Preventable medical errors are the third-leading cause of death in the United States. Many of these errors are attributable to system-level problems in health systems. A growing body of evidence validates organizational learning’s potential for improving health systems, including better patient outcomes, improved finances, and more effective teams. However, because conceptualizations of organizational learning have been inconsistent, the literature on organizational learning is not theoretically coherent. This presentation is intended to offer a rigorous analysis of the concept of organizational learning in health systems, thus laying a foundation for additional theory development, research, and practical applications.
Walker & Avant’s approach was used to guide this analysis. A search for relevant literature was conducted in the CINAHL, MEDLINE, Academic Search Premier, Business Source Premier, PsycINFO, SCOPUS, Web of Science, and Sociological Abstracts databases, yielding 2322 articles. After eliminating duplicates, articles of poor quality and papers unrelated to organizational learning in hospitals, 150 articles remained. Books and chapters on organizational learning were also consulted. Data was systematically extracted to determine the uses, antecedents, contextual factors, empirical referents, and consequences of organizational learning in health systems.
By definition, organizational learning is a positive change process through which healthcare organizations can position themselves to achieve their desired outcomes. Therefore, organizational learning has practical implications for research and clinical practice. Clinicians can integrate the antecedents of organizational learning (i.e. experience, reflection, and dissemination) into their daily practice, while researchers can study the efficacy of interventions that foster those antecedents. Clinical leaders can facilitate organizational improvements by attending to the contextual factors associated with organizational learning: a shared purpose and motivation, interpersonal connections, a sense of psychological safety, adequate resources, and individual and collective skills related to organizational improvement. Researchers can use the empirical referents of organizational learning (i.e. interaction, collective reflection, deliberate learning, practicing, retention, and leadership) to develop observation tools and instruments to evaluate the prevalence of behaviors related to organizational learning in various settings. Researchers and clinicians can study the impact of organizational learning by looking for improvements in clinical, organizational, financial, and team outcomes, as well as successful change efforts.
This analysis advances the conceptual clarity of organizational learning in health systems. It provides a foundation for theoretical developments and a coherent body of research on organizational learning. Furthermore, clinical practitioners can use this concept to guide their efforts to advance organizational learning within their own organizations to achieve excellent patient care.
