organizational learning, knowledge transfer, long-term care, primary care, informational continuity, evidence-informed practice
I have a sustained interest in the role of knowledge in organizational performance, how its acquisition, generation, use, non-use, and disuse relates to organizational performance. I have particular interests in contributing to our understanding of why and how workers in organizations generate or acquire new knowledge, how they collectively learn about and use new knowledge, and why some organizations are highly effective in applying new knowledge to enhance their performance while others are less adept at doing so. My work draws from, and aims to contribute to, the literature on organizational learning and knowledge transfer (Argote 2016, March 1991), and relates to the concept of learning health systems.
A focus on the relationships between organizational learning and performance is particularly germane to health care, where it is within practitioners’, consumers’ and publics’ interests for care-providing organizations to be good learners and high performers, such that cost-effective, high-quality care and services are consistently provided and are the subject of continuous improvement. There is also an interest in realizing the full potential of new knowledge – embedded, for example, in clinical practise guidelines, quality improvement initiatives, new management practises, an organization’s policies, or newly trained professionals. Often, new knowledge of this sort has been generated at considerable cost, with the intent of improving performance in health services organizations. And, frequently in health care, this costly new knowledge is not taken up, or the intended targets (practitioners, managers, organizations) do not have the capacity to implement it, or resultant practise change is not sustained such that the intended health, operational, or societal benefits are only partially or never realized.
My program of research focuses on three interrelated foci:
- Understanding the Conditions in which Learning is Adaptive: Studies of organizational learning and knowledge transfer that advance understanding of what adaptive and maladaptive learning comprises, and how and why it manifests.
This research focus relates to addressing questions around how, what and why organizations learn adaptively. Here, “adaptive” learning describes learning that leads to positive change and enhanced performance; not all learning is adaptive, and some of it can be detrimental to organizations.
Organizational learning is a social process in which members of an organization, and features and factors in that organization, contribute to or detract from learning about action-outcome relationships including actions relating to the application of new knowledge imported into the organization. In the organizational learning literature, there is recognition that some learning experiences lead to superficial and reversible changes in organizational behaviour, some lead to inferior behaviours and performance, and others lead to profound and sustained positive changes that resolve a problem or significantly improve organizational performance. A good deal of this research suggests that the outcomes of learning experiences are in part a function of an organization’s adaptive learning capacity (discussed above). The research that I have conducted in this area addresses questions including: Why do some organizations engage in higher-order learning, while others do not? And, Is the type of learning that occurs dependent upon the conditions or context in which learning takes place, i.e., the organization’s adaptive learning capacity? And if so, What are the determinants of learning capacity, i.e., managerial, structural, cultural, historical, geographic?
The importance of this focus relates to how we can use what we learn, about what conditions are conducive or support of adaptive learning, in intentional ways…to build robust processes in health care organizations that facilitate and maximize learning about new knowledge, to ensure that other components of capacity – including human resources and other resources – are present at adequate levels (Berta et al. 2018), and to remove barriers to learning.
- Factors that Influence Social Learning Processes: Studies of factors that influence the related social processes of building organizational learning capacity, innovation diffusion, and knowledge transfer.
This research focus relates to understanding the factors that influence three distinct but relatable social learning processes: organizational learning, innovation diffusion, and knowledge transfer. Organizational learning has its origins in the organization and management sciences, while innovation diffusion originated in the communication sciences with sociologist Everett Rogers (2005), and knowledge transfer is used in the dissemination and implementation sciences to refer to processes intended to facilitate the transfer of (largely) new research evidence-based knowledge to practitioners to improve their practise. While I originally took great pains to differentiate these processes, and the theories that underlie them, I have come to use them as complementary frameworks to guide my work in studying the learning processes of complex systems. The research that I have conducted in this area addresses questions including: What contributes to building learning capacity? Are there factors that facilitate, and others than impede, the building of learning capacity? What processes facilitate knowledge transfer within an organizational system? What factors influence innovation diffusion within an organizational system? and in broader systems comprised of similar but geographically dispersed organizations?
The importance of this work relates to how we can use what we learn to improve social learning processes, and optimize the value of new knowledge to an organization or to a system of organizations. We may wish, for example, to assist nursing homes in their preparation to implement new evidence-based practice guidelines, to improve the transfer of patient information amongst care practitioners, or to contribute to a government innovation dissemination initiative that stands to improve the care of residents broadly in the nursing home sector (Berta et al. 2014).
III. Associations between Adaptive Capacity & Performance. Studies that examine the relationships between learning capacity and system performance, where “system” is broadly defined as including “small s” organizational systems or units within them, through to large “S” complex systems comprised of multiple interacting organizations or “populations” of organizations.
This research focus addresses the relationships between elements of adaptive learning capacity and system performance. System performance refers to organizational systems, or smaller systems or units within them, and larger systems comprised of multiple loosely or tightly connected organizational systems.
Adaptive learning capacity in organizations comprises processes, individuals, and other resources that are socially constructed and sustained including organizational structures, policies, organizational culture, and organizational memory - the sum of an organization’s or system’s operating experience and knowledge. Some of these elements are likely to relate more closely to organizational performance than others, and some are more or less modifiable than others. The questions that are addressed through work in this area are: How do different elements of adaptive (learning) capacity relate to system performance? Of those that relate closely to performance, which are modifiable?
The importance of this work relates to using knowledge about modifiable elements of adaptive capacity to enhance the performance of health care systems. For example, facilitation – discussed in one of our papers (Berta et al. 2015) - is both a process and a role in organizations that stands to support higher-order reflective learning amongst workers which has been shown in other industries to relate positively to organizational performance. Facilitation, then, can be conceptualized as an adaptive learning process. If the relationships between facilitation, higher-order learning, and performance can be demonstrated, and if the conditions under which facilitation (i.e., type of facilitation, point of involvement in the learning process) is influential on performance can be established, then organizations may quite readily acquire this capacity through hiring a trained facilitator.
Thesis Supervision (2011+)
- San Wen Ng. How Organizational Experiments Influence Organizational Learning (2012)
- Melanie Kazman Kohn. Evidence Based Strategic Decision Making in Ontario Public Hospitals (2013)
- Anna Ballon-Kaushansky. Entrepreneurship in Publicly-funded Hospitals: A Multi-case Study of Privately Funded Rehabilitation in Ontario Hospitals (2014)
- Jennifer Innis. Health Literate Discharge Practices in Ontario Hospital (2016)
- Tyrone Anthonio Perreira. Insights into Nurses’ Work: Exploring Relationships among Work Attitudes and Work-related Behaviours (2016)
- Kadia Petricca. Introducing the “Third Phase” of Priority Setting: Advancing Methods for Priority Setting Practice through the Contribution of Systems Theory. Lessons from a Case Study of District Health Planning and Priority Setting in Ethiopia (2017)
- Carlos German Ruiz. Consensus on Access to Mental Health Services by Children and Adolescents in Antioquia, Colombia (2011)
Additional Recent Publications
Reay, P., Whitney Berta, M. Kohn. 2009. What’s the Evidence on Evidence-Based Management? The Academy of Management Perspectives 23(4): 5-18. http://simplelink.library.utoronto.ca/url.cfm/292058