Organizational Learning: A Significant Aspect in the Healthcare Profession - Essay Example

Organizational Learning: A Significant Aspect in the Healthcare Profession Introduction Organizational learning is a significant aspect in the healthcare profession. Through it, professionals are able to perfect their skills and resulting in improved service delivery. This paper presents the paradox which exists in the health care organizations whereby despite the expertise that is manifested in the healthcare professionals, the organizations are unlikely to promote organizational learning. However, there are a few aspects where organizational learning is evident in healthcare organizations in the United States as well as the United Kingdom. These have been discussed. The paper also indicates that professional segregation in terms of gender is evident in healthcare organizations. Medicine dominates the division of labour and the majority of doctors are male. Other occupations such as radiographers and nurses are subordinate to doctors and are predominantly female. This is another failure of the organizations in the promotion of organizational learning (David A. Gavin 1993 pp.40-52). The role of the government in organizational learning and healthcare has been discussed. Being the regulator in all professions, it has the capability of monitoring the effectiveness of these healthcare organizations. There is also a tendency of blame culture in the organizations. This has been discussed and is portrayed as a major drawback in organizational learning whereby leaders tend to shift blame to others while on the other hand they dissociate themselves from failure. It is usually manifested in defensive reasoning. Institutional polymorphism which is a major source of change in organizations has been discussed. It is known to be triggered by normative pressures within the organization. The concepts of single loop and double loop learning have also been discussed. The usefulness of division of labor in maintaining prestige amongst the healthcare professionals has been discussed (Paulj. DiMaggio, Walter W. Powell 2008 pp.138-146). Profession A profession is an occupation that is based upon specialization in a particular field whose skills are acquired through learning (Eliot Freidson, 2001 p. 67). The main goal of a profession is to offer assistance and guidance to others either for compensation or on voluntary basis. In professions, particular knowledge in a specific field is used to assist a particular person who is willing to pay for it or for compensation by another interested party. Activities in every profession entail the use of understanding and expertise in order to help others solve a particular problem causing distress. Recognition by the law differentiates professions from other occupations whose representation is usually through trade unions and other such groups. Hence professions will usually associate themselves with the occupation rather than the organization that they work for (Eliot Freidson, 2001 56-68). This can be a source of division and competition between professionals and managers in health care organizations. In order for one to become a professional, he has to acquire formal qualifications through the process of education which involves learning and examinations, after which he joins a regulatory body which has powers bestowed to it to maintain monopoly in the particular field as well as discipline its members. These powers are usually from the government that is the overall regulator of all professions through setting standards (Sue Llewellyn 2001 pp. 580-603). Professionals usually take up full time responsibilities in their field of expertise as well as ensuring that they establish information and learning institutions such as schools and linking the profession to universities. They usually struggle to achieve authorized support in order for them to be self regulating which leads them to developing official standards for all professionals in the field. In the medical profession, the professionals are usually esteemed for their far reaching academic knowledge and their skills as well as the ability to put them in to practice (Sue Dopson et al. 2003). Maintenance of the Privileged Position in the Division of Labor Professionals in the medical profession are usually autonomous and exercise substantial control of their work. This is exercised even when they work in community organizations that fall outside the professional body. It is mandatory for every member of the profession to observe the rules that are set by the professional bodies which usually follow a particular code of conduct. Discipline is meted out on those who contravene the rules and regulations. The bodies have always strived to achieve independence from the government. They normally have distinguished practitioners who oversee their performance. They usually defend their earnings through the fact that they offer services to the public and they play a major role in public health. They are able to maintain their monopoly due to their recognition by the law. Those who do not adhere to their regulations are excluded from the profession and therefore can not exercise their skills in the field. Ineffectual members are driven out of the profession, while the unskilled are barred from entering in to the profession (Ritz Wenzel, 2001 pp. 81-87). In health care organizations there is a complex division of labor. Professional self regulation has enabled it to be superior over other professions. This implies that entry in to the profession is not as simple as it is in other professions. It enjoys legitimate monopoly and a register whose entries are restricted by the standards that have been set by the professionals. This register is the authorization to practice in the profession, and the persons registered are deemed to be competent in the profession. Incompetence can lead to removal from the register (Bristol Report Inquiry, 2001 pp. 1-9). Maintenance of prestige largely depends on the professional bodies. These bodies have the mandate of negotiating the remuneration of members especially where it has to be decided by the government. This puts the members at an advantage over the other public servants who are employed by the government. Their success is also attributed to the ability of reassuring the public safety. Being respected for their knowledge and proficiency in health matters, their reassurance is unquestionable to people who have no information concerning health care. That way they are able to maintain high esteem and prestige. The significance of the medical profession in other professions is far reaching. In law, medical professionals who have been certified by the regulatory bodies are the ones who legitimize or proof certain issues regarding convicts as either true or false. They can approve or disapprove sanity in a convict; investigators in the criminal justice rely upon them for post mortem examinations while on the other hand, the health of high ranking government officers is highly reliant on them. The government being the overall regulatory body and its ranking depending on health professionals, it is left with no otherwise but to allow the medical professionals to exercise their duties without much interference (Ratham Hajjeh 2004 pp. 45-56). Organizational Learning This is a process through which individuals within an organization interact and exchange knowledge. It usually takes place by chance or through the usual work. It is usually a social process through which individuals exchange knowledge and experiences in order to facilitate the presence of an informed group of decision making staff within an organization. It is usually necessary for organizations to encourage a learning culture in regard to the day to day practices. A learning organization is that which has the capacity to facilitate creation, gaining and transmit skills within it in order to achieve the necessary behavioural changes which are necessary in organizational development. A learning organization is capable of adapting to new developments in the working environment. Organizational learning helps in achieving the desired flexibility in the medical profession which is usually faced with changing needs of the public in regard to health matters (Carroll J. S. and Edmondson A. C. 2002 pp. 31-36). Through continuous learning, an organization is capable of establishing better methods of dealing with recurrent problems. This is usually significant in the health profession whereby the medical professionals are supposed to learn highly through past mistakes. The most significant aspect of learning in the medical profession is usually the interaction that takes place between the professionals themselves. Through it, they can exchange knowledge and experiences which can help in improving their decision making skills. In essence, these interactions are supposed to empower the organization as a whole rather than controlling the organization for the purpose of individual empowerment. The process of organizational learning should present professionals with new and better ways of solving problems. For knowledge to be effective in its application the organization should analyze its usefulness; organize the most appropriate way in which it can be put in to use followed by its transmission to the relevant professionals. This is followed by mobilization of the professionals to use the new knowledge (Ratham Hajjeh 2004 pp. 40-51). Health Care Organizations and Organizational Learning The medical profession is faced by continuous challenges associated with the changing demands of the public. New strains of pathogens arise every now and then, and all have to be dealt with effectively in order to protect humans from succumbing to them. As more and more ailments emerge, healthcare workers learn through exchange of ideas and experiences and eventually come up with ways of solving the problem. The theoretical knowledge that has been acquired through education is not enough to deal with day to day occurrences. There is need to pay attention to details and have an open mind for learning. Making the appropriate clinical decisions requires the health care professionals to collect information from as many sources and in a timely fashion. High quality health care practices require proficiency in information gathering since they involve a lot of skill that can hardly be contained in the brain of a person as a whole (DH Information 2005). To promote organizational learning, healthcare organizations encourage professionals to get involved in scanning which is significant in the learning process through assisting them in effective management of risks. This usually involves the use of systems of early warning which have the ability to sense and identify a particular event that may adversely affect the public or the patient. Scanning is actually the process of acquiring and analyzing information that may have an adverse impact on the patient. This is significant in preventing unwarranted situations. Another way that organizational learning has been promoted in health care is the development of the inter-organizational approach whereby healthcare professionals learn at a higher speed while minimizing costs. The extensive problems that have cropped up in the health care system of the United States have led to the formation of a number of organizations in the health care profession. These have come up in a bid to work together towards development of superior arrangements which can help them to solve the escalating problems in the healthcare profession. This is because of the need to provide better services to patients. The health care organizations are encouraging and promoting organizational learning. This is being achieved through encouraging collaboration amongst health care workers, who usually work in groups of more than 15 professionals for close to two years trying to study in-depth of particular issues in regard to health care such as trends in the infection rates and general service delivery. The teams are encouraged to share information in sessions whereby ways of improving service delivery are discussed (Paulj. Dimaggio Walter W. Powell 2008 p.152). From these sessions, organizations develop plans on how to improve services within themselves. This is usually done through developing plans which aim at information sharing and more participation in inter-organizational learning. These have also promoted holding of monthly conferences whereby the organizations exchange experiences and also undertake self assessment through comparing their success and failures with those of the other organizations. These are usually followed by discussions aimed at establishing remedial measures. More over, information exchange has gone a step higher since the organizational collaboration led to site visits and constructive discussions between the health experts. In the United Kingdom, the National Health Service promotes collaborative learning amongst the health professionals which has promoted service delivery in the health care profession (DH Information 2005). On the other hand, there are cases whereby health care organizations are seen to be most unlikely to promote organizational learning. For example, research indicates that close to 10% of the patients who are admitted in hospitals in the United Kingdom usually suffer from healthcare related infections. Most of these infections have been found to be preventable. Healthcare organizations have failed in promotion of organizational learning whereby such infections should not be recurrent. The health care professionals should be taught to learn from mistakes as well as appropriate scanning. Organizations have failed to promote organizational learning these may be attributed to the social systems as well as the prevailing organizational structures. Some of them have been discouraging health professionals to identify and analyze failure in the process of exercising the medical practice. On the other hand, gender segregation is evidenced whereby leadership in the healthcare organizations comprises a large percentage of male professionals. In most cases more than 80% are male. This is an indication of the organizational structural failures that hamper organizational learning (Sue Llewellyn 2001 pp. 67-71). Such cases are evidenced by situations whereby the organizational structures do not allow learning through mistakes. Most of the mistakes tend to be punishable through expulsion from the organization or being downgraded. This is a crude way of treating mistakes in the health profession since most of the professionals will not acknowledge having made a mistake in order for them not to face the consequences. On the other hand, rewards and promotions in these organizations are usually for those who perform without making mistakes. Still in such a case, a health professional will most unlikely acknowledge failure in a certain process and therefore will tend to keep it secret in order not to miss the reward. This does not give organizational learning a chance to be practiced in the health care organizations (Ratham Hajjeh 2004 pp. 56-61). Rather than encourage experimentation in organizations in order to improve on the existing procedures, organizations are known to suppress such smart objectives where by the professionals can have a chance to share information concerning procedures regarding particular fields that require further research. Funds are usually no available for such undertakings. Such healthcare organizations develop a culture whereby professionals tend to avoid experimenting or exposing their mistakes while on the other hand they go for the non informative procedures in which they ensure that they are on the safe side in regard to the organizational structure. Due to the fact that experimenting or engaging in a risky activity may lead to reprimand, the professionals just avoid creative endeavors which could otherwise be an asset to the organization. Organizational learning deteriorates and the quality of service becomes poor in turn. The small failures that happen each day and pass without being discussed eventually become complex leading to an organizational failure. The organizational structures in health care are also largely affected by socials factors. The emotional characteristics of human beings tend to affect organizational learning in that persons in the health care organizations do not acknowledge their mistakes due to negative feelings that occur in them once they fail in a certain procedure. In most cases, people are likely to dissociate themselves from their own failure due to these feelings especially if they have a track record of being perfect in the medical profession. This causes a breakdown in organizational learning (DH Information 2005). On the other hand, it is common for the leaders in these healthcare organizations to engage in blame games and excuses once failures occur. Being the leaders and dissociating themselves from mistakes discourages organizational learning. Peter Davey (2005 pp. 67) cites the case of a CEO in a particular health care organization who spent more than half an hour trying to convince people that he was not to blame for a mistake that was apparently his. Such are the failures that are common within organizations and which are a threat to organizational learning. They present no chance for people to learn through constructive discussions. The government has a major role to play in ensuring that the services offered to the public are of desirable quality. Being the top most organ above all institutions, it is important to ensure that organizational learning which in turn can improve the services offered to the public is promoted by the organizations in the health care profession. It should be non partisan in implementation of its policies in regard to all professions. It should also provide the necessary support to healthcare organizations in order for them to be capable of promoting organizational learning. In provision of services, it should spear head activities aimed at protecting the public from problems that may arise from the health care profession. In the United Kingdom, the government through the National Health Service plays a major role in protecting the public from hospital acquired infections. Government policies are important in ensuring that planning and implementation of prevention and control of hospital transmitted infections are adequately carried out. The health act 2006 assists the National Health Service bodies to develop measures to be undertaken in order to accomplish effective prevention and control of hospital acquired infections. The procedures that the National Hospital Service managers are supposed to follow in order for them to guarantee the health of the patients are indicated in the code of practice. It aims at ensuring that health workers minimize the risk of exposing patients to health related ailments (DH Information 2005). The Code relates to the quality of health care services that are offered to the people of the United Kingdom by the National Health Services’ bodies. It states that each of them should possess adequate systems in order for it to comply with the provisions of the code of practice aimed at reducing the risk of hospital associated infections to the patients, hospital staffs as well as visitors. The government has recently developed new rules that are aimed at ensuring that proper hygienic standards are observed in all bodies under the National Health Service as well as private hospitals. This was extended to all healthcare facilities and home based care service providers. Health care professionals have an obligation of ensuring that the patients are offered the most appropriate services. This promotes organizational learning since the health care professionals have to satisfy the government’s policies in regard to medical services (PSE, 2008). In single-loop learning, the professionals remain in their original state while incorporating new procedures in the system. On the other hand double loop learning involves changing the way things work. It involves making the necessary modifications in order to improve the working procedures. The two kinds of learning are significant in the proper running of the organization. They usually originate from identification of errors in an individual, which may affect the other professionals as well as the patient. Single loop learning helps the individual to learn from his past mistakes. However, other professionals can learn from the mistakes of one of their own and develop the better strategies. Conversely, double loop learning necessitates an overall change in the health care system which causes changes in major organizational policies. Both of them are significant in improvement of individual and organizational performance (Ratham Hajjeh 2004 pp. pp. 76-84). Defensive reasoning is the case whereby the organizational leaders or professionals tend to shift the blame to others or trying to cover up errors in order not to take the liability for the mistakes that have been made. This is usually detrimental to organizational learning because the health care professionals can not learn from mistakes that they have committed. This is usually manifested in organizations which are highly prestigious in the healthcare profession. They tend to shift blame or cover up mistakes in order to maintain their prestige. They usually do this in order to avoid losing their status in the hierarchy of the medical profession. This is usually a threat to organizational learning since a lot of information is with held by such organizations (Paulj DiMaggio and Walter W. Powell 2008 p.153-156). Conclusion In the investigation conducted to establish whether healthcare organizations promote organizational learning, it was established that there exists a gap that the organizations should strive to fill. Lack of responsible promotion of organizational learning reduces the possibility of offering quality services to the public in the healthcare professionals. The government needs to put more efforts to ensure that the public benefit from the health care professionals who have been empowered through organizational learning. Through this, provision of proper healthcare services can be realized. The health care professionals are seen to maintain prestige due to their high specialization and division of labor. Bibliography 1. Bristol Report Inquiry, 2001. Final Report Summary, viewed on 25th Mar. 2009 at, 2. Carroll J. S. and Edmondson A. C. 2002. Organizational Matters: Leading Organizational Learning in Health Care, Qual. Saf. 3. Davey P. 2005. Interventions to improve antibiotic prescribing practices for hospital inpatients. In: Cochrane Database of Systematic Reviews. John Wiley & Sons ltd. 4. DH Information 2005. Action on Health Care: Associated Infections in England, HCAI Consultation, Department of Health, viewed on 13 Mar. 2009 at 5. DiMaggio P, Powell W, 2008. The Iron Cage Revisited: Institutional Isomorphism and Collective Rationality in Organizational Fields, Yale University 6. Dopson S, Locock L, Gabbay J, Ferlie E and Fitzgerald L. 2003. 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