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While previous studies have described structural, process and social aspects of the healthcare communication space there is no overall model of it. Such a model is an essential first step to improving the operationalization and management of healthcare communication. The paper aims to discuss these issues.

This paper used a case study approach to study team-based communication on a palliative care unit. Non-participant observation, interviews and documents were analyzed using qualitative content analysis.

The analysis developed an overall model of the healthcare communication space that consists of five stages: purpose, practices and workflows, structures, implementation, and the development of common ground to support team-based communication. The authors’ findings emphasized that implicit communication remains a predominant means of communication and workflow issues at the individual level are a frequent cause of unnecessary group communication tasks.

To improve team-based communication we first need to develop protocols that support team communication needs such as loop closing of group communication tasks in order to minimize unnecessary individual communication tasks. We also need to develop common ground at the protocol, document and terminology levels as part of supporting team-based communication.

Service‐oriented architecture is becoming increasingly important for healthcare delivery as it assures seamless integration internally between various teams and departments, and externally between healthcare organizations and their partners. In order to make healthcare more efficient and effective, we need to understand and evaluate its processes, and one way of achieving that is through process modeling. Modeling healthcare processes within a service‐oriented environment opens up new perspectives and raises challenging questions. The purpose of this paper is to investigate one of these questions, namely the suitability of web service orchestration and choreography, two closely related but fundamentally different methodologies for modeling web service‐based healthcare processes.

The authors use a case‐based approach that first developed a set of 12 features for modeling healthcare processes and then used the features to compare orchestration and choreography for modeling part of the scheduled workflow.

The findings show that neither methodology can, by itself, meet all healthcare modeling requirements in the context of the case study. The appropriate methodology must be selected after consideration of the specific modeling needs. The authors identified usability, capabilities, and evolution as three key considerations to assist with selection of a methodology for healthcare process modeling. Further, sometimes one method will not meet all modeling needs and hence the authors recommend combining the two methodologies in order to harness the benefits of modeling healthcare processes in a service‐oriented environment.

Although literature exists on process modeling of web services for healthcare, there are no criteria describing necessary features for micro‐level modeling, nor is there a comparison of the two leading service composition methodologies within the healthcare context. This paper provides some necessary formalization for process modeling in healthcare.

This article aims to encourage healthcare administrators to consider the learning organization concept and foster collaborative learning among teams in their attempt to improve patient safety.

Relevant healthcare, organizational behavior and human resource management literature was reviewed.

A patient safety culture, fostered by healthcare leaders, should include an organizational culture that encourages collaborative learning, replaces the blame culture, prioritizes patient safety and rewards individuals who identify serious mistakes.

As healthcare institution staffs are being asked to deliver more complex medical services with fewer resources, there is a need to understand how hospital staff can learn from other organizational settings, especially the non‐healthcare sectors.

The paper provides suggestions for improving patient safety which are drawn from the health and business management literature.

In this paper, the author explores his research journey into the learning organization and its impact on his academic career. This paper describes how Peter Senge’s book The Fifth Discipline: The Art and Practice of The Learning Organization (1990) was the spark that led to the author’s focus on empirical research in the field.

This paper provides author’s personal reflections on how this decision put him on a path to a variety of serendipitous experiences, exciting research areas and also enabled him to engage in productive collaborative research with many of his colleagues.

The findings conclude with a discussion on what the author see as new challenges and perspectives for advancing research into the learning organization.

This paper provides a unique perspective on how The Fifth Discipline by Peter Senge has influenced an academic career. It presents a personal reflection of a research journey into the learning organization that spans over 30 years.

The purpose of this paper is to explore the relationship between organizational learning and patient safety culture in hospital pharmacy settings as determined by the learning organization survey short-form (LOS-27) and pharmacy survey on patient safety culture instruments, and to further explore how dimensions of organizational learning relate to dimensions of pharmacy patient safety culture.

This study is a cross-sectional study. Data were obtained from three public hospital pharmacies and three private hospital pharmacies in Kuwait. Partial least square structural equation modeling was used to analyze the data.

A total of 272 surveys (59.1 percent response rate) were completed and returned. The results indicated a significant positive relationship between organizational learning and patient safety culture in hospital pharmacy settings (path coefficient of 0.826, p-value <0.05 and R² of 0.683). Several dimensions of the organizational learning showed significant links to the various dimensions of the pharmacy patient safety culture. Specifically, training (TRN), management that reinforces learning (MRL) and supportive learning environment (SLE) had the strongest effects on the pharmacy patient safety culture dimensions. Moreover, these effects indicated that MRL, SLE and TRN were associated with improvements in most dimensions of pharmacy patient safety culture.

To the best of the authors’ knowledge, this is the first attempt to assess the relationship between organizational learning, patient safety culture and their dimensions in hospital pharmacy settings.

There is evidence that patient safety has not improved commensurate with the global attention and resources dedicated to achieving it. The authors explored the perspectives of hospital leaders on the challenges of leading safe care.

This paper reports the findings of a three-year longitudinal study of eight Australian hospitals. A representative sample of hospital leaders, comprising board members, senior and middle managers and clinical leaders, participated in focus groups twice a year from 2015 to 2017.

Although the participating hospitals had safety I systems, the leaders consistently reported that they relied predominantly on their competent well-meaning staff to ensure patient safety, more of a safety II perspective. This trust was based on perceptions of the patient safety actions of staff, rather than actual knowledge about staff abilities or behaviours. The findings of this study suggest this hegemonic relational trust was a defence mechanism for leaders in complex adaptive systems (CASs) unable to influence care delivery at the front line and explores potential contributing factors to these perceptions.

In CASs, leaders have limited control over the bedside care processes and so have little alternative but to trust in “good staff providing good care” as a strategy for safe care. However, trust, coupled with a predominantly safety 1 approach is not achieving harm reduction. The findings of the study suggest that the beliefs the leaders held about the role their staff play in assuring safe care contribute to the lack of progress in patient safety. The authors recommend three evidence-based leadership activities to transition to the proactive safety II approach to pursuing safe care.

This is the first longitudinal study to provide the perspectives of leaders on the provision of quality and safety in their hospitals. A large sample of board members, managers and clinical leaders provides extensive data on their perspectives on quality and safety.

This two-part paper is concerned with the creation of a generalised cybernetic agency-based ecosystem. The purpose of the first part is to explore the basis for the creation of an agentic ecology theory to provide a generalised multidisciplinary context-free manifold that can be applied to specific domains and contexts. As an element of this, it will explore the relationship between agency and its agents (at various foci) and the nature of agency ecologies and their evolution. It will also explore the relationship between viability and sustainability. In the second part of the paper, the purpose will be to formulate a general basis for agency ecology, followed by an agency model that recognises the analytical and decision-making attributes of the viability–sustainability relationship by centering on the modelling a socioeconomic ecosystem and a social disciplinary species model.

Agency theory will be used to model a generic agency ecology and its environment of subordinate elements – especially those subordinates that can be used as amenities to satisfy the needs to agency development. Part 1 of the paper will take a tour of concepts relevant to the representation of neo-ecosystem structures and their application. Part 2 will centre on delivering a schema capable of embracing agency neo-ecology from which applications may derive.

It is shown that agency theory as a modelling schema can be used as a methodology through which to provide diagnosis to examine the condition of, or for locating problems within, an agency in its ecosystem environment. This is illustrated within a socioeconomic context.

The paper is conceptual in nature, and there has been no intention to diagnose any substantive issues within the socioeconomic context.

A generalised agency ecology approach is proposed over this two-part paper that is novel through the use of third-order cybernetics.

This study investigates the impact of the degree of process maturity on the degree of patient orientation in the context of radical process changes. The study is based on a sample of healthcare providers in Ukraine which experiences a fundamental transformation of its healthcare system.

The investigation was conducted among the full population of the chief physicians from 53 medical institutions (hospitals, general practitioners centers, dental clinics, and maternity clinics) in one of the largest cities in Ukraine. We investigated the maturity of the process of interaction with patients as perceived by these top managers. We applied variance-based structural equation modeling (SmartPLS3).

The study shows that each stage of process maturity predetermines the following one. With regard to the impact of each stage of process maturity on patient orientation, all stages show a positive and significant relationship toward patient orientation, i.e. even the lowest stage of maturity is critical for patient orientation. A further contradictory finding to extant literature is, that based on the set of indicators, the process appears to be in different stages at the same time. This speaks against the regular sequence-based approach toward process maturity.

Although it has been assumed that higher degrees of process maturity are associated with higher customer (patient) orientation, this work shows that the relationship holds also for each stage of process maturity separately. This research is based on a very unique sample – the almost complete set of chief physicians and their deputies of practically all medical institutions of a large city.