Knowledge Sharing and Organizational Learning in the Context of Hospital Infection Prevention
Knowledge Sharing and Organizational Learning in the Context of Hospital Infection Prevention
复制标题
医院感染预防背景下的知识共享和组织学习
DOI：
10.1097/qmh.0b013e3181ccbd1d
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发表时间：
2010
影响因子：
1.2
通讯作者：
P. Rangachari
中科院分区：
文献类型：
--
作者：
P. Rangachari
最近，在预防感染方面取得成功的医院将其改进方法标记为丰田生产系统（TPS）方法或正偏差（PD）方法。 PD 与 TPS 的区别在于，PD 是一种自下而上的改进方法，而不是自上而下的改进方法。采用这两种方法的设施表明，PD 可能比 TPS 更有效地预防感染。本文整合了组织学习、制度和知识网络理论，开发了一个理论框架，用于理解医疗保健组织中有效知识共享网络的结构和演变，即最有利于学习和改进的网络。与医院成功案例提出的论点相反，该框架表明，与密度丰富的网络（即自下而上的“类 PD”结构）相比，富含经纪和层级的网络（即自上而下的“类 TPS”结构）对于医疗保健组织的学习和改进可能更有效。理论框架和随后的分析有助于确定与感染预防背景下的组织学习和改进相关的文献中的几个空白。这反过来又有助于为健康管理研究和实践提出建议。
Recently, hospitals that have been successful in preventing infections have labeled their improvement approaches as either the Toyota Production System (TPS) approach or the Positive Deviance (PD) approach. PD has been distinguished from TPS as being a bottom-up approach to improvement, as against top-down. Facilities that have employed both approaches have suggested that PD may be more effective than TPS for infection prevention. This article integrates organizational learning, institutional, and knowledge network theories to develop a theoretical framework for understanding the structure and evolution of effective knowledge-sharing networks in health care organizations, that is, networks most conducive to learning and improvement. Contrary to arguments put forth by hospital success stories, the framework suggests that networks rich in brokerage and hierarchy (ie, top-down, “TPS-like” structures) may be more effective for learning and improvement in health care organizations, compared with a networks rich in density (ie, bottom-up, “PD-like” structures). The theoretical framework and ensuing analysis help identify several gaps in the literature related to organization learning and improvement in the infection prevention context. This, in turn, helps put forth recommendations for health management research and practice.