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Academic Medical Centers (AMCs) and Patient Safety

Staff  |  Issue: June 2008  |  June 1, 2008

A learning organization is defined as one that actively creates, captures, transfers, and mobilizes knowledge to allow adaptation to a changing environment.8,9 Thus, the key aspect of organizational learning is the interaction that takes place among individuals.10 A learning organization does not rely on passive processes in the hope that organizational learning will take place through serendipity or as a byproduct of normal work. Instead, it actively promotes, facilitates, and rewards collective learning.8-12 Successful companies have utilized techniques of organizational learning for years to maximize efficiency and productivity.

Recently, healthcare organizations have also identified organizational learning as a critical component of their success. This study begins to identify the characteristics that several top AMC performers have in the domains of quality and patient safety, and, as such, will be useful to academic medical centers as they continue in their quest for improvements in patient care.

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All physicians need to increase their understanding of how system redesign and reducing waste and complexity can improve the care we deliver to our patients. Moving beyond simply understanding these changes, we need to be leaders in organizational change and exemplify the principles of accountability, transparency, and professionalism. For those of us in AMCs, we need to remind ourselves that the tripartite mission of research, education, and patient care has developed a fourth dimension—quality and safety—that we must not only practice, but teach. It’s about time.

Dr. Von Feldt is associate professor of medicine in the rheumatology division at the University of Pennsylvania School of Medicine in Philadelphia and a TR board member. Dr. Myers is assistant professor of clinical medicine in the division of general internal medicine and the patient safety officer at the Hospital of the University of Pennsylvania.

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References

  1. Committee on Quality of Health Care in America, Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C.: National Academy Press; 2001.
  2. Corrigan J, Kohn L, Donaldson M, Eds. To Err is Human: Building a Safer Health System. Washington, D.C.: National Academy Press; 1999.
  3. Keroack MA, Youngberg BJ, Cerese JL, Krsek C, Prellwitz LW, Trevelyan EW. Organizational factors associated with high performance in quality and safety in academic medical centers. Acad Med. 2007;82(12):1178-1186.
  4. McFarlane D, Murphy J, Olmsted M, Drozd E, Hill C. America’s best hospitals 2007 methodology. Available online at www.usnews.com/usnews/health/best-hospitals/methodology_report.pdf. Last accessed May 12, 2008.
  5. Health Grades I. Hospital report card mortality and complication based outcomes 2007 methodology white paper. Available online at www.healthgrades.com/media/DMS/pdf/HospitalReportCardsMortalityComplications2008.pdf. Last accessed May 12, 2008.
  6. Department of Health and Human Services. Hospital compare: A quality tool for adults, including people with Medicare. www.hospitalcompare.hhs.gov/hospital. Last accessed May 12, 2008.
  7. Pronovost PJ, Berenholtz SM, Needham DM. A framework for healthcare organizations to develop and evaluate a safety scorecard. JAMA. 2007;298(17):2063-2065.
  8. Argyris C, Schon D. Organizational Learning: A theory of action perspective (Series on Organization Development). Addison-Wesley, New Jersey; 1978.
  9. Nonaka I. A dynamic theory of organizational knowledge creation. Organ Sci. 1994;5(1):14-37.
  10. Schein E. Organizational Culture and Leadership. San Francisco: Jossey-Bass Wiley, 1992:3-27.
  11. Gilmore T, Shea G. Organizational learning and the leadership skill of time travel. J Management Development. 1997;16:302-311.
  12. Druckman D, Singer J, Van Cott H, Eds. Organizational culture. In Enhancing Organizational Performance. Committee on Techniques for the Enhancement of Human Performance, Commission on Behavioral and Social Sciences and Education, National Research Council, National Academy Press, Washington, D.C. 1997:65-96.

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Filed under:Education & Training Tagged with:Care TeamErrorsInstitute of MedicineQualityrheumatologySafety

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