Can health care organizations learn?

By March 23, 2014Advocate, Consumer, Leader
I’m stuck. I’m obsessed with how organizations learn. In my day job as Vice President of Quality Management at Advocates, Inc., we’ve been considering how to promote Advocates as a learning organization including persons supported and their networks, those closest to the work, and all partners. How thrilling! What a goal!!  But how do we actually do it? I’ve read so many books and articles. But they’re prescriptions with no promise of actually working.
If an organization learns at one point in time, how do you hardwire the culture of learning beyond a charismatic leader?  Are organizations like people? An person learns to drive. She passes a driving test and drives. Now its in her bones and muscle memory. The wish to learn must be in the bones and muscle memory. What happens when her bones and muscle memory of driving don’t work as well as they did. How does she know? If her leg is broken or she’s blind it’s immediately clear. She can’t drive. If reflexes slow or vision lessens it’s not so clear.

Health care is in an extended epidemic of not learning. Last week, I was teaching at a nursing leadership academy for the Organization of Nurse Leaders of Massachusetts and Rhode Island.  As I listened to the attendees speaking about their challenges as middle managers, I was struck that they were dealing with the same problems I dealt with as a new manager 30 years ago. Struggles with too much expected with too few resources. People close to the work task focused – What do I need to do to get through the day? While their leaders are financially focused – how do we survive and make enough to grow and invest? No alignment. A disconnect between leaders and those closest to the work.
One success factor may be an organizational acceptance that it’s never completely learned. The dynamic tension between resources, mission, values, technology will never be solved.  The signal that learning has stopped is when we think we’ve solved it. I suspect that hardwiring learning comes from the top AND the ground. Organizational leaders (CEOs) come and go. The wish to learn must be hardwired from the Board or the shareholders. Since the ingredients and cooking of learning comes from the people at the center and the people closest to the work, they must be integral to the learning. Not an afterthought, not token and occasional but central. Whatever outcomes and experience health care organizations use to measure themselves, people at the center and people closest to the work need to chew on it and digest it. Without that it’s ink on paper without meaning. Then we need the stones to hear the feedback and redesign with the feedback in mind in partnership with those same people. Haven’t seen it yet. Don’t know if I’m right.
I love this challenge! Hope I learn more about learning.


  • Danny says:

    Thanks Alan.

  • Alan says:

    Danny, great post. I always start with the question, “Is learning a core value (of the organization”? If so, how would I know it if I landed from Mars? Is there a minimum number of hours that the employee has been allocated for learning, annually, and is it enforced by the organization? If so, how is it enforced? And what organizational systems are set-up to support this core value of learning…?

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