Background: Närsjukvården Österlen AB (=NÖAB) won a five-year contract, late in 2000, to operate the local health care services in Simrishamn on behalf of the Region Skåne. The economical forecast for 2002 was a loss of 18 million SEK. A turnaround was urgent.

Aim: Primarily to evaluate Knowledge Management (=KM) techniques as a tool in the process of turning a health care organization around. Secondarily, to describe the means by which NÖAB became a more efficient health care organization. In order to evaluate the use of KM in the turnaround process it is necessary to answer three fundamental research questions. Did a turnaround take place? Did the individual projects contribute to increased efficiency? And finally can the approach used in the projects be characterized as KM.

Method: The study was an ongoing case study using action research combined with evaluation. The Evaluation uses public data (both quantitative and qualitative) and evaluations done by third parties. That allows for a profound validation of the conclusions. Three central processes were singled out for the evaluation. 1) The makeover of the acute patients’ way into the system, 2) the disease management program (=DPM) for patients suffering from COPD and 3) the introduction of an error-management system.

Results: The operating results were raised from minus 15 million SEK in 2002 to plus 10 million SEK in 2005. Manhours were reduced with 20.6%. The average cost for a consultations were reduced with 24.6%. The introduction of the COPD DPM resulted in a saving of approximately 1 million SEK a year. A total of 312 adverse event reports were filled during the first 10 month - an average of 31 a month. The introduction of KM turned the organization into a patient centered, lean health care organization. Changed the decisions making, and resulted in a significant shift towards an acceptance culture.

Conclusion: From the nature of the described projects, the description of the landmarks used and the discussion on how the projects fit into a Knowledge Management way of thinking it is concluded that a Knowledge Management approach was applied. The success of the turnaround described in the case makes a strong argument for the use of Knowledge Management when faced with the need to optimize health care systems.