How to implement a knowledge management program in hospital‐in‐the‐home units

Juan‐Gabriel Cegarra‐Navarro (Departamento de Economía de la Empresa, Universidad Politécnica de Cartagena, Cartagena, Spain)
Gabriel Cepeda‐Carrión (Departamento de Administración de Empresas y Marketing, Universidad de Sevilla, Sevilla, Spain)

Leadership in Health Services

ISSN: 1751-1879

Publication date: 9 February 2010



The Spanish health care system has undergone important changes, particularly in the development of new homecare services. In practice, however, results have been mixed. Some homecare services have been successful, but implementation failures are common and the intended patients are frequently reluctant to use home care services. A possible explanation for efficiency and effectiveness gaps of services provided by hospital‐in‐the‐home units may relate to the advantages and disadvantages of the knowledge processes that these units highlight as a result of their different structural properties. The purpose of this paper is to present a conceptual framework for hospital‐in‐the‐home units developed to guide learning within the context of homecare services.


Using data collected from the hospital‐in‐the‐home unit at a Spanish regional hospital, this work examines how the existence of some practices is linked to knowledge transfer and how this component is linked to patient service.


This paper reports a knowledge management program that is customised and based on four frameworks – i.e. technical infrastructure; people to facilitate and drive the process; a system that supports and rewards sharing; and the team leader.

Research limitations/implications

Conducting this type of single case study (an interview‐based case study approach) is to be understood foremost as a prelude to further quantitative studies including common measures for patients, clinicians, staff, managers and board members.


In an applied sense, the model provides homecare practitioners with identifiable factors that enable the four frameworks and address the relevant issues by changing strategies at both the individual and organisational levels. Without a knowledge management program, practitioners may lose the ability to see the market signals stemming from healthcare members, and they may decide to go solely by their own ways of doing and interpreting things.



Cegarra‐Navarro, J. and Cepeda‐Carrión, G. (2010), "How to implement a knowledge management program in hospital‐in‐the‐home units", Leadership in Health Services, Vol. 23 No. 1, pp. 46-56.

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