Knowledge management, digital innovation, and sustainability outcomes in Indian hospitals: A capability-based perspective

This study examines the association between knowledge management capabilities (KMC) and sustainability-oriented digital transformation in Indian hospitals through their relationships with digital innovation initiatives (DII) and sustainability outcomes (SO). Building on the knowledge-based view and dynamic capabilities (DC) theory, we test (a) the relationship between KMC and DII; (b) the relationship between KMC and DII, respectively, and SO; (c) whether DII mediates the KMC–SO relationship; and (d) whether DC moderates the KMC–DII relationship. Using a cross-sectional survey of managers in public and private hospitals in India (N = 250) and partial least squares structural equation modelling with bias-corrected bootstrapping, we find that KMC is positively associated with DII (β = 0.445, p < 0.001) and SO (β = 0.283, p < 0.001), and DII is positively associated with SO (β = 0.386, p < 0.001). DII partially mediates the effect of KMC on SO (indirect effect = 0.156). The interaction effect of DC is positive but not significant (β = 0.112, p = 0.230), suggesting that knowledge capabilities can support sustainability-oriented digital innovation even when DC levels differ. By positioning knowledge management as the mechanism that converts data and experience into actionable knowledge for digital innovation, the study provides evidence from a heterogeneous, resource-constrained healthcare context and offers actionable implications for sustainable digitalization.