Research Projects

The Learning Practice: Learning Organisations in Primary Care

Researchers

Rosemary Rushmer, CPPM, Dept. of Management, University of St Andrews
(PI contact at: rkr@st-andrews.ac.uk)
Huw Davies, Professor of Health Care Policy & Management, Director of Centre for Public Policy & Management (University of St Andrews), and Associate Director of Social Dimensions of Health Institute (Universities of Dundee and St Andrews).
Diane Kelly, Asst Director, NHS Education for Scotland, Glasgow
Murray Lough, Asst Director, NHS Education for Scotland, Glasgow
Gail Greig, PhD Student, CPPM, Dept. of Management, University of St Andrews
Joyce Wilkinson, PhD Student, CPPM, Dept. of Management, University of St Andrews

Background

Ongoing legislative reform, economic forces and the pace of technological change combine to exert pressure on health care service provision to constantly adapt to changing circumstances. In exploring the capacity of Primary Care to respond to and meet change on this scale, the ideas of the Learning Organisation and Organisation Learning have been used. These ideas suggest that for change and learning to be successful it should be carried out by the practitioners who deliver services by working and learning together to make things better for themselves and their patients. This collective learning is likely to be more realistic, sustainable and enduring than externally imposed requirements for change.

Aims of the Study

• To identify the nature of collective learning in GP practices, factors involved, impact, trends and possible links to outcomes.
  
• To describe different approaches to developing learning cultures, processual and contextual factors, helping or hindering forces.
  
• To explore the extent to which the capacity to learn and change shapes Primary Care provision within Scotland (commonalties, variation and diversity within and across Practices)
  
• To develop and enhance the capacity of GP practices to undertake their own learning

Methods

An in-depth systematic literature review has informed the development of a psychometric diagnostic tool (the Learning Practice Inventory - LPI) to assist GP practices to identify their present collective learning capacity and to prioritise areas for development. In facilitated meetings with GP practices, an education package supports development efforts. The LPI is undergoing validation and refinement. In parallel to this work, qualitative observation and case study methods will complement our understanding of the various strategies that GP practices adopt to foster learning. It will allow us to explore the internal dynamics of practice life that impacts on the potential for practitioners to learn as a community of practitioners.

Funding

This project is part-funded by NHS Education for Scotland. The qualitative research is being undertaken as part of a PhD Studentship award from the Chief Scientist Office, the Scottish Executive