A Description of the Learning Organisation Within the a&E Department

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The concept of a learning organization knows its roots back to Garratt in 1987, which later on in the late 90’s was revived by Peter Senge. Senge (1990) focuses on the organization acting as a unit where innovative ideas are generated and common goals are reached. Collective commitment of the team is fundamental. Furthermore, according to Senge (1990), the organization must go through 5 domains in order to reach the productivity of a learning organization: systems thinking, personal mastery, mental models, building shared vision and team learning. Therefore it is clear that organizational learning goes beyond knowledge. This notion involves the process of action and reflection (Carroll & Edmondson, 2002) or action learning (Revans, 1979). Having members of an organization engage in this process depend on various factors such as change. Furthermore medical knowledge and routine practices are continuously evolving over time, making organizational learning more popular with healthcare (Tucker, Nebharmb & Edmondson, 2006). A typical organizational culture such as the accident and emergency department (A&E) of Mater Dei hospital represents a chaotic setting where professionals are able to handle a variety of problems simultaneously, some being unpredictable (Smith & Feied, 1999). Being an emergency nurse involves being an all-rounder, such as being a triage nurse, a pre-hospital nurse, in-hospital emergency nurse and resuscitation nurse. Furthermore, an emergency department is the frontier of a hospital that provides immediate care to the patient. Therefore in such a complex culture expertise is a must. As suggested by several authors experience is a valuable resource, which promotes organizational learning (Garvin, 1993; Dunphy, Turner & Crawford, 1996; Carroll & Edmondson, 2002). In fact senior staff in the A&E department (those with more than three years experience as an emergency nurse) are involved in training junior nurses, educational organizations such as the MENA that carry out seminars on a three month basis, working with other members of the multidisciplinary to organize short educative meetings approximately once a week and are a point of reference during work. Having said this, these individuals form the basis of team learning. However, before team learning starts to progress, members of the team such as the professional development nurse help train new staff individually. This gives way for the initial steps of individual learning where the shared vision of the team can be fostered (Senge, 1990). Even though individual learning takes up more time and cost it is the bedrock of team learning (Carroll & Edmondson, 2002). In fact the NHS has made it a requirement that every professional has a Professional Development Program (Sheaff & Pilgrim, 2006). The same is being introduced for nurses in the A&E department by the practice development nurse. Curiosity of new recruits helps them to learn at their own will. This is where individual learning translates into personal mastery. Making mistakes comes part of this process. In fact Stinson, Pearson & Lucas, 2006, mentions that learning from mistakes to be an opportunity to learn from, rather than to blame. However curiosity itself is not enough to proliferate into team learning. Limitations such as time, costs and being understaffed overshadow the use of open dialogue (Berwick, 1996). As previously mentioned team learning is not just the sharing of knowledge but open dialogue about perceptions (mental models) of current issues, and the creation of innovative ideas as a team (O’Connor & Kotze, 2008). Mental models are powerful tools that affect what we do as they in turn affect what we see (Senge, 1990). Self-awareness comes part and parcel of individual learning. Having different people looking at the same issue but giving different opinions and knowledge fosters a learning organization – or as Stinson, et al.,...
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