Knowledge creation and strategy formation in a public, nonprofit healthcare organization: A descriptive case study

Although organizational knowledge is considered the most strategically important resource and learning the most strategically important capability for organizations, many initiatives being undertaken to develop and exploit this knowledge are not explicitly linked to or framed by the organization's strategy. The study described the relationship between knowledge creation and strategy formation knowledge structures as they occurred within the boundaries and context of a public, nonprofit healthcare organization. This organization had more than 5,300 employees, a 14-member top management team, and a seven-member publicly elected board of directors. During the study, the organization experienced the departure of the chief executive officer and the return of a former chief executive officer with 22 years of previous service with the organization.; The study followed a descriptive case study format using qualitative methods. The primary method of data collection was the interviews of the top management team and the board of directors. Data were also captured through document analysis and observation. Data from the interview transcripts were analyzed and captured using computer-aided cognitive mapping. Causal maps served as a research technique to explore the knowledge structures of the organization. In addition, the interpretation of results was discussed in the context of an organizational learning system model. The level of analysis of the study was at the organizational (collective) level.; The findings of this study did not reflect a coherent sense of direction for the organization. The knowledge structures did not encapsulate a systems perspective about the interdependencies within the system or the exploration of new possibilities. There was a heavy emphasis on obtaining and applying information with a propensity toward performance. For the organizational learning structure, this resulted in little critical inquiry and little actual organizational learning. Concerning strategy, it reinforced operations rather than vision.; Implications of organizational knowledge structures and organizational learning for practice, research, and methods are explored in the final parts of this study.