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Knowledge management as a driver of performance in ambulatory healthcare – a systematic literature review through an intellectual capital lens

Nina S. Pflugfelder (Chemnitz University of Technology, Chemnitz, Germany)

Journal of Intellectual Capital

ISSN: 1469-1930

Article publication date: 2 October 2020

Issue publication date: 18 February 2021




The purpose of this study is to investigate how Knowledge Management (KM) and Intellectual Capital (IC) can increase the organizational performance of ambulatory healthcare providers and how such performance can be assessed.


Following the PRISMA guidelines, a structured review of peer-reviewed English-speaking articles up to 31st December 2019 was conducted. A search of ACM Digital Library, Cochrane Library, DARE, EBSCOHost, Medline, ProQuest, PubMed, ScienceDirect, Scopus and Web of Science produced 8,391 results. All studies that did not examine the impact of KM initiatives on organizational performance in an ambulatory healthcare provider setting were eliminated. The final sample of 31 studies was examined regarding the design of the KM initiatives as well as the performance concepts and indicators employed.


A range of KM tools and methods (Electronic Health Records, Clinical Decision Support, Health Information Technology, Training, Communities of Practice) have been shown to improve healthcare processes but evidence of an impact on outcomes remains mixed. Performance indicators focus on medical quality but rarely capture economic or social performance. Indicators have been adapted from the medical field, but do not adequately capture IC and KM-induced performance.


This review provides an overview of KM initiatives in ambulatory healthcare and assesses the associated performance metrics through an IC lens. Thereby, it enables further research on the interplay of IC, KM and performance in ambulatory care and points to several research gaps. It provides managers with guidance for designing KM initiatives in their organizations



Funding: No funding was provided specifically for this article.Thank you to my supervisor, Prof. Peter Pawlowsky, for his guidance throughout this project and to the anonymous reviewers for helping me produce the best version of this paper.


Pflugfelder, N.S. (2021), "Knowledge management as a driver of performance in ambulatory healthcare – a systematic literature review through an intellectual capital lens", Journal of Intellectual Capital, Vol. 22 No. 2, pp. 403-432.



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