Orchestrating knowledge and relationships in elderly care: an interventionist study of a Japanese university hospital

Purpose This study aims to explore how knowledge management (KM) and relational capital (RC) can serve as strategic levers to address the challenges of an aging population within healthcare systems. Focusing on Kansai Medical University (KMU) and its affiliated hospital in Japan, the research examines how integrating traditional Japanese care principles, organizational knowledge systems and digital transformation fosters sustainable, patient-centered elderly care. Design/methodology/approach An interventionist research (IVR) approach was used through a longitudinal single-case study at KMU. Data was collected over six months via participant observation, institutional documentation and semi-structured interviews with key stakeholders. The analysis combined theoretical insights from KM and RC with empirical evidence to identify how knowledge flows, interprofessional collaboration and digital tools shape healthcare delivery for the elderly. Findings The results highlight that KMU’s ability to integrate relational and technological infrastructures enables efficient knowledge sharing across departments, enhancing care coordination and organizational learning. Traditional Japanese principles of self-help (Ji-jo), mutual aid (Go-jo), social solidarity (Kyo-jo) and government care (Ko-jo) remain embedded in the institutional culture and are operationalized through RC and digital systems. Originality/value This study offers one of the first empirical examinations of how KM and RC jointly enable healthcare organizations to manage demographic aging. By positioning the university as an orchestrator of knowledge flows among multiple stakeholders, the research contributes to the theoretical understanding of KM and RC in healthcare and provides practical insights for policymakers and hospital administrators seeking to design knowledge-driven, relationally grounded models of elderly care.