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The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe Zhang Assistant Professor School of Management Xi’an jiaotong University

The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

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Page 1: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China

after the Sichuan 5.12 earthquake

Zhe ZhangAssistant Professor

School of Management

Xi’an jiaotong University

Page 2: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Motivation?

Page 3: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

凡高印象派画家Vincent van GoghPost-Impressionist painter

Look at them , many celebrities also need help!

卓别林美国著名演员Charlie ChaplinAmerican Actor

里根美国前总统

Ronald

ReaganThe 40th President of the United States

拿破仑法国皇帝Napoleon I Emperor of the French

费尔普斯美国著名运动员Michael Phelps Famous American athletes

Page 4: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Motivation

Nowadays about 450 million people around the world suffer from mental illnesses, with associated costs accounting for 11% of all global medical expenditures. For example, of these, about 45 million adults suffer from schizophrenia (Curlin, F. A.2007).

Furthermore, the financial crisis which exploded for nearly one year has caused enormous investor losses, while at the same time a large number of employees have to endure greater mental pressure in many countries including China.

Besides these normal phenomenon which can cause the mental disease, with the more and more natural disaster frequently happen these days, it has become another major cause for mental disease.

Page 5: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Motivation

Context: more and more natural disaster

e.g. South Asian tsunami of 2004, Hurricane Katrina and the Kashmiri earthquake in 2005, the California wildfires of 2007; Earthquake in Italy (2009); in Haide (2010);in Indonesia (2010)

Page 6: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Motivation

After the natural disaster, people in the disaster area definitely have a unique traumatizing time, which will bring challenge not only to the physical conditions but also to the psychological endurance. When their lovely homeland overnight turns into a place full of debris and corpses, especially when they witness the family members’ loss with their own eyes, no wonder they will be shocked by these diabolical scenes, therefore and it’s most likely to increase the suicide rate caused by various kinds of mental disease.

Page 7: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Motivation

On May 12th, 2008, at 2:28 pm, a severe earthquake of magnitude 8.0 struck suddenly in the Sichuan province, China. The earthquake claimed the lives of almost 70,000 people, leaving 4.8 million homeless and over 15 million displaced.

Page 8: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Motivation

After Sichuan 5.12 earthquake, the mental disease is prevailing in disaster area. In order to decrease the suicide rate, Sichuan local governance with the assistant of the diverse hospitals have established “three-level network of prevention and treatment on mental disease”, which aims at disseminating the knowledge on prevention and treatment from doctors to recipients, especially finding out some pre-diagnostic symptoms.

Page 9: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Three-level network of prevention and treatment (1) common phenomenon and diagnosis on children PTSD, depression et al.; (2) the principles of drug treatment on children PTSD, depression et al.; (3) the principles of psychological treatment on children PTSD, depression et al.; (4) the principles of treatment on children common emotional and behavioral problems

(1) the common methods on student’s emotional ease and communications; (2) the performance of emotional, behavioral problems and some relevant risk factors after the disaster; (3) early identifying children emotional and behavioral problems after the disaster; (4) the treatment procedure after discovering the student’s mental health problem.

network-training for the teachers in the school (primary school and middle school)

network-training for the teachers in the school (primary school and middle school)

network-training for the mental health instructors in the school

network-training for the mental health instructors in the school

network-training for the professional

personnel in the local mental health institutions

network-training for the professional

personnel in the local mental health institutions

Page 10: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

10

Some relevant activities after the 5.12 earthquake

Page 11: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Motivation

How to disseminate the knowledge of the prevention and treatment on mental disease from the doctors to the recipient more effectively and more efficiency deserves us to focus on.

Page 12: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Motivation

This study examines the impact of knowledge characteristics, the network status of the doctor, the network status of the hospital in which the doctor is affiliated, and the relationship quality between doctor and recipient on the effectiveness and efficiency of knowledge transfer from the doctor to patients.

Page 13: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Framework

The characteristics of knowledge of prevention and treatment on mental health

problem

Valuable knowledge

rare

low status hospital

relationship quality between doctor and

recipient

comprehension

speed

Control variablesHospital sizeHospital place

Knowledge type (prevention or treatment )

Doctor°Øs professional levelDoctor°Øs personal characteristics

(gender, age, ethics)

high status doctors

Dissemination effects

Page 14: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Hypothesis

Knowledge characteristics and doctor-recipient relationship quality

knowledge on “psychiatric prevention and treatment”: value and rareness (Barney,1991)

“valuable” if it enables the recipient to formula a viable approach to prevent the disease in a more effective and efficient manner.

“rare” when it is possessed by a limited number of doctors

H1: Perceived value and rareness associated with knowledge being transferred from doctor to the recipient will be positively related to the relationship quality between doctor and the recipient.

Page 15: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Hypothesis

Network status and knowledge transfer After the earthquake, the low status organization is usually

proximate to the first-line disastrous area; therefore the proximity makes it possible to dispatch the numerous psychiatrists to provide the accessible knowledge on “psychiatric prevention and treatment”.

Especially after the earthquake, the speed of mobilizing resources is one of the most important factors for management in the context of crisis, certainly for the knowledge transfer process at that urgent time.

H2: the low-status hospital with which doctor is affiliated is positively associated with the speed of knowledge transferred from doctor to recipient.

Page 16: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Hypothesis

Doctors who belong to high-status professional groups is deemed to master more integrated knowledge, correspondingly is taken as more authoritative than the low-status doctor.

What’s more, a large number of high-status doctors are not only doctors at the hospital, but also have a title of professor or associate professor, most of them lead a group of students who are pursuing master degrees or ph.d. Therefore, it’s no wonder that the high-status doctor always have more experience not only to consult with patient but also impart knowledge.

H3: the high-status doctor is positively associated with the comprehension of knowledge transferred from doctor to the recipient.

Page 17: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

hypothesis

Doctor-recipient relationship quality refers to the extent to which the relationship between the doctor and recipient is close, strong, and based on mutual trust.

Both Dhanaraj et al. (2004) and Lane et al., (2001) have suggested that trusting relationship facilitate knowledge transfer.

the doctor-recipient relationship quality can also be expected to have a positive effect on the speed of knowledge transfer between doctor and recipient. Just as Reagans and McEvily (2003) have found that the strength of ties between two individuals impact the ease of knowledge transfer, with close ties resulting in less time and effort being spent on the transfer process

H4: The doctor-recipient relationship quality mediates the relationship between knowledge characteristics and the comprehension and speed of the knowledge transferred between doctor and recipient.

Page 18: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Methods

We collected data using a survey of crisis management in China’s healthcare system after the 5.12 Wenchuan earthquakes.

The main survey was administered from December 2008 to April 2009.

Page 19: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Method

A survey team distributed survey packages to participating hospitals, such as the Huaxi hospital, other hospitals in the Huaxi network, other regional hospitals, affiliated healthcare facilities in Sichuan province and some hospitals in other badly-hit provinces.

Table 1 Survey summary of information

Target Number of package

Hospitals out of Sichuan 20

Huaxi 50

regional hospitals (24) 72

Huaxi networking hospitals (25) 53

Sum 195

Page 20: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Methods

These doctors mainly included departments of neurology. The only group that exhibited a within-group response rate and mission data of lower than 50% was eliminated from our sample. There are A and B two packages of questionnaire, in which A is for doctors to fill in, B needs the recipient to fill in.

After eliminating the incomplete questionnaires, the final sample consisted of 146 groups with 146 doctor and the correspondingly recipient.

Page 21: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Scales

Value

Rare

Barney (1991)

Doctor-recipient relationship quality Reagans and McEvily (2003)

Comprehension Speed

Zahra et al. (2000)

Low-status hospital If the hospital is directly administered by the department of health at the p rovincial level or lower then that level

High -status doctor If the doctor has a professor or associate professor title

Page 22: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Method

We used factor analysis to test the reliability and validity of the scales. Structural equation modeling (SEM) with latent constructs was used to test the four hypotheses. The LISREL program (Jöreskog & Sörbom, 2001) was used to perform SEM analyses. The fit of the measurement model was assessed followed by the test of the structural model (Anderson & Gerbing1988; Wu, Tsui & Kiniki, 2009).

Page 23: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

ResultFigure 2 Results of the SEM Model with Latent Constructs (N=146)a

Valuable knowledge

rare

low status hospital

relationship quality between doctor and

recipient

comprehension

speedhigh status doctors

Indicator 1

Indicator 2

Indicator 1

Indicator 2

0.81

0.80

0.77

0.84

+0.33**

0.28**

Indicator 1

Indicator 2

Indicator 3

Indicator 4

0.880.880.92

0.85

Indicator 3 Indicator 4Indicator 1 Indicator 2

Indicator 1 Indicator 2 Indicator 3

0.92

0.87 0.90

0.80

0.85 0.830.78

+0.12*

+0.20*

+0.33***

+0.21**

a Standard factor loadings and path coefficients are presented. All factor loadings are significant at the .05 level.

* P<0.1; ** P<0.05; *** P<0.01.

Page 24: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Limitation

Retrospective biasWe collected data retrospectively because of the

particular context for this research. In the context of the earthquake, every participant in our research was part of the backbone of the rescue mission. Because this natural disaster was on such a large scale, we had to wait for quite a long period of time before conducting the research.

Page 25: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Limitation

collecting the data retrospectively allowed for a more focused data-gathering process (Poole et al., 2000). At the same time, unconscious respondent bias may arise in retrospective studies, leading to confusion about cause-and-effect relationships (Leonard-Barton, 1990).

Page 26: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Conclusion

Based on a sample of 146 doctor-recipient pairs from 52 hospitals in diverse districts of China, this study finds that the high-status doctor is affiliated positively impact the effectiveness of knowledge transfer. In addition, low-status hospital was found to have a positive effect on knowledge transfer efficiency. In particular, results highlight the strong positive impact that the quality of relationship between the doctor and the recipient has on both the efficiency and effectiveness of knowledge transfer.

Page 27: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

2009-2011 reform plan

The country's basic public health services

disease preventionmaternal and children health health education occupational health prevention and treatment of mental

illness

Page 28: The effectiveness and efficiency of knowledge transfer from the doctor to recipient: An empirical study in China after the Sichuan 5.12 earthquake Zhe

Thank you !