PurposeKnowledge sharing is recognized as one of the most important ways to improve organizational performance. Organizations strive to facilitate knowledge sharing routines, yet these attempts often fail. Although the successful deployment of knowledge sharing practices has been a focus of knowledge management and organizational performance studies, little research has considered the impacts of institutional structures. As such, the purpose of this study is to investigate the extent to which institutional structures facilitate knowledge sharing practices and their impacts on organizational performance.Design/methodology/approachBased on 220 usable survey responses, the authors applied structural equation modeling (SEM) to observe the extent to which institutional structures enhance organizational performance through knowledge sharing, and other important knowledge sharing‐related constructs (i.e. leadership and punitive behavior). The healthcare industry was used as the research context as it is a knowledge‐intensive industry.FindingsThe study finds that knowledge sharing practices were strongly influenced by institutional structures, and together considerably enhanced patient safety. Furthermore, the institutional structures had a high impact on leadership roles and the abatement of punitive behaviors, which in turn collectively considerably enhanced patient safety.Originality/valueThis paper recognizes the power of institutional structures that successfully facilitate knowledge sharing practices within an environment that is unfriendly to knowledge sharing behaviors.
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