LEARNING HEALTHCARE ORGANIZATIONS

Learning Healthcare Organizations



Learning Healthcare Organizations

The transformational change management is the process of selecting and deciding which changes to encourage, allow, or refuse based on the evaluation of the impact of these changes on the triple constraint and the gains or losses in business. Researchers report varying levels of change management capability across the healthcare organizations. The change management maturity model has five levels or stages that range from no change management to organizational competency.

The practices and principles of the “learning organization” may offer the means to an organizational infrastructure supportive of nurses in the practice in healthcare organizations. Learning Organizations (LO) have received growing recognition in the corporate and business literature in the past several decades. Knowledge attainment and practice improvement require adopting new ideas. Garvin (1993) notes that the first step of the LO is to become “skilled at creating, acquiring, and transferring knowledge, and at modifying its behavior to reflect new knowledge and insights. Organizations cannot become a LO overnight— becoming a learning organization is a journey, not a destination.

Development of a LO requires commitment and long-term vision by the organization, or as making use of Noah's principle, “one survives not by predicting rain but by building arks” (Redding & Catalanello, 1994). A learning organization has a capacity that is embedded and shared for changing and doing something new (Watkins & Marsick, 1993). Important to health care is the recognition by members of the LO that they belong to a collaborative community that depends on the collective capability of the organization to create new knowledge, change, and learn from experiences (Ettlie, Bridges, O'Keefe, 1984).

Shrivastava (1983) defined organizational learning as the conversion of individual knowledge and insights into a systematic organizational knowledge base that informs decision making. Shrivastava categorized the literature according to four organizational learning perspectives: adaptive learning (responding to the environment), assumption sharing (changing theories in use), development of knowledge base (capacity of learning to produce and share knowledge), and institutionalized experience effects (repeated performance producing knowledge for future use). The system is managed internally through integration and pattern maintenance; it manages in the environment through adaptation and goal attainment. The purpose is concerned with the means or ends (Parsons, 1951). These collective actions constitute patterns that carry out prerequisite functions for the total system. According to Parsons, change of social systems takes place through both performance and learning, although the goal of social action theory is performance. Mutual exchange among the subsystems is called a medium of interchange, which acts to ensure the continual circulation of resources within the action system (Schwandt, 1996; Schwandt & Marquardt, 2000).

In order to bring transformational change in the healthcare organizations, there are many factors to be considered. Changing organizational environments require continual learning. Johnson and D'Argenio (1991) found short-term learning interventions showed minimal changes in leadership effectiveness year after program completion. Kleinman (2003) and Scoble and Russell (2003) determined graduate education fulfilled the needs of nurse managers when programs combined business competencies and clinical ...