Research on organizations from all different sectors (including industry, business, and health care) has shown that organizations that promote practices associated with learning organizations have significantly better outcomes, such as improved quality, efficiency, and effectiveness. Organizations and their leadership, therefore, are making wise investments when they support cultures that promote continuous learning (Robbins, Garman, Song, & McAlearney, 2012).
As you may have surmised by watching the video by Peter Senge, organizations do better when they expect everyone within the organization to “make a deep commitment to learning.” In his presentation, “high leverage” refers to the ability to make positive changes, to be innovative. When we get stuck in one way of thinking and one way of doing things (habit), we miss opportunities to improve and enhance the way we work together. Senge urges us to break out of our old “mental models” and to “triangulate” or bring our knowledge and ideas together with others—to gain multiple perspectives. He also emphasizes that it takes time to “develop, adapt and apply.” Evidence-informed leaders need to “walk the talk.” Leaders have to constantly challenge the status quo and invite diverse perspectives from their staff, from patients and families, and from their colleagues to explore better ways for delivering quality, safe care within their organizations.
Let’s return to the Mid Staffordshire Trust. Within the trust, leaders ignored evaluation data that reported adverse events, and they ignored patient complaints and staff complaints. They focused almost exclusively on financial targets set by the government to produce balanced budgets. The NHS finally commissioned a public inquiry of Mid Staffordshire Trust after a whistle-blower group of families went to the media with stories of terrible injury to their loved ones. Julie Bailey, one of the organizers of the movement, lost her mother. The public and the media were responsible for government action.
Essential Learning Activity 8.3.1
Watch this Channel 4 News video titled “Mid Staffs: Julie Bailey and Jeremy Hunt” (7:51). The reporter interviews Julie Bailey, one of the organizers of the public movement (who lost her mother), and Jeremy Hunt, the Minister of Health. The video is dated February 6, 2013, shortly after the release of the Francis report on the Mid Staffordshire Trust.
In the video, Ms. Bailey concludes that “we need a leader” to make the changes necessary to ensure quality, safe care delivery. Ms. Bailey also asserts that change will not happen without new leadership. The reporter, however, challenges whether or not the resignation of the current leader will take care of the problem. What do you think?
Essential Learning Activity 8.3.2
Read the 2017 “Position Statement on Harm Reduction” from the British Columbia Nurses’ Union (BCNU). The background of the position statement highlights how evidence-informed harm reduction approaches represent nursing principles. Identify those concepts of harm reduction that are associated with nursing professional standards and codes of ethics.
For more information on injectable drugs and risks that influence evidence-informed nursing, see the World Health Organization’s web page on HIV/AIDS.