Organizational learning in health care

Organizations that learn - consistently improving their processes and products by integrating new insights and knowledge - perform well in a changing environment. This premise has led to much theorizing about effective processes for promoting organizational learning. However, little empirical research has followed to guide organizations such as those in health care that have a need and desire to learn in order to overcome performance problems and absorb rapidly-changing knowledge. This dissertation aims to advance empirical research on organizational learning by examining the improvement efforts of health care organizations involved in quality improvement "collaboratives," organized programs in which teams from multiple institutions work to improve care around a specific topic. Using survey, archival, interview and observation data from participants in four collaboratives sponsored by the Institute for Healthcare Improvement, I first assess which features of collaboratives matter most for learning. I find that access to faculty experts knowledgeable about the specified topic and achieving improvement matters most. Second, I capitalize on the existence of collaboratives to investiga