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The following table summaries the interview results based on cognitive, structural and relational dimensions of relational capital.

Relational capital based on the interview scripts and archive data of three hospitals Relational

Capital components

Wan Fang Hospital Far Eastern Memorial Hospital

Tsuchi Hospital

Cognitive 1. Patient-centered and community based

1. Tsuchi is volunteer based system that that is an integral part of the whole

community

2. Build ―patient security information system‖ 3. Project team design

for easier external

patient care

3. Develop various kinds of indicators for self

1.A 1.A lot of volunteers are doing service in the

7 areas with 32 local clinics

From the summary of the above table, Figure 2 was drawn to delineate the formation of relational capital with the theories that apply to its stage development.

1. Stage one – cognitive perspective

Intentional relational capital creation starts with needs for additional relational capital.

stage 1.1 – goal-setting theory

In the creation process, setting the goal regarding what type of relationship with whom is very important. Therefore, goal-setting theory initiates the relational capital creation process.

stage 1.2 –social cognition theory

The above goal needs to be socially recognized by the top management team and all the organizational members, that is when social cognition theory comes in.

With the cognition, consensus of organizational goal should be reached and the platform for achieving the goals should be built.

stage 1.3 –expectancy theory

The actual relational capital formulation should be processed through people, that is each relevant individual should understand what to achieve, how to achieve it, and what to expect. This is when expectancy theory comes in.

2. Stage two – structural perspective

Once the goal is set, members accept the direction, and there is clear expectation, organizations need to construct the matching environment and policies for goal achievement. That is, the structural perspective of relational capital should build the essential platform.

stage 2.1 –resource dependency theory

With the prospect, what resources are needed and who owns the resources have to be identified and approached. In other words, matching resources need to be ready to build the desirable relational capital. This is when resource dependency theory comes in.

stage 2.2 – social exchange theory

After the resources are identified, social exchanges may be required for building the relationship. This is when social exchange theory comes in.

3. Stage three – relational perspective stage 3.1 –networking theory

With organizational goal, members‘ cognition and expectation, identified resources, and whom to exchange the resources, organizations need to actually network to obtain relational capital. This is when networking theory comes in.

stage 3.2 – social capital theory

After the above stated processes, organizations should be able to obtain the desirable relational capital. Yet, the approaches advocated by social capital theory have to be attended to. This is when social capital theory comes in.

How Figure 2 model works for relational capital creation and accumulation is elaborated hereunder with the evidences from the three hospitals.

1. Stage one – cognitive perspective stage 1.1 – goal-setting

Wan Fang – to become patient-centered and artistic hospital, to participate relevant award competition for self-renewal and for publicity

Far Eastern – to become patients‘ best choice for heart surgery, through medical technology advancement, internal medical team co-development, and external alliance

Tsuchi – volunteer based system that enlarges the connectivity with the mass amount of citizens

stage 1.2 –social cognition

All three hospitals have successfully built the image they expect to project to the general public, through the organizational culture and members‘ manifested behaviours.

stage 1.3 –expectation

All three hospitals have achieved their original expectation to a certain degree:

Wan Fang – its reputation has been firmly established that WF has successfully acquired another 1,300-bed hospital.

Far Eastern – contrary to the discipline-centered and doctor-centered tradition, FE has successfully built the working model of team development that provides better

a team and perform equal quality care following the standard operation procedure;

the kidney doctors and heart doctors are working closely together for better kidney and heart transplant surgery.

Tsuchi –Tsuchi has successfully projected an image of a very caring hospital. Its volunteers comfort the last mile patients with Buddha prayer, which is appreciated by the family members.

2. Stage two – structural perspective stage 2.1 –resource dependency

Wan Fang – Taipei Medical School, Taipei city government, and the local community

Far Eastern – well-trained medical doctors from National Taiwan Hospital and nurses, Far Eastern group

Tsuchi – citizens and volunteers, Tsuchi received huge donation including money and volunteers‘ time

stage 2.2 – social exchange theory

Wan Fang – Taipei Medical School supports well-trained doctors and WF provides internship opportunities for the medical school resident-students; WF runs the hospitals for Taipei city government in exchange for government resources; WF conducts regular free medical consulting services in local communities to boost its reputation for more patients

Far Eastern – teach doctors of other hospital for the developed advanced surgery technology to obtain recognition and to attract more qualified doctors (FE is a relatively new hospital)

Tsuchi – to attract patients that need more service; the volunteers are ranked into different levels according to their donation of either money or time

3. Stage three – relational perspective stage 3.1 –networking

Wan Fang – WF uses the following measures to do network for better hospital performance in addition to the required medical care:

a. art gallery

b. free community medical service and free meals for the community aged single residents

c. acquire more resources from Taipei city government

d. acquire qualified doctors from Taipei Medical School

Far Eastern –uses the following measures to do network for better hospital performance in addition to the required medical care:

a. advanced surgery technology b. more comprehensive medical care

c. external alliance with National Taiwan Medical School d. successfully apply for a MRT FE station near the hospital

Tsuchi –uses the following measures to do network for better hospital performance in addition to the required medical care:

a. own a TV channel

b. provide the opportunity for the petty citizens to fulfil their wish for doing something good to the society

c. volunteers invite more volunteers to do the service d. comfort the last mile patients with Buddha prayer stage 3.2 – social capital

Wan Fang – nearby communities are the sources of its social capital

Far Eastern – very qualified internal and external medical teams are the sources of its social capital

Tsuchi – huge amount of volunteers is the most important source of its social capital

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