Jonathan Jacobs; Emily Hammond; Maggie Gunn, Brigham Young University
Purpose: This systematic review was conducted to gain a better understanding of the contextual factors, mechanisms, and outcomes associated with organizational learning in inpatient hospitals. Background: Organizational learning is a positive change process by which organizations enhance their ability to achieve their desired outcomes. In hospitals, examples of desired outcomes include improvements in patient safety, care quality, patient experience, and financial viability. Although a growing body of research supports organizational learning as an effective strategy for achieving gains in each of these performance areas, the literature on organizational learning in inpatient hospitals has not been systematically reviewed. Thus, nursing researchers and leaders are without a practical resource to guide their efforts to study and foster organizational learning. Methods: Databases searched were CINAHL, MEDLINE, Academic Search Premier, Business Source Premier, PsychINFO, SCOPUS, Web of Science, and Sociological Abstracts. The search terms used were ("organi?ational learning" OR "team learning" OR "group learning" OR "collective learning" OR "learning organi?ation*" OR “workplace learning”) AND (hospital OR hospitals) with no limits set on date of publication. After an initial scan for duplicates, approximately 2,300 articles remained. Article titles were sorted for relevance based on the following criteria: reports empirical data from an inpatient hospital setting, treats organizational learning as a process rather than an output, situated in an inpatient hospital setting, written in English, published in a peer-reviewed journal, refers to human improvements in knowledge, cognition, or behavior. Article abstracts were reviewed, followed by a review of the full text. The remaining 197 articles were scored using the Mixed Methods Appraisal Tool. During the appraisal process, 47 additional articles that did not meet the inclusion criteria or had critical methodological flaws were removed. Data extraction was performed for the remaining 150 articles, with a focus on contextual factors, mechanisms, and outcomes associated with organizational learning in inpatient hospitals. Results: Contextual factors associated with organizational learning included: shared purpose, motivation, psychological safety/relationships, infrastructure, skills in organizational improvement, and experience as a team. Mechanisms associated with organizational learning included: interaction, collective reflection, deliberate learning, practice, retention, and leadership. Outcomes associated with organizational learning included: clinical outcomes, patient outcomes, team outcomes, financial outcomes, and adoption of new/improved clinical practices. Implications: Organizational learning is an important process for improving patient care and performance in inpatient hospitals. This systematic review provides a practical resource for nursing leaders and researchers to advance the practice and science of organizational learning.