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Patient safety improvement through management has been a prime issue since 2000, when the Institute of Medicine reported that preventable mismanagement was responsible for the majority of medical errors. Learning culture, interdisciplinary action teams, and punitive culture have been discussed as viable ways to address these errors. While these individual factors have been found to be significant, we have yet to understand the interactions of these elements. The role of leadership, which has been overlooked, is critical to facilitate or constrain these elements. The interactions of these three elements and the role of leadership were analyzed using structural equation modeling. Our finding revealed the three elements were closely knitted, and leadership roles had considerable impact in nurturing learning culture and constraining punitive culture, which in turn enhanced patient safety

Knowledge sharing is recognized as one of the most important ways to improve organizational performance. Organizations strive to facilitate knowledge sharing routines, yet these attempts often fail. Although the successful deployment of knowledge sharing practices has been a focus of knowledge management and organizational performance studies, little research has considered the impacts of institutional structures. As such, the purpose of this study is to investigate the extent to which institutional structures facilitate knowledge sharing practices and their impacts on organizational performance.

Based on 220 usable survey responses, the authors applied structural equation modeling (SEM) to observe the extent to which institutional structures enhance organizational performance through knowledge sharing, and other important knowledge sharing‐related constructs (i.e. leadership and punitive behavior). The healthcare industry was used as the research context as it is a knowledge‐intensive industry.

The study finds that knowledge sharing practices were strongly influenced by institutional structures, and together considerably enhanced patient safety. Furthermore, the institutional structures had a high impact on leadership roles and the abatement of punitive behaviors, which in turn collectively considerably enhanced patient safety.

This paper recognizes the power of institutional structures that successfully facilitate knowledge sharing practices within an environment that is unfriendly to knowledge sharing behaviors.

Effectively handling knowledge is crucial for any organization to survive and prosper in the turbulent environments of the modern era. Leadership is a central element for knowledge creation, acquisition, utilization and integration processes. Based on these considerations, this study aims to offer an overview of the evolution of the literature regarding the knowledge management-leadership relationship published over the past 20 years.

A bibliometric analysis coupled with a systematic literature review were performed over a data set of 488 peer-reviewed articles published from 1990 to 2018.

The authors discovered the existence of four well-polarized clusters with the following thematic focusses: human and relational aspects, systematic and performance aspects, contextual and contingent aspects and cultural and learning aspects. The authors then investigated each thematic cluster by reviewing the most relevant contributions within them.

Based on the bibliometric analysis and the systematic literature review, the authors developed an interpretative framework aimed at uncovering several promising and little explored research areas, thus suggesting an agenda for future knowledge management-leadership research. Some steps of the paper selection process may have been biased by the interpretation of the researcher. The authors addressed this concern by performing a multiple human subject reading process whose reliability was confirmed by a Krippendorf’s alpha coefficient value >0.80.

To the best knowledge, this is the first study to map, systematize and discuss the literature concerned to the topic of the knowledge management-leadership relationship.