Development of a Short-Form Learning Organization Survey: The LOS-27
Despite urgent need for innovation, adaptation, and change in health care, few tools enable researchers or practitioners to assess the extent to which health care facilities perform as learning organizations or the effects of initiatives that require learning. This study's objective was to develop and test a short-form Learning Organization Survey to fill this gap. The authors applied exploratory factor analysis and confirmatory factor analysis to data from Veterans Health Administration personnel to derive a short-form survey and then conducted further confirmatory factor analysis and factor invariance testing on additional Veterans Health Administration data to evaluate the short form. Results suggest that a 27-item, 7-factor survey (2 environmental factors, 1 on leadership, and 4 on concrete learning processes and practices) reliably measures key features of organizational learning, allowing researchers to evaluate theoretical propositions about organizational learning, its antecedents, and outcomes and enabling managers to assess and enhance organizations' learning capabilities and performance.
[Show abstract] [Hide abstract] ABSTRACT: Psychological safety plays a vital role in helping people overcome barriers to learning and change in interpersonally challenging work environments. This article focuses on two such contexts—health care and education. The authors theorize differences in psychological safety based on work type, hierarchical status, and leadership effectiveness. Consistent with prior research, the authors employ cross-industry comparison to highlight distinctive features of different professions. The goal is to illuminate similarities and differences with implications for future psychological safety research. To do this, the authors review relevant literature and present analyses of large data samples in each industry to stimulate further research on psychological safety in both sectors, separately and together.0Comments 0Citations
- "The LOS-27 includes 27 items related to seven dimensions of organizational learning in three categories: supportive learning environment, leadership that reinforces learning, and learning processes and practices. The survey was originally developed by Garvin and colleagues (Garvin, Edmondson, & Gino, 2008) and revised by Singer and colleagues (Singer, Moore, Meterko, & Williams, 2012) to optimize its contents for use in healthcare settings and reduce its length. Psychometric analysis of response patterns in this sample supported data validity. "
[Show abstract] [Hide abstract] ABSTRACT: BACKGROUND: Daily clinical team meetings (i.e., "huddles") may be helpful in implementing new roles and responsibilities for patient care because they provide a regular opportunity for member learning and feedback. PURPOSES: We examined how huddles were implemented in the context of the VA patient-centered medical home (PCMH) transformation, including assessing barriers and facilitators to regular huddling among small teams ("teamlets"). We assessed the extent to which teamlet members that huddled had higher self-efficacy for PCMH changes, reported better teamwork experiences, and perceived more supportive practice environments. METHODOLOGY/APPROACH: We used a convergent mixed-methods approach to analyze 79 teamlet member interviews from six VA primary care practices and 418 clinician and staff PCMH survey responses from the six interviewed practices and 13 additional practices in the same region. FINDINGS: Most members reported participating in teamlet huddles when asked in surveys (85%). A minority of interview participants, however, described routine huddling focused on previsit planning that included all members. When members reported routine teamlet huddling, activities included (a) previsit planning, (b) strategizing treatment plans for patients with special or complex needs, (c) addressing daily workflow and communication issues through collective problem solving, and (d) ensuring awareness of what team members do and what actions are happening on the teamlet and in the practice. Primary care providers (PCPs) were least likely to report routine huddling. PCP huddlers reported greater self-efficacy for implementing PCMH changes. All huddlers, irrespective of role, reported better teamwork and more supportive practice climates. The most common barriers to teamlet huddling were limited time and operational constraints. PRACTICE IMPLICATIONS: In order to improve the impact of huddles on patient care, practice leaders should clearly communicate the goals, requirements, and benefits of huddling and provide adequate time and resources to ensure that frontline teams use huddle time to improve patient care.0Comments 6Citations
- "We posit that routine brief structured team communication , that is, huddling promotes the development and reinforcement of team norms and improves awareness of team resources and ''who does what on the team.'' Specifically, we expect that primary care team members that regularly engage in brief, structured communication will be more effectively able to develop and navigate the behavioral boundaries of their teams and foster a practice climate where lowerstatus members feel empowered to ask questions about the work at hand and learn from the experiences of fellow members (Edmondson, 2011; Santana, Curry, Nembhard, Berg, & Bradley, 2011; Singer, Moore, Meterko, & Williams, 2012). "
[Show abstract] [Hide abstract] ABSTRACT: Organizational learning, the process by which a group changes its behavior in response to newly acquired knowledge, is critical to outstanding organizational performance. In hospitals, strong organizational learning culture is linked with improved health outcomes for patients. This study characterizes the organizational learning culture of hospitals in China from the perspective of a cardiology service. Using a modified Abbreviated Learning Organization Survey (27 questions), we characterized organizational learning culture in a nationally representative sample of 162 Chinese hospitals, selecting 2 individuals involved with cardiovascular care at each hospital. Responses were analyzed at the hospital level by calculating the average of the two responses to each question. Responses were categorized as positive if they were 5+ on a 7-point scale or 4+ on a 5-point scale. Univariate and multiple regression analyses were used to assess the relationship between selected hospital characteristics and perceptions of organizational learning culture. Of the 324 participants invited to take the survey, 316 responded (98 % response rate). Perceptions of organizational learning culture varied among items, among domains, and both among and within hospitals. Overall, the median proportion of positive responses was 82 % (interquartile range = 59 % to 93 %). “Training,” “Performance Monitoring,” and “Leadership that Reinforces Learning” were characterized as the most favorable domains, while “Time for Reflection” was the least favorable. Multiple regression analyses showed that region was the only factor significantly correlated with overall positive response rate. This nationally representative survey demonstrated variation in hospital organizational learning culture among hospitals in China. The variation was not substantially explained by hospital characteristics. Organizational learning culture domains with lower positive response rates reveal important areas for improvement.0Comments 0Citations
- "The questions derived from the LOS-27 represent the primary focus of this paper [4, 41]. The LOS-27 consists of 27 questions, grouped into 7 domains of organizational learning characteristics (Additional file 1:Table S1) . The survey also included questions pertaining to quality improvement in AMI care adapted from the SAMI instrument, which was developed through qualitative research with hospital staff to determine organizational characteristics that differentiated high-performing from low-performing hospitals on the basis of 30-day riskstandardized mortality rates for AMI [45, 46] . "