A Model for Cultivating a Culture of Continuous Learning and Improvement: An Ethnographic Report
Structural Approaches to Address Issues in Patient Safety
ISBN: 978-1-83867-085-6, eISBN: 978-1-83867-084-9
Publication date: 24 October 2019
Abstract
The importance of culture is often emphasized for continuous learning and quality improvement within health care organizations. Limited empirical evidence for cultivating a culture that supports continuous learning and quality improvement in health care settings is currently available.
The purpose of this report is to characterize the evolution of a large division of physical therapists and occupational therapists in a pediatric hospital setting from 2005 to 2018 to identify key facilitators and barriers for cultivating a culture empowered to engage in continuous learning and improvement.
An ethnographic methodology was used including participant observation, document review, and stakeholder interviews to acquire a deep understanding and develop a theoretical model to depict insights gained from the investigation.
A variety of individual, social, and structural enablers and motivators emerged as key influences toward a culture empowered to support continuous learning and improvement. Features of the system that helped create sustainable, positive momentum (e.g., systems thinking, leaders with grit, and mindful design) and factors that hindered momentum (e.g., system uncertainty, staff turnover, slow barrier resolution, and competing priorities) were also identified.
Individual-level, social-level, and structural-level elements all influenced the culture that emerged over a 12-year period. Several cultural catalysts and deterrents emerged as factors that supported and hindered progress and sustainability of the emergent culture.
Cultivating a culture of continuous learning and improvement is possible. Purposeful consideration of the proposed model and identified factors from this report may yield important insights to advance understanding of how to cultivate a culture that facilitates continuous learning and improvement within a health care setting.
Keywords
Acknowledgements
Acknowledgments
The authors would like to acknowledge the current and former staff and residents for the Division of Occupational Therapy and Physical Therapy at Cincinnati Children’s Hospital for their support and willingness to share their experiences and the faculty and staff at the James M. Anderson Center for Health Systems Excellence for the many trainings, experiences, and resources provided that helped support CLI efforts.
Citation
Quatman-Yates, C.C., Paterno, M.V., Strenk, M.L., Kiger, M.A., Hogan, T.H., Cunningham, B. and Reder, R. (2019), "A Model for Cultivating a Culture of Continuous Learning and Improvement: An Ethnographic Report", Structural Approaches to Address Issues in Patient Safety (Advances in Health Care Management, Vol. 18), Emerald Publishing Limited, Leeds, pp. 197-225. https://doi.org/10.1108/S1474-823120190000018009
Publisher
:Emerald Publishing Limited
Copyright © 2019 Emerald Publishing Limited