The article aims to examine the relationship between knowledge management (KM) and organizational performance with two different managerial methods. The methodology is to use SPSS statistical software for principal component factor analysis and t test. A case study has been conducted at the Pin-Tung Taiwan public hospital, which has implemented in an ongoing project of total quality management TQM/ ISO 9002 certification from 1997 to 2002. The purpose of this study is to investigate the difference of knowledge learning in an organization to adopt different approaches to improve performance. It may benefit for practices to effective knowledge management as promoting a new. The result found that knowledge management is positively impacted on organizational performance. Knowledge management for managerial methods of TQM I ISO are different. The knowledge management, which considered with three factors knowledge gain, accumulate, and share, are valid and reliable to measure The new methods is like as an enabler for an organization to continuous improvement. While knowledge management could be looked as a processor to adapt different methods. It also suggests that a learning hospital is anticipated to organizational paradigm. It needs to focus not only on finding a new managerial method but also on right knowledge management to create the right knowledge.