'Learning Organizations': a clinician's primer.
OBJECTIVE
Most clinicians are poorly informed in relation to the key concepts of organizational learning. Yet the paradigm may offer clinicians a powerful method for using their knowledge and skills to respond to the demands of a changing environment through experimentation and learning. The concept is critically examined. Organizational learning principles are presented, including a conceptual framework for assessing health services as Learning Organizations. Barriers to organizational learning and strategies to overcome these are discussed.


METHODS
The seminal works of Argyris and Senge are reviewed and a framework for assessing organizational learning in health services is proposed. Current area health service actions are evaluated against the 'diagnostic' framework for a Learning Organization.


RESULTS
Although critical examination reveals a poor empirical basis for the concept, the metaphor of the Learning Organization provides a useful conceptual framework and tools for individuals and organizations to apply in developing knowledge and effecting change. The Clinical Practice Improvement and Root Cause Analysis programs being conducted across NSW area health services meet the criteria for effective organizational learning.


CONCLUSIONS
Key concepts from organizational learning theory provide a diagnostic framework for evaluating area health services as Learning Organizations and support two current strategies for overcoming barriers to organizational learning.
Northern Sydney Central Coast Health, University of Sydney, NSW, Australia.
Nick
N
O'Connor
Beth
B
Kotze
D001315:Australia; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000458:organization & administration; D036262:Empirical Research; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007858:Learning; D009936:Organizational Innovation; D011361:Professional Competence