Building learning organizational culture during COVID-19 outbreak: a national study

Translation and Psychometric Properties of the Persian Version of the Organizational Learning Instrument-Development Stages (OLI-DS) Instrument in Hospital Units

Aim: The Organizational Learning Instrument-Development Stages (OLI-DS) measure hospital units' readiness to engage in organizational learning. This study aimed to translate and evaluate the psychometric properties of the Persian version of this instrument. Background: Organizational learning is crucial for nurses as it enables them to continuously develop their knowledge, skills, and abilities, enhancing the quality of patient care. However, validated instruments are needed to assess organizational learning in Persian-speaking healthcare settings. Design: The research was carried out using a cross-sectional design. Methods: This research study involved 319 clinical nurses selected using convenience sampling. The OLI-DS tool, consisting of 35 items, underwent a forward-backward translation process to Persian before being utilized for a psychometric analysis. The face, content, and construct validity were used to evaluate the tool's effectiveness. The quality and accuracy of the measurements were determined by calculating internal consistency and stability reliability. The data were analyzed using SPSS and AMOS software. Results: The intended meaning and clarity of the original English version were preserved in the Persian rendition of the OLI-DS instrument. The confirmatory factor analysis (CFA) further confirmed the consistency of the Persian version with the proposed four-factor model, indicating a good fit. The overall instrument had excellent values for Cronbach's alpha coefficient (α = 0.931), McDonald's omega (ω = 0.921), coefficient H (H = 0.979), and mean interitem correlation (ρ = 0.278). The convergent and discriminant validity of the four latent factors was found to be good. The stability of the overall OLI-DS instrument was ICC = 0.942 (95% CI, 0.902-0.955). Conclusion: The Persian version of the OLI-DS has been validated to evaluate hospital units' readiness for organizational learning processes. It is a robust tool for assessing their preparedness to participate in and benefit from organizational learning initiatives. Implications for Nursing Management: The robust psychometric validation of the Persian version of the OLI-DS instrument equips nursing administrators and leaders with a reliable tool. This tool can assess and monitor organizational learning and development in healthcare settings, empowering them to make informed decisions in critical nursing management activities.

Enhancing Healthcare Accountability for Administrators: Fostering Transparency for Patient Safety and Quality Enhancement

Transparency in healthcare organizations is essential for creating a culture of patient-centered care where patients are respected, informed, and actively engaged in their health and well-being. Organizational transparency is a crucial element in healthcare, enhancing patient safety and quality improvement. Transparency involves open communication about healthcare organizations' performance, outcomes, and processes, leading to improved accountability, trust, and patient engagement. Transparent organizations prioritize patient-centered care, involving patients in decision-making and fostering shared mental models between healthcare providers and patients. Psychological safety is vital for organizational transparency. Patient safety reporting systems play a key role in transparency, allowing anonymous reporting of safety concerns and incidents. These systems facilitate early risk identification, continuous improvement, and compliance with regulatory requirements. Transparency in reporting encourages a culture of openness, learning from near misses, and addressing systemic issues and human errors. It aligns with ethical principles, potentially mitigating legal challenges. This review synthesizes key themes, including the importance of patient-centered care, the role of psychological safety in fostering transparency, and the effectiveness of patient safety reporting systems.

What makes health systems resilient? An analytical framework drawing on European learnings from the COVID-19 pandemic based on a multitiered approach

Introduction

The COVID-19 pandemic posed an unprecedented challenge, which caught many health systems widely unprepared. The aim of this research was to develop a comprehensive analytical framework on health system resilience in the context of pandemics. In addition to serving as a tool to analyse the preparedness and resilience of health systems, the framework is intended to provide guidance to decision-makers in health policy.

Methods

The analytical framework was developed based on a multitiered approach. A comprehensive review of the existing literature was conducted to identify relevant frameworks on health system resilience (published between 1 January 2000 and 30 November 2021) and determinants of resilience that emerged during the COVID-19 pandemic. Input was then gathered in several rounds of consultations with designated field experts and stakeholders, drawing on their experiences from the pandemic. Finally, the framework was empirically validated in several case studies.

Results

The framework distinguishes between prerequisites of resilience, pertaining to precautions to be taken in 'normal' times, and response strategies in the face of shocks. Both sections are further divided into six building blocks that were adapted from the WHO health system framework: governance and leadership, information and research, financing, physical resources, human resources, and service delivery. An overarching component on contextual factors-subdivided into situational, structural, cultural and international factors-represents an important addition to the existing spectrum of resilience frameworks.

Conclusions

Foundations for a resilient health system must be laid in 'normal' times and in all areas of the health system. In the face of a shock, adequate response strategies need to be developed. An essential learning from the COVID-19 pandemic has been that contextual factors of societies and subgroups play a major role in the ability of health systems to overcome a shock, as they impact the implementation and effectiveness of crisis management policies.

A blueprint for learning: How NHS England (London) learned during its response to the Covid-19 pandemic

Identification and sharing of lessons is a key aspect of emergency preparedness, resilience and response (EPRR) activity in the national health service (NHS) in England (NHS England, 2022). The overall intent of the lessons identification and implementation process is to improve readiness and response to future major incidents and emergencies, such that, wherever possible, patient harm is minimised and staff well-being is maximised. In this commentary, we draw on international literature to outline some of the major challenges in healthcare organisations to learning from major incidents and emergencies. We describe our experience of identifying lessons and set out the approach used by NHS England (London) to identifying lessons from the NHS response to the Covid-19 pandemic in the capital. We describe the knowledge garnered in our organisation about learning methods during the Covid-19 pandemic. The commentary considers the different approaches to identifying lessons, and the subsequent challenges of learning and implementation. This paper places its focus on the learning processes followed rather than what was learned as a result. It also explores whether the learning process undertaken by NHS England (London) demonstrates the hallmarks of a learning organisation.

Whole-of-Nation Moral Learning by Spiritual Hearts: A Case of Brunei's Transformation to tackle the COVID-19 Pandemic

All nations are continuously learning how best to live with the COVID-19 pandemic. Utilizing organizational moral learning and Islamic spirituality perspectives, this paper proposes a learning framework called the whole-of-nation moral learning by spiritual hearts to understand the dynamics of learning and change in a nation tackling the pandemic. It proposes that to overcome the pandemic or any other crises, governance requires the combination of moral leadership and followership by spiritual hearts as agents for moral learning and change, supported by realigned and reconfigured systems for holistic growth. Brunei's journey in tackling the pandemic illustrates the framework.

Nurses' Perceptions of Patient Safety Culture During the Pandemic in Covid-19 Referral Hospitals

Patient safety culture is essential in creating a safe and healthy hospital environment. This study aims to portray nurses' perceptions of patient safety culture during the Pandemic in COVID-19 Referral Hospitals. This paper was a descriptive study. The population was nurses working in inpatient, Covid-19 isolation, intensive, and emergency rooms. In addition, the sample was 268 nurses with a stratified random sampling. Data collection used a questionnaire using Google Forms. It consisted of the demographic characteristics of respondents (name, gender, age, marital status, working time, education, nurse position, levels of nursing, and patient safety training) also nurses' perception of patient safety culture. The Hospital Survey on Patient Safety Culture (HSOPC) was an instrument to assess patient safety culture. Data analysis used IBM SPSS Statistics version 22.0 to describe the mean, median, minimum, and maximum values and presentation. Results showed that the mean patient safety culture among nurses in COVID-19 referral hospitals was 147.09 (62.55%). In addition, the lowest dimension of patient safety culture was feedback and communication (31.75%), while the highest was an organizational improvement (73.16%). Thus, the patient safety culture in the COVID-19 referral hospital still needed improvement. A good patient safety culture can increase patient safety and the quality of health services. Therefore, hospital management should optimize all dimensions of patient safety culture to ensure patient safety. Future research could explore predisposing factors of patient safety culture

A Delphi method on the positive impact of COVID-19 on higher education institutions: Perceptions of academics from Malaysia

The COVID-19 pandemic has drastically altered the education sector. Rather than the impact of COVID-19, many higher education institutions (HEIs) are on the verge of insolvency due to a lack of digital transformation readiness and poor business models. The bleak financial future many HEIs will face while others may be forced to close their doors completely will erode HEIs’ ability to fulfil their societal responsibilities. However, HEIs that have survived and maintained their operations anticipate the transition to online learning or the effects of any economic crisis, including university closures in the short, medium, or long term. The entire educational ecosystem was forced to transform its operations quickly and entirely to an online teaching-learning scenario in just a few weeks. Notably, HEIs that have long offered online courses worldwide can easily transition to digital teaching and learning when necessary. The second roundtable session’s result of the International Higher Education Conference, organized by INTI International University on March 31 2022, was used to organize a Delphi method to identify further factors that positively impact HEIs by COVID-19. The importance of these factors was then determined using Kendall’s coefficient of concordance. Recommendations on how HEIs should move towards institutional sustainability during the endemic phase are presented accordingly.

What is "hospital resilience"? A scoping review on conceptualization, operationalization, and evaluation

Background

COVID-19 underscored the importance of building resilient health systems and hospitals. Nevertheless, evidence on hospital resilience is limited without consensus on the concept, its application, or measurement, with practical guidance needed for action at the facility-level.

Aim

This study establishes a baseline for understanding hospital resilience, exploring its 1) conceptualization, 2) operationalization, and 3) evaluation in the empirical literature.

Methods

Following Arksey and O'Malley's model, a scoping review was conducted, and a total of 38 articles were included for final extraction.

Findings and discussion

In this review, hospital resilience is conceptualized by its components, capacities, and outcomes. The interdependence of six components (1) space, 2) stuff, 3) staff, 4) systems, 5) strategies, and 6) services) influences hospital resilience. Resilient hospitals must absorb, adapt, transform, and learn, utilizing all these capacities, sometimes simultaneously, through prevention, preparedness, response, and recovery, within a risk-informed and all-hazard approach. These capacities are not static but rather are dynamic and should improve continuously occur over time. Strengthening hospital resilience requires both hard and soft resilience. Hard resilience encompasses the structural (or constructive) and non-structural (infrastructural) aspects, along with agility to rearrange the space while hospital's soft resilience requires resilient staff, finance, logistics, and supply chains (stuff), strategies and systems (leadership and coordination, community engagement, along with communication, information, and learning systems). This ultimately results in hospitals maintaining their function and providing quality and continuous critical, life-saving, and essential services, amidst crises, while leaving no one behind. Strengthening hospital resilience is interlinked with improving health systems and community resilience, and ultimately contributes to advancing universal health coverage, health equity, and global health security. The nuances and divergences in conceptualization impact how hospital resilience is applied and measured. Operationalization and evaluation strategies and frameworks must factor hospitals' evolving capacities and varying risks during both routine and emergency times, especially in resource-restrained and emergency-prone settings.

Conclusion

Strengthening hospital resilience requires consensus regarding its conceptualization to inform a roadmap for operationalization and evaluation and guide meaningful and effective action at facility and country level. Further qualitative and quantitative research is needed for the operationalization and evaluation of hospital resilience comprehensively and pragmatically, especially in fragile and resource-restrained contexts.

Building the Culture of Public Health as a Positive Reflection from the COVID-19 Crisis

The goal of this study was to look at the impact of different components of COVID-19 on the development of a public health culture during the COVID-19 pandemic. Culture is largely acknowledged to have the greatest and most profound influence on many aspects of human and group behavior. Culture is the process of integration that distinguishes members of one group or category of people through others; in other words, culture is the operating system of the communities, cultural nuances among societies cause people to demonstrate different behavioral patterns in the face of events. However, the cultural differences of each community make it impossible to apply these metrics universally. Observing the impact of countries’ cultural traits in the fight against outbreaks is one area where social scientists have not put much attention. As a result, this study demonstrates how cultural shifts affect their fight against outbreaks and public health challenges. The human response to COVID-19 is likely to be influenced by country culture and how (and when) overcome will be determined by it. Cultural ideas and assumptions should be assessed as part of public health interventions. These interventions should indeed be addressed at the societal level to stimulate awareness and participation while also guaranteeing culturally relevant events. Healthcare practitioners should emphasize public health exertions on culturally relevant forms of instruction, prevention, behavior and follow-up for successful pandemic management, effective screening, and diagnosis in infected individuals. Public health professionals must recognize the significance of this and learn to use communication messaging and guidelines, which must be culturally acceptable and context-dependent rather than merely grounded on medical methodologies, as was the case in many countries with COVID-19 management.

Health Policy Development During COVID-19 in Saudi Arabia: Mixed Methods Analysis

Healthcare systems are increasingly required to utilize effective approaches, apply evidence-based practice, and consequently sustain successful strategic management. Document analysis provides insights into the effective management tools applied by agencies to respond to crises. This article provides a practical exploration of how the Saudi health authority applied effective measures to eventually reduce the administrative and clinical consequences while managing the COVID-19 pandemic. The conceptual descriptive framework was based on health policy triangle of Walt and Gilson. Official reports and supporting documents issued by the Saudi government toward COVID-19 were operationally analyzed. Moreover, five healthcare professional experts were invited in a semistructured interview to assess the strategic steps that have been utilized to minimize the health risk by conducting a healthcare risk analysis. Various documents showed that two major entities were responsible for managing regulations and medications of COVID-19 in addition to six other entities that were partially involved. Although each entity was approved to work independently, their efforts were cohesively associated with each other. Most documents were well-applied on personal, social, organizational, and national strata. However, it is unclear how lessons identified became affirmative, while the collaboration remains vague, especially under the emergence of a new entity such as the Public Health Authority. Healthcare professional experts also positively supported the effectiveness of such policies to confront COVID-19 through the following three domains: health guidelines, utilizing simulation (telehealth/telecommunication) services, and ensuring continuity of services.

Employee Perceptions About Participation in Decision-Making in the COVID Era and Its Impact on the Psychological Outcomes: A Case Study of a Cooperative in MONDRAGON (Basque Country, Spain)

This research aims to study possible effects or impacts of COVID-19 in the context of a democratic organizational system analyzing how COVID-19 has influenced employees' perception of their participation in decision-making and its impact on some psychological outcomes and emotions. COVID-19 has accelerated the process of implementation of new frameworks at work (digitalization, teleworking, new skills, and abilities) that have generated the modification of culture and employee management practices. Our hypothesis are, on the one hand, that COVID-19 has generated changes in participation structures and internal communication mechanisms, having to make modifications not to deteriorate the perception of employees about their participation in decision making. On the other hand, COVID-19 has generated changes in the psychological outcomes and emotions of the employees. In the study, we analyze a cooperative belonging to the MONDRAGON cooperative group, where participation in decision-making and ownership is in its DNA. Through qualitative (5 focus groups) and quantitative (short questionnaire) methodologies, involving 42 employees, we investigate firstly, how COVID-19 has affected perceptions about participation in decision-making analyzing what role has played internal communication in these perceptions. Secondly, we investigate how COVID-19 has affected psychological outcomes and emotions. In this case, the perceptions arising from participation in decision-making focus on the assessment that participators make of the governance channels and the day-to-day meetings. Therefore, their appropriateness seems to be a key factor in the perception of participation in the COVID-19 era. Differences have been detected between the perceptions of blue and white collar employees. Such differences have also been founded in the psychological outcomes and emotions. Although this is a single case study, the analysis carried out provides elements of reflection to modify and restructure the decision-making and participation mechanisms, adapting them to the needs of blue and white collar employees in order to "guarantee" the expected outcomes.