The moderating role of organizational intelligence on the relationship between knowledge management and healthcare service quality in Iranian hospitals

Abstract

Modern healthcare systems face mounting challenges stemming from technological advancements, rising patient expectations, and the growing imperative to integrate evidence-based data into clinical practice. Although effective Knowledge Management (KM) is widely recognized as essential for enhancing the Quality of Health Services (QHS), the organizational conditions under which KM yields tangible quality improvements remain underexplored. This study introduces Organizational Intelligence (OI) as a contextual moderator, proposing that the effectiveness of KM in improving QHS is contingent upon the organization's collective cognitive capacity. A cross-sectional, correlational design was employed in 2025 across five hospitals in Kermanshah, Iran, involving 407 staff members and 600 patients. Staff reported moderate levels of KM (M = 122.74, SD = 19.80) and OI (M = 66.54, SD = 12.73), while patients indicated a substantial QHS gap (M = 23.23, SD = 8.94), reflecting unmet expectations. A strong positive correlation emerged between KM and OI (r = 0.459, p < 0.001), and both constructs individually predicted QHS (adjusted R 2 = 0.478 and 0.490, respectively). The full hierarchical moderation model accounted for a significant portion of the variance in the QHS gap (adjusted R 2 = 0.481), with the interaction term reaching significance (t = 6.661, p < 0.001), suggesting that OI may moderate the KM–QHS relationship. Staff managerial experience was positively correlated with both organizational capabilities. Importantly, these findings are derived from exploratory hospital-level analyses and should be interpreted as preliminary evidence; replication with a larger sample of hospitals is necessary to confirm their robustness. These findings advocate for strategic investments in fostering OI through leadership development, urging policymakers to prioritize organizational learning and adaptive capabilities as a means of elevating healthcare quality.