**6.1 Conclusions**

The study draws several conclusions. When an organization implements knowledge management, if it can integrate the concepts and objectives of knowledge management into the staff's standard procedures of daily work by matching education and training courses, it can become deeply rooted in the staff's daily work. Even if knowledge management is not clear by definition, employees can still improve their participation in knowledge management activities through daily work processes. Therefore, companies would construct a set of suitable norms for employees to follow so that knowledge management becomes a part of daily work norms and knowledge accumulation and knowledge protection activities can be carried out more reliably.

Furthermore, due to the nature of CRO employees' work, they rely heavily on the absorption of empirical knowledge, including communication skills with the hospitals and the clients, familiarity with the clinical trial process, clinical trial data recording, and review skills, etc. Such knowledge acquisition is necessary for experience sharing in the organization to allow employees to communicate with each other through the mentoring system, or experience and knowledge sharing activities similar to the mentoring system, to achieve the purpose of imparting and spreading experience and knowledge. In addition, the establishment of information technology can provide a systematic platform for employees of the company to record, integrate, and transfer knowledge to improve the efficiency of knowledge diffusion and exchange.

Additionally, when CROs implement knowledge management, they emphasize the support of the leadership and the coordination of the improved human resource management system for knowledge diffusion and accumulation. The higher the support of the organization's leadership for knowledge management, the higher the willingness of employees to participate in knowledge management activities. A robust human resource management system, including the design of rewards or performance evaluation systems, can increase employees' motivation for knowledge diffusion and communication. Clear handover specifications can avoid loss of experience and knowledge during the movement of personnel. Thus, it can promote the easier implementation of accumulation and storage of knowledge.

Whether it comes from the internal norms of the organization, the content of clinical trial books, the acquisition of relevant prior knowledge, or the absorption of updated knowledge from outside the organization on regulatory and implementation aspects, knowledge management can improve the efficiency of the organization members in the implementation of the clinical trial. With this knowledge, when faced with the needs and questions of the clients and the hospital staff, they can quickly answer and carry out diffusion and exchange of knowledge.

### **6.2 Theoretical implications**

According to the above conclusions, this research provides two major academic contributions. First of all, the study takes CROs as the objects to explore the "integrity" of knowledge management. The CRO industry is a knowledge-intensive industry. Although several prior researches have been conducted on its strategic aspects, business, and operating models, the knowledge management of CROs have seldom been discussed. Therefore, this research focuses on the CRO industry and

selects institutions that provide clinical trial services to explore their knowledge management practices and the impact of influential factors on knowledge management activities.

In past empirical research on knowledge management, there have been more discussions on the influential factors of knowledge management or knowledge management activities in a single dimension. The results of these studies may have several limitations. Based on the perspective of "integrity," this research explores four aspects of knowledge management: strategy and leadership, organizational culture, human factors, and information technology; and four aspects of knowledge management activities: knowledge creation and absorption, knowledge accumulation and storage, knowledge diffusion and exchange, and knowledge protection. This is expected to contribute to a holistic approach to knowledge management studies.

Second, this research takes the organizational level as the unit of analysis to conduct empirical research on knowledge management. Past empirical studies on knowledge management mostly focused on the "project level" or "individual tintegrated research, especially with the "organization level" as the unit of analysis. Knowledge management of CROs is expected to be helpful in the research field of knowledge management at the organizational level.
