SAGE Publications Los Angeles z London z New Delhi z Singapore z Washington DC DOI: 10.1177/097206341001200409 Healthcare Services Based on Knowledge Structure

This article presents a conceptual structure for enabling knowledge creation and knowledge transference in the knowledge-intensive health services. Identifying the proposed critical elements in health management, it analyses the required organisational characteristics for the change from a traditional context to a complex context. The conceptual framework applied to the hospital management highlights the differences between ‘structure based on information ’ and ‘structure based on knowledge’. Hospitals which are focused on solving complex problems demand new service strategies for the creation and transference of knowledge. A qualitative research was applied in a in-depth case study and conducted as an exploratory investigation in the Vascular Medical Center, that includes neurology and cardiology services, and is a Brazilian hospital specialised in complex problems. By looking into the patient’s adherence, two critical contexts were identifi ed: one was the interaction between patients and healthcare professionals, and the second was the organisational behaviour regarding the patients ’ experiences. Knowledge structure demands the reconfi guration of the internal value chain of hospitals considering the results of the assistance process. The organisational context to promote knowledge for solving adherence problems was characterised as a facilitator environment that would be required to develop an educational process for both patients and healthcare professionals