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Ishii K, Fujitani K, Matsushita H. Interprofessional collaboration mediates the relationship between perceived organizational learning and safety climate in hospitals: A cross-sectional study. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2024:JRS230026. [PMID: 38759025 DOI: 10.3233/jrs-230026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
BACKGROUND Organizational learning (OL) and interprofessional collaboration (IPC) are said to enhance medical safety in hospitals, but the relationship between these variables has not been quantitatively tested. OBJECTIVE This study examines the mediating effects of IPC on the relationship between OL and safety climate (improvement, compliance, and patient/family involvement). METHODS An anonymous self-reporting questionnaire was administered to 1,495 healthcare workers from November 2021 to January 2022. The questions regarded the hospital's safety climate, OL, and IPC. A mediation analysis using structural equation modeling was conducted to examine the mediating role of IPC on the relationship between OL and the three safety climates. The indirect effect was estimated using 2,000 bootstrap samples. RESULTS Responses from 643 healthcare workers were analyzed. The direct effects of OL were 𝛽 = .74, 75 (p < .001) on improvement and involvement and 𝛽 = 0.1 (p > .05) on compliance. The indirect effects of IPC on improvement and involvement were 𝛽 = .14 (95%CI: .00 ∼ .06) and 𝛽 = .37 (95%CI: .04 ∼ .09), respectively. CONCLUSION This study determined the mechanisms that enhance a hospital's safety climate, demonstrating that IPC mediates the relationship between OL and improvement and patient/family involvement. However, OL and IPC are not related to compliance.
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Affiliation(s)
- Keiko Ishii
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsumi Fujitani
- Graduate School of Health Care Science, Bunkyo Gakuin University, Tokyo, Japan
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2
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Löfqvist N. Enhancing capability for continuous organisational improvement and learning in healthcare organisations: a systematic review of the literature 2013-2022. BMJ Open Qual 2024; 13:e002566. [PMID: 38569667 PMCID: PMC10989174 DOI: 10.1136/bmjoq-2023-002566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/24/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Healthcare organisations strive to meet their current and future challenges and need to increase their capacity for continuous organisational improvement and learning (COIL). A key aspect of this capacity is the development of COIL capability among employees. OBJECTIVE This systematic review aims to explore common attributes of interventions that contribute to the development of COIL capability in healthcare organisations and to explore possible facilitating and hindering factors. METHODS A comprehensive search was conducted in Scopus, MEDLINE and Business Source Complete for primary research studies in English or Swedish, in peer-reviewed journals, focusing on organisational improvements and learning in healthcare organisations. Studies were included if they were published between 2013 and 23 November 2022, reported outcomes on COIL capability, included organisations or groups, and were conducted in high-income countries. The included articles were analysed to identify themes related to successful interventions and factors influencing COIL capability. RESULTS Thirty-six articles were included, with two studies reporting unsuccessful attempts at increasing COIL capability. The studies were conducted in nine different countries, encompassing diverse units, with the timeframes varying from 15 weeks to 8 years, and they employed quantitative (n=10), qualitative (n=11) and mixed methods (n=15). Analysis of the included articles identified four themes for both attributes of interventions and the factors that facilitated or hindered successful interventions: (1) engaged managers with a strategic approach, (2) external training and guidance to develop internal knowledge, skills and confidence, (3) process and structure to achieve improvements and learning and (4) individuals and teams with autonomy, accountability, and safety. CONCLUSION This review provides insights into the intervention attributes that are associated with increasing COIL capability in healthcare organisations as well as factors that can have hindering or facilitating effects. Strategic management, external support, structured processes and empowered teams emerged as key elements for enhancing COIL capability.
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Affiliation(s)
- Ninni Löfqvist
- Department of Communication, Quality Management, and Information Systems, Mid Sweden University, Östersund, Sweden
- Department of Pediatrics, Region Västernorrland, Härnösand, Sweden
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Kiljunen O, Savela RM, Välimäki T, Kankkunen P. Managers' perceptions of the factors affecting resident and patient safety work in residential settings and nursing homes: A qualitative systematic review. Res Nurs Health 2024. [PMID: 38522016 DOI: 10.1002/nur.22382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/23/2024] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
Identifying ways to ensure resident safety is increasingly becoming a priority in residential settings and nursing homes. The aim of this qualitative systematic review was to identify, describe, and assess research evidence on managers' perceptions regarding the barriers and facilitators of daily resident and patient safety work in residential settings and nursing homes. A qualitative systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. Published studies were sought through academic databases: Academic Search Premier, CINAHL, PubMed (MEDLINE), Scopus, SocINDEX, and Web of Science Core Collection in April 2023. Finally, 12 studies were included. The results of the included studies were synthesized using thematic synthesis after data extraction. According to the results, (1) competent staff and material resources; (2) management and culture; (3) communication, networks, optimal use of expertise; and (4) effective use of guidelines, rules, and regulations play a significant role in the success of resident and patient safety work. The findings revealed that promoting resident safety should not be seen solely as the responsibility of individual residential or nursing home personnel, as it requires multiprofessional cooperation and access to wider networks. Staff and managers must be receptive to learning, changing, and improving safety. Moreover, to ensure resident safety, it is essential to ensure that the organizations support safety work in residential and nursing home units.
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Affiliation(s)
- Outi Kiljunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Päivi Kankkunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Osborne R, Bailey C, Dinsmore D, Lyter E, Burnfield J, Medearis H, Roura A. Structural Equation Modeling: Effects of Master Adaptive Learner and Clinical Learning Environment Attributes on Career Satisfaction and Intention to Stay. Phys Ther 2024; 104:pzad152. [PMID: 37941504 DOI: 10.1093/ptj/pzad152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/16/2023] [Accepted: 11/03/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE The objective of this observational study was to test a proposed conceptual model depicting the influence of personal and environmental attributes of clinical learning environments on rehabilitation professionals' career satisfaction and intention to stay with their current organization. The mediating effects of 2 loci of engagement were also assessed. METHODS Rehabilitation professionals (physical therapists, occupational therapists, speech-language pathologists, and registered nurses; n = 436) from 4 health care organizations in the Northeast, Southeast, and Midwest regions in the USA completed a battery of questionnaires related to personal attributes (resilience and orientation toward lifelong learning), environmental attributes (innovation support and basic psychological need satisfaction at work), loci of engagement (professional and organizational), career satisfaction, and intention to stay. Data were analyzed using structural equation modeling. RESULTS The measurement and structural model fit was acceptable. The greatest total effects on career satisfaction (r = .459) and intention to stay (r = .462) were observed through the influences of basic psychological need satisfaction, professional engagement, and organizational engagement. Orientation toward lifelong learning was negatively associated with career satisfaction (r = -.208) and intention to stay (r = -.154), but this was mitigated by organizational engagement (r = -.060 and - .134, respectively). Small but significant total effects were also observed between innovation support, professional and organizational engagement, and intention to stay (r = .144) and resilience, professional and organizational engagement, and career satisfaction (r = .110). CONCLUSION Clinical learning environments that support rehabilitation professionals' basic psychological needs (autonomy, competency, and relatedness) are associated with greater career satisfaction and intention to stay. This association is further enhanced by organizational engagement and innovation support. IMPACT Rehabilitation organizations interested in developing and retaining master adaptive learners should create clinical learning environments that reinforce rehabilitation professionals' sense of autonomy, competency, and relatedness, and are supportive on innovative behaviors.
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Affiliation(s)
- Raine Osborne
- University of North Florida, Department of Physical Therapy, Jacksonville, Florida, USA
- Brooks Rehabilitation, Jacksonville, Florida, USA
| | - Chloe Bailey
- Brooks Rehabilitation, Jacksonville, Florida, USA
| | - Daniel Dinsmore
- University of North Florida, Department of Physical Therapy, Jacksonville, Florida, USA
| | - Emily Lyter
- Good Shepherd Rehabilitation, Allentown, Pennsylvania, USA
| | - Judy Burnfield
- Madonna Rehabilitation Hospitals, Lincoln, Nebraska, USA
| | | | - Amanda Roura
- University of Florida Health, Jacksonville, Florida, USA
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Gambirasio M, Magatti D, Barbetta V, Brena S, Lizzola G, Pandolfini C, Sommariva F, Zamperoni A, Finazzi S, Ivaldi S. Organizational Learning in Healthcare Contexts after COVID-19: A Study of 10 Intensive Care Units in Central and Northern Italy through Framework Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6699. [PMID: 37681839 PMCID: PMC10487410 DOI: 10.3390/ijerph20176699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023]
Abstract
The rapid spread of the SARS-CoV-2 virus has forced healthcare organizations to change their organization, introducing new ways of working, relating, communicating, and managing to cope with the growing number of hospitalized patients. Starting from the analysis of the narratives of healthcare workers who served in the intensive care units of 10 hospitals in Central and Northern Italy, this contribution intends to highlight elements present during the pandemic period within the investigated structures, which are considered factors that can influence the birth of organizational learning. Specifically, the data collected through interviews and focus groups were analyzed using the framework analysis method of Ritchie and Spencer. The conducted study made it possible to identify and highlight factors related to aspects of communication, relationships, context, and organization that positively influenced the management of the health emergency, favoring the improvement of the structure. It is believed that the identification of these factors by healthcare organizations can represent a valuable opportunity to rethink themselves, thus becoming a source of learning.
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Affiliation(s)
- Maddalena Gambirasio
- Department of Human and Social Sciences, University of Bergamo, Piazzale Sant’Agostino 2, 24129 Bergamo, Italy
| | - Demetrio Magatti
- Laboratory of Clinical Data Science, Department of Medical Epidemiology, Mario Negri Institute for Pharmacological Research IRCCS, Villa Camozzi, Via G.B. Camozzi 3, 24020 Bergamo, Italy; (D.M.); (V.B.); (S.F.)
| | - Valentina Barbetta
- Laboratory of Clinical Data Science, Department of Medical Epidemiology, Mario Negri Institute for Pharmacological Research IRCCS, Villa Camozzi, Via G.B. Camozzi 3, 24020 Bergamo, Italy; (D.M.); (V.B.); (S.F.)
| | - Silvia Brena
- Independent Researcher, Via Papa Giovanni XXIII 18, Mozzo, 24030 Bergamo, Italy;
| | - Giordano Lizzola
- Independent Researcher, Via Piemonte 5, Alzano Lombardo, 24022 Bergamo, Italy;
| | - Chiara Pandolfini
- Laboratory of Evolutionary Age Epidemiology, Department of Medical Epidemiology, Mario Negri Institute for Pharmacological Research IRCCS, Via Mario Negri 2, 20156 Milano, Italy;
| | | | - Anna Zamperoni
- Cà Foncello Hospital, Aulss2, Piazzale dell’Ospedale, 1, 31100 Treviso, Italy;
| | - Stefano Finazzi
- Laboratory of Clinical Data Science, Department of Medical Epidemiology, Mario Negri Institute for Pharmacological Research IRCCS, Villa Camozzi, Via G.B. Camozzi 3, 24020 Bergamo, Italy; (D.M.); (V.B.); (S.F.)
| | - Silvia Ivaldi
- Department of Human and Social Sciences, University of Bergamo, Piazzale Sant’Agostino 2, 24129 Bergamo, Italy
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Feng T, Zhang X, Tan L, Su Y, Liu H. Near-miss organizational learning in nursing within a tertiary hospital: a mixed methods study. BMC Nurs 2022; 21:315. [PMID: 36380309 PMCID: PMC9667619 DOI: 10.1186/s12912-022-01071-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Near-miss organizational learning is important for perspective and proactive risk management. Although nursing organizations are the largest component of the healthcare system and act as the final safety barrier, there is little research about the current status of near-miss organizational learning. Thus, we conducted this study to explore near-miss organizational learning in a Chinese nursing organization and offer suggestions for future improvement. Methods This was a mixed methods study with an explanatory sequence. It was conducted in a Chinese nursing organization of a tertiary hospital under the guidance of the 4I Framework of Organizational Learning. The quantitative study surveyed 600 nurses by simple random sampling. Then, we applied purposive sampling to recruit 16 nurses across managerial levels from low-, middle- and high-scored nursing units and conducted semi-structured interviews. Descriptive statistics, structured equation modelling and content analysis were applied in the data analysis. The Good Reporting of A Mixed Methods Study (GRAMMS) checklist was used to report this study. Results Only 33% of participants correctly recognized near-misses, and 4% of participants always reported near-misses. The 4I Framework of Organizational Learning was verified in the surveyed nursing organization (χ2 = 0.775, p = 0.379, RMSEA < 0.01). The current organizational learning behaviour was not conducive to near-miss organizational learning due to poor group-level learning (βGG = 0.284) and poor learning absorption (βMisalignment= -0.339). In addition, the researchers developed 13 codes, 9 categories and 5 themes to depict near-miss organizational learning, which were characterized by nurses’ unfamiliarity with near-misses, preferences and the dominance of first-order problem-solving behaviour, the suspension of near-miss learning at the group level and poor learning absorption. Conclusion The performance of near-miss organizational learning is unsatisfactory across all levels in surveyed nursing organization, especially with regard to group-level learning and poor learning absorption. Our research findings offer a scientific and comprehensive description of near-miss organizational learning and shed light on how to measure and improve near-miss organizational learning in the future. Supplementary information The online version contains supplementary material available at 10.1186/s12912-022-01071-1.
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Lyman B, George KC, Frandsen SN. Facilitating Organizational Learning in Nursing Teams. J Contin Educ Nurs 2022; 53:379-384. [PMID: 35914272 DOI: 10.3928/00220124-20220706-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Organizational learning is an effective strategy professional development educators and other nurse leaders can use to improve individual, team, and organizational outcomes. Professional development educators can foster organizational learning by implementing certain actions, called mechanisms, associated with organizational learning. This article highlights five such mechanisms, presents practical examples of each, and suggests evidence-based recommendations professional development educators and nurse leaders can use to better facilitate organizational learning. [J Contin Educ Nurs. 2022;53(8):379-384.].
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8
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Lyman B, Thorum KC, Lyman B. Contextual Factors Associated With Organizational Learning in Hospitals: An Instrument Development Study. J Nurs Manag 2022; 30:3535-3545. [PMID: 35560746 DOI: 10.1111/jonm.13674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 04/04/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022]
Abstract
AIM Develop a valid, reliable research instrument to measure contextual factors associated with organizational learning in hospitals. BACKGROUND A valid, reliable instrument for measuring contextual factors associated with organizational learning is needed so nurse leaders and researchers can improve healthcare by facilitating and studying organizational learning. METHODS The Organizational Learning in Hospitals model guided development of the Organizational Learning Instrument-Context. Content validity was refined and evaluated through cognitive interviews and expert reviews. The instrument was distributed to direct care nurses in Magnet® hospitals in the United States. Intraclass correlation coefficients validated the use of multi-level analyses. Construct validity was assessed using multi-level confirmatory factor analysis and coefficient omega was used to assess internal reliability. RESULTS Participants were 1063 nurses in 120 inpatient units in 11 Magnet® hospitals. Results were as follows: Item-level content validity=0.86-1.0, scale-level content validity=0.95, intraclass correlation coefficients=0.171-0.270, coefficient omega=0.945-0.982, and standardized factors loadings=0.672-0.964. Model fit statistics were: CFI=0.963, TLI=0.961, and RMSEA=0.059. CONCLUSIONS Initial testing indicates the Organizational Learning Instrument-Context has adequate levels of reliability, content validity, and construct validity. IMPLICATIONS FOR NURSING MANAGEMENT Hospital leaders and researchers may begin using this instrument to improve and study contextual factors associated with organizational learning in hospital units.
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Affiliation(s)
- Bret Lyman
- College of Nursing, Brigham Young University, Provo, Utah, USA
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Lyman B, Ethington KM. Developmental stages associated with organizational learning in hospitals: An instrument development study. J Adv Nurs 2022; 78:3662-3672. [PMID: 35441733 DOI: 10.1111/jan.15262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/12/2022] [Accepted: 04/02/2022] [Indexed: 11/30/2022]
Abstract
AIM To develop and test the Organizational Learning Instrument: Development Stages instrument, a measure of hospital units' readiness to engage in organizational learning. DESIGN Cognitive interviewing, expert review and a quantitative, cross-sectional survey. METHODS Item development was informed by previous research on organizational learning. Content validity was assessed and strengthened using cycles of cognitive interviewing and expert review. The resulting instrument was distributed by email to all nurses providing direct patient care in inpatient units in 11 Magnet® hospitals. Data were collected in 2018. Intraclass correlations, using hospital unit as the grouping variable, indicated the need to use multilevel methods to analyse the survey data. Thus, coefficient omega and multilevel confirmatory factor analysis were used to estimate the instrument's reliability and construct validity, respectively. RESULTS The Organizational Learning Instrument: Development Stages is a 35-item survey comprised of four scales: Identity & Ownership, Team & Respect, Accountability & Support and Reliability & Sustainability. The expert review yielded scale-level content validity scores from 0.90 to 1.0 and item-level content validity scores from 0.86 to 1.0. Survey participants were 1212 nurses, working in 99 inpatient units, across 11 Magnet® hospitals. Intraclass correlations ranged from 0.113 to 0.158. Coefficient omega reliability for the four scales was 0.981-0.993. Standardized factor loadings for the 35 items were 0.699-0.961, with acceptable model fit statistics (comparative fit index = 0.980, Tucker-Lewis Fit Index = 0.979, and root mean squared error of approximation = 0.060). CONCLUSIONS These results indicate the instrument meets or exceeds generally accepted criteria for content validity, reliability and construct validity instrument, and is suitable for further use and testing. IMPACT Nurse administrators, managers and researchers now have a valid, reliable instrument to better foster and study organizational learning in hospital units. Advances in organizational learning are expected to improve a variety of patient, staff and organizational outcomes in hospital units.
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Affiliation(s)
- Bret Lyman
- College of Nursing, Brigham Young University, Provo, Utah, USA
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Lyman B, Smith EL, George KC. Mechanisms of Organizational Learning in Hospitals: An Instrument Development Study. J Nurs Manag 2022; 30:1069-1077. [DOI: 10.1111/jonm.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/04/2022] [Accepted: 03/07/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Bret Lyman
- College of Nursing Brigham Young University Provo Utah USA
| | - Emily L. Smith
- Registered Nurse, Intermountain Medical Center, Intermountain Healthcare Murray Utah USA
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Lyman B, Mendon CR. Pre-licensure nursing students' experiences of psychological safety: A qualitative descriptive study. NURSE EDUCATION TODAY 2021; 105:105026. [PMID: 34214951 DOI: 10.1016/j.nedt.2021.105026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/24/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Organizational learning is essential for consistently providing safe, efficient, high-quality patient care. Psychological safety is foundational for organizational learning. For pre-licensure nursing students psychological safety is crucial for both their learning and patient safety. Understanding pre-licensure nursing students' experiences of psychological safety can guide efforts to cultivate clinical environments conducive to learning and excellent patient care. OBJECTIVES The objective of this study was to gain insight into pre-licensure nursing students' first-hand experiences with psychological safety in clinical settings. DESIGN A qualitative, descriptive design was used for this study. SETTINGS Participants were recruited from 12 different nursing programs across eight states. PARTICIPANTS A total of 26 pre-licensure nursing students participated in this study. Included were students who had completed at least one clinical rotation, but had not yet obtained licensure as a registered nurse. METHOD Semi-structured interviews were conducted via telephone. Interviews were analyzed using a constant comparative approach to thematic analysis. RESULTS Four primary themes emerged from the data, two of which had sub-themes: 1) Feeling Self-Conscious, with the sub-themes Expecting Expectations and Interpreting Feedback; 2) Engaging; 3) Learning and Performing; and 4) Moving Forward, with the sub-themes Using Coping Strategies and Developing Confidence. CONCLUSIONS This study reinforces the importance of psychological safety for nursing students' learning and for patient safety. Feeling psychologically safe allowed students to engage in the clinical setting, to learn from their experiences, and to perform their very best. With these insights, faculty and clinical preceptors can cultivate effective learning environments where patients can also receive safe, high-quality patient care.
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Affiliation(s)
- Bret Lyman
- College of Nursing, Brigham Young University, Provo, UT, USA.
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Feng TT, Zhang X, Tan LL, Liu HP. Cross-cultural adaptation and validation of the strategic learning assessment map for Chinese nursing organisation: A cross-sectional study. Nurse Educ Pract 2021; 56:103185. [PMID: 34509748 DOI: 10.1016/j.nepr.2021.103185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 07/27/2021] [Accepted: 08/22/2021] [Indexed: 10/20/2022]
Abstract
AIM To translate the Strategic Learning Assessment Map into Chinese and validate it in Chinese nursing organisations. BACKGROUND Nursing is the largest occupational organisation in the health sector and its adaptation and innovation are important for the realisation of sustainable development goals. Organisational learning is critical in cultivating the adaptive and innovative abilities of organisations, but there is limited research on its measurement. Although the Strategic Learning Assessment Map is a widely acknowledged organisational measurement instrument, it has not yet been adapted and validated in China. DESIGN A cross-sectional study design was used. METHODS The Chinese version of the Strategic Learning Assessment Map was generated through forward-backward translation and was tested with a convenience sample of 2745 nurses from 7 administrative regions of mainland China. The internal consistency, content validity, structural validity and theoretical framework were examined. RESULTS Results validated the theoretical framework and showed excellent content validity, convergent validity and fitness of the measurement model; only discriminant validity was not satisfactory. Cronbach's α values for the overall scale and its subscales ranged from 0.97 to 0.99. CONCLUSIONS The Chinese version of the Strategic Learning Assessment Map is a reliable organisational learning instrument for Chinese nursing organisations.
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Affiliation(s)
- Ting Ting Feng
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ling Ling Tan
- The Second Affiliated Hospital of University of South China, Hengyang, Hunan Province, China
| | - Hua Ping Liu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Lyman B, Horton MK, Oman A. Organizational learning during COVID-19: A qualitative study of nurses' experiences. J Nurs Manag 2021; 30:4-14. [PMID: 34414626 PMCID: PMC8420306 DOI: 10.1111/jonm.13452] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/08/2021] [Accepted: 08/15/2021] [Indexed: 02/06/2023]
Abstract
Aim The aim of this study is to test the validity of the Organizational Learning in Hospitals model in the context of the COVID‐19 pandemic. Background Organizational learning is especially crucial in circumstances of intense, complex, enduring change, as with the COVID‐19 pandemic. Nurse managers need additional guidance for fostering organizational learning under such circumstances. The Organizational Learning in Hospitals model may be a helpful resource but requires additional validation. Methods Semi‐structured interviews were conducted to gather 19 nurses' first‐hand experiences of organizational learning during the COVID‐19 pandemic. Data were analysed using deductive thematic analysis. Results Nurses' experiences of organizational learning generally aligned with the tenets of the model. Specifically, effective organizational learning occurred when the contextual factors and mechanisms portrayed in the model converged. Model and contrary cases illustrate this phenomenon. Conclusions This study validates and adds context to the model. It offers practical examples of the contextual factors and mechanisms of organizational learning. Leaders can use the model to guide their efforts to foster organizational learning. Implications for Nursing Management This study reaffirms the importance of nurse leaders' central role in organizational learning. Nurse leaders can use the Organizational Learning in Hospitals model, and the practical examples provided, to foster organizational learning during challenging times.
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Affiliation(s)
- Bret Lyman
- College of Nursing, Brigham Young University, Provo, Utah, USA
| | - Morgan K Horton
- College of Nursing, Brigham Young University, Provo, Utah, USA
| | - Alyssa Oman
- College of Nursing, Brigham Young University, Provo, Utah, USA
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Sarakbi D, Mensah-Abrampah N, Kleine-Bingham M, Syed SB. Aiming for quality: a global compass for national learning systems. Health Res Policy Syst 2021; 19:102. [PMID: 34281534 PMCID: PMC8287697 DOI: 10.1186/s12961-021-00746-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 06/23/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Transforming a health system into a learning one is increasingly recognized as necessary to support the implementation of a national strategic direction on quality with a focus on frontline experience. The approach to a learning system that bridges the gap between practice and policy requires active exploration. METHODS This scoping review adapted the methodological framework for scoping studies from Arksey and O'Malley. The central research question focused on common themes for learning to improve the quality of health services at all levels of the national health system, from government policy to point-of-care delivery. RESULTS A total of 3507 records were screened, resulting in 101 articles on strategic learning across the health system: health professional level (19%), health organizational level (15%), subnational/national level (26%), multiple levels (35%), and global level (6%). Thirty-five of these articles focused on learning systems at multiple levels of the health system. A national learning system requires attention at the organizational, subnational, and national levels guided by the needs of patients, families, and the community. The compass of the national learning system is centred on four cross-cutting themes across the health system: alignment of priorities, systemwide collaboration, transparency and accountability, and knowledge sharing of real-world evidence generated at the point of care. CONCLUSION This paper proposes an approach for building a national learning system to improve the quality of health services. Future research is needed to validate the application of these guiding principles and make improvements based on the findings.
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Affiliation(s)
- Diana Sarakbi
- Health Quality Programs, Queen's University, Kingston, Canada.
- Health Quality Programs, Queen's University, Cataraqui Building, 92 Barrie Street, Kingston, ON, K7L 3N6, Canada.
| | | | | | - Shams B Syed
- Integrated Health Services, World Health Organization, Geneva, Switzerland
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Lyman B, Biddulph ME, George KC. Organizational Learning and Motivation in Certified Nurse Aides: A Qualitative Study. Res Gerontol Nurs 2021; 14:255-263. [PMID: 34292805 DOI: 10.3928/19404921-20210708-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Organizational learning is linked to improved outcomes in health care settings. In long-term care facilities, the unique position and expertise of certified nurse aides (CNAs) are crucial for excellent resident care, thus is it important to understand their sources of motivation. However, CNA motivation has not been adequately studied. The current qualitative descriptive study explored sources and implications of CNA motivation, particularly as it relates to engaging in organizational learning. Twenty-four CNAs working in a state Veteran's home were interviewed. CNAs described their sources of motivation as: I'm a Natural Caregiver, Support From Administration, Working as a Team, Love for Residents, and Self-Care. When motivated, CNAs had more positive attitudes about their work, a higher level of engagement with residents, a stronger drive to accomplish extra tasks, and less desire to quit. Engaging CNAs in organizational learning may provide an opportunity to motivate CNAs and optimize their unique position and expertise to improve resident care. [Research in Gerontological Nursing, xx(x), xx-xx.].
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Lyman B, Biddulph ME, Hopper VG, Horton MK, Mendon CR, Thorum KC, Smith EL. Creating a Work Environment Conducive to Organizational Learning. J Contin Educ Nurs 2021; 52:281-285. [PMID: 34048303 DOI: 10.3928/00220124-20210514-07] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Through organizational learning, health care teams can consistently provide excellent patient care in a complex and changing environment. Nurse managers, educators, and other leaders can facilitate organizational learning within their teams by promoting certain contextual factors in the clinical work environment. This article provides an overview of contextual factors associated with organizational learning, includes practice-based examples of these factors, and offers evidence-based recommendations for creating a learning-focused work environment. [J Contin Educ Nurs. 2021;52(6):281-285.].
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Ishii K, Takemura Y, Ichikawa N. Relationships between the components of nurse managers' transformational leadership and organisational learning subprocesses in a hospital ward: A cross-sectional study. J Nurs Manag 2020; 29:672-680. [PMID: 33128791 DOI: 10.1111/jonm.13203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/17/2020] [Accepted: 10/23/2020] [Indexed: 11/29/2022]
Abstract
AIMS To investigate the association between the five components of nurse managers' transformational leadership and each process of organisational learning in a hospital ward. BACKGROUND Elucidating the components of nurse managers' transformational leadership that promote organisational learning is needed. METHODS In 2018, 591 self-report questionnaires from two hospitals in Japan were analysed, using the measurement scale for Organizational Learning Subprocesses and Multifactor Leadership Questionnaire. Hierarchical linear modelling was conducted using the wards' mean scores of five components of transformational leadership and five subprocesses of organisational learning. RESULTS None of the transformational leadership components were significantly associated with information acquisition, but all five were significantly positively associated with information distribution and information integration. Only some of the five components showed a significant association with information interpretation and organisational memory. CONCLUSION Transformational leadership may be effective to promote the four organisational learning processes other than information acquisition. IMPLICATIONS FOR NURSING MANAGEMENT A nurse manager should exercise leadership other than transformational leadership, or use other strategies to promote information acquisition. However, particular behaviours of transformational leadership, such as intellectually stimulating behaviours and personal considerations, could be effective in promoting the understanding of information among the members and establishing new routines.
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Affiliation(s)
- Keiko Ishii
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukie Takemura
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoko Ichikawa
- Department of Nursing Administration, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Organizational learning culture and business intelligence systems of health-care organizations in an emerging economy. JOURNAL OF KNOWLEDGE MANAGEMENT 2020. [DOI: 10.1108/jkm-09-2019-0517] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to investigate the role of business intelligence systems (BIS) in the relationship between organizational learning culture and organizational performance in the health-care context.
Design/methodology/approach
A quantitative approach was applied to identify the hypothesized relationships. Data were obtained from a survey of 217 mid- and top-level managers of health-care organizations in Bangladesh. Structural equation modeling was used to analyze the data.
Findings
The findings attest to the effectiveness of the mediating role of BIS in the relationship between organizational learning culture and organizational performance within health-care organizations. The theoretical and practical implications of the findings are also discussed.
Research limitations/implications
The study data were collected from a single country, which made generalization difficult. Further research should be carried out to replicate the present study with different organizational cultural variables and organizational outcomes, such as patient satisfaction.
Practical implications
This study provides a clear direction for hospital managers to invest more resources in an effective learning culture, to be positively mediated by BIS and to eventually enhance their hospitals’ performance. In addition, this study also suggests that hospital managers should focus on building a knowledge-based learning culture, to effectively use the information provided by BIS.
Originality/value
Despite the prior study on the applications of BIS and their value to an organization, little is known about the impact of organizational learning culture on BIS in health-care organizations. The findings give support to the argument that organizational learning culture plays an important role in BIS that, in turn, affects business performance.
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Lyman B, Biddulph ME, Hopper VG, Brogan JL. Nurses' experiences of Organisational learning: A qualitative descriptive study. J Nurs Manag 2020; 28:1241-1249. [DOI: 10.1111/jonm.13070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/29/2020] [Accepted: 06/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Bret Lyman
- College of Nursing Brigham Young University Provo UT USA
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Lyman B, Gunn MM, Mendon CR. New graduate registered nurses' experiences with psychological safety. J Nurs Manag 2020; 28:831-839. [PMID: 32173958 DOI: 10.1111/jonm.13006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 11/27/2022]
Abstract
AIM The purpose of this study was to gain insight into new graduate registered nurses' experiences with psychological safety. BACKGROUND Organizational learning allows acute care hospitals to consistently provide high-quality patient care. Psychological safety is critical for organizational learning. New graduate nurses in particular need to feel psychologically safe as they transition into professional nursing practice. Understanding new graduate registered nurses' experiences of psychological safety can guide leaders and others to create work environments that foster psychological safety and organizational learning. METHOD Semi-structured interviews were conducted with 13 newly graduated registered nurses working in inpatient hospital settings. Interviews were analyzed using thematic analysis. RESULTS Four primary themes featured prominently in the new graduate nurses' experiences of psychological safety: building credibility, making personal connections, feeling supported and seeking safety. CONCLUSION Understanding these themes will help nursing education programmes, nurse managers, nurse colleagues and new graduate registered nurses foster psychological safety and create environments conducive to organisational learning. IMPLICATIONS FOR NURSING MANAGEMENT All members of the health care team involved in the new graduate registered nurses' transition to practice have a role in fostering psychological safety. Additional research is needed to better understand psychological safety and how to foster it.
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Affiliation(s)
- Bret Lyman
- College of Nursing, Brigham Young University, Provo, UT, USA
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