An organizational learning framework for patient safety. | AHRQ Patient Safety Network

An organizational learning framework for patient safety. | AHRQ Patient Safety Network

• Commentary
 
• Published February 2016

An organizational learning framework for patient safety.

Edwards MT. Am J Med Qual. 2016 Feb 25; [Epub ahead of print].

Organizations are encouraged to learn from their failures, but evidence shows that changes after errors are not always implemented. This commentary presents a model to help organizations learn from system failures through focusing on improvements that align collaboration, accountability, culture, and process enhancement with elements of high reliability.

PubMed citationAvailable at

Related Resources

JOURNAL ARTICLE › STUDY

An organisation without a memory: a qualitative study of hospital staff perceptions on reporting and organisational learning for patient safety.

Sujan M. Reliab Eng Syst Saf. 2015;144:45-52.

JOURNAL ARTICLE › STUDY

Quality improvement for patient safety: project-level versus program-level learning.

Rivard PE, Parker VA, Rosen AK. Health Care Manage Rev. 2013;38:40-50.

JOURNAL ARTICLE › COMMENTARY

Kaiser Permanente's performance improvement system, part 4: creating a learning organization.

Schilling L, Dearing JW, Staley P, Harvey P, Fahey L, Kuruppu F. Jt Comm J Qual Patient Saf. 2011;37:532-543.

BOOK/REPORT

Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary.

Grossmann C, Goolsby WA, Olsen L, McGinnis JM; Institute of Medicine and National Academy of Engineering. Washington, DC: The National Academies Press; 2011. ISBN: 9780309120647.

JOURNAL ARTICLE › COMMENTARY

Strategies for learning from failure.

Edmondson AC. Harv Bus Rev. April 2011;89:48-55.

View More