Research

Evidence in the learning organization

Gerald E Crites¹ , Megan C McNamara² , Elie A Akl³ , W Scott Richardson⁴ , Craig A Umscheid⁵ and James Nishikawa⁶

¹  Wright State University Boonshoft School of Medicine, One Elizabeth Place, Suite 500, Dayton, OH, USA

²  School of Medicine, Case Western Reserve University, Louis Stokes Cleveland VA Medical Center, 10701 East Boulevard, Cleveland, USA

³  School of Medicine, State University of New York at Buffalo, Erie County Medical Center, CC142, Buffalo, NY, USA

⁴  Wright State University Boonshoft School of Medicine, Miami Valley Hospital, Weber CHE Building, 2nd Floor, 128 E. Apple St, Dayton, OH, USA

⁵  School of Medicine, University of Pennsylvania, 1 Founders Pavilion, 3400 Spruce Street, Philadelphia, PA, USA

⁶  Faculty of Medicine, University of Ottawa, 1053 Carling Ave., Room 412 Parkdale Building, Ottawa, ON, Canada

author email corresponding author email

Health Research Policy and Systems 2009, 7:4doi:10.1186/1478-4505-7-4

Published:	26 March 2009

Abstract

Background

Organizational leaders in business and medicine have been experiencing a similar dilemma: how to ensure that their organizational members are adopting work innovations in a timely fashion. Organizational leaders in healthcare have attempted to resolve this dilemma by offering specific solutions, such as evidence-based medicine (EBM), but organizations are still not systematically adopting evidence-based practice innovations as rapidly as expected by policy-makers (the knowing-doing gap problem). Some business leaders have adopted a systems-based perspective, called the learning organization (LO), to address a similar dilemma. Three years ago, the Society of General Internal Medicine's Evidence-based Medicine Task Force began an inquiry to integrate the EBM and LO concepts into one model to address the knowing-doing gap problem.

Methods

During the model development process, the authors searched several databases for relevant LO frameworks and their related concepts by using a broad search strategy. To identify the key LO frameworks and consolidate them into one model, the authors used consensus-based decision-making and a narrative thematic synthesis guided by several qualitative criteria. The authors subjected the model to external, independent review and improved upon its design with this feedback.

Results

The authors found seven LO frameworks particularly relevant to evidence-based practice innovations in organizations. The authors describe their interpretations of these frameworks for healthcare organizations, the process they used to integrate the LO frameworks with EBM principles, and the resulting Evidence in the Learning Organization (ELO) model. They also provide a health organization scenario to illustrate ELO concepts in application.

Conclusion

The authors intend, by sharing the LO frameworks and the ELO model, to help organizations identify their capacities to learn and share knowledge about evidence-based practice innovations. The ELO model will need further validation and improvement through its use in organizational settings and applied health services research.