DailyKaizen

Donna Kerr, a Group Health member, has accepted my invitation to be a guest blogger during her time with us in our Olympia Medical Center:

A Learning Organization – an introduction

At Ted’s invitation, I write this entry as a guest. I have the splendid fortune to be participating this week as the patient on a primary care Quality Improvement Support Team (QIST). The team is focusing on changes in the information system to support an effort to ensure that no hypertensive patient goes inappropriately untreated. The team includes physicians, “flow staff,” information-system builders, administrators, professional improvement staff and me. The goal is to design a solution, to develop an effective modification to the information system, and to have it “go live” for local testing prior to global implementation.

I am witnessing an organization that is learning from experience. This primary-care QIST, a cross-functional team, is engaged in a focused discussion of the problem that has been identified through HEDIS data. That leadership might discuss such a problem is not by itself predictive of an organization that has the capacity to learn. The crucial pieces are (1) that key medical and informatics staff are involved, (2) that the perspective of each participant is being heard and valorized; (3) that some clinicians actually acknowledge errors, even in the presence of me, a patient; and (4) that the point of the QIST is to define and implement a solution in light of information gleaned from the errors and with the goal of improving patent care.

I celebrate the capacity of this “lean”-inspired system to define a problem created by practice and to learn from this experience. This is truly extraordinary in organizational life, where the destructive practices of obfuscation and denial are commonplace. In particular, I am heartened by the fact that my healthcare organization has a culture that supports learning – a culture where it is apparently safe to own problems, recognize limitations in knowledge or its application and acknowledge mistakes. As an educator who has also led organizational development, I appreciate how very difficult it is develop an organization with the capacity to learn from experience. As a patient in this healthcare organization, I could not be more pleased.

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