Abstract
This paper contributes to research on organizational learning by investigating
specific learning activities undertaken by improvement project teams in hospital
intensive care units and proposing an integrative model to explain
implementation success. Organizational learning is important in this context
because medical knowledge changes constantly and hospital care units must learn
if they are to provide high quality care. To develop a model of factors
affecting improvement project teams driving essential organizational learning in
healthcare, we draw from three streams of related research - best practice
transfer (BPT), team learning (TL), and process change (PC). To test the model's
hypotheses, we collected data from 23 neonatal intensive care units seeking to
implement new or improved practices. We first analyzed the frequency of specific
learning activities reported by improvement project participants and discovered
two distinct factors: learn-what (activities that identify current best
practices) and learn-how (activities that operationalize practices in a given
setting). Next, OLS regression analyses supported three of our four hypotheses.
Specifically, a high level of supporting evidence for a unit's portfolio of
improvement projects was associated with implementation success. Learn-how was
positively associated with implementation success, but learn-what was not.
Psychological safety was associated with learn-how, which was found to mediate
between psychological safety and implementation success.