs work at the hospital, but their activities are less extensive, and a few have no direct contact with patients. By collecting data through interviews, it was possible to maximize the exploration of different perspectives and activities within the planning and control of production and capacity. The interviews were used as the primary data source. In addition, internal documents used in the planning and control of production and capacity were requested and used as a secondary data source. Both authors

conducted all the interviews, which were tape-recorded and afterwards transcribed

Thematic analysis was used for the qualitative analysis of the collected data [40]. This method was used to interpret the various aspects of KM mechanisms in the infrastructure of the health-care organization and its OM. By using a deductive thematic analysis, different codes were found in the empirically collected data. Then, a detailed analysis of the specific data that mapped to the aim of the study was conducted. Since the analysis focused on the specific theoretical aspects of the collected data, there is a clear connection between the analysis method and the theoretical perspective [39]. The aim was to analyze the collected data in depth as the data contain meanings that the respondents expressed as their experiences of

The coding process aimed to fit the theoretical preconception of the study. As such, the coding was theory driven, as we searched in the transcripts for codes within the predefined theory-based themes. The analysis resulted in codes at both a semantic and a latent level. Codes were identified both in the explicit meanings of the data and in the underlying ideas and assumptions. The latent codes are thus based on interpretations of the data during the analysis [40]. The analysis was inspired by a constructionist perspective since it was assumed that meanings and

Based on the aim of the study, three different KM mechanisms were analyzed in the collected data: (1) learning and knowledge creation culture, (2) organizational architecture for adaptive and exaptive capacity, and (3) "business model" for

The health care provided at the hospital is based on needs, forecasts, and the division of resources between the departments. The operations at each of the three areas at the hospital affect each other. Different activities, together with the culture and infrastructure, affect the outcomes of the OM, and knowledge is thus managed

the work practice rather than measure data quantitatively.

experiences are socially constructed within the context.

knowledge capitalization and value capture.

OM at the hospital.

verbatim.

**4. Results**

**256**

**3.3 Data analysis**

**Figure 1.** *Schematic view of OM for health-care planning at the hospital.*

in different ways. **Figure 1** shows the OM planning process where knowledge mechanisms have to be in place for a smooth work.
