ORGANIZATIONAL LEARNING WITHIN A HOSPITAL SETTING: A CASE STUDY (CHANGE, BEHAVIOR, PARTICIPANT OBSERVATION, DEVELOPMENT)
Over a three year period one hospital became the setting for the study of three organizational changes. An ethnographic approach was utilized as the researcher gained access to the hospital site as a participant observer. Three specific organizational changes were examined and are referred to as Cases A, B and C. Case A reports a hospital-wide computerization project that altered the transfer of patient related information from written and verbal means to a computer-assisted mode. Case B presents the decentralization of the Nursing Service Division. Decentralization, common in organizations, reflects a structural change that fosters problem-solving and decision-making at the lowest and most appropriate level. Case C details the hospital's response to a federal legislative mandate requiring a fiscal adjustment from a retrospective to prospective payment system. The introduction of Diagnostic Related Groups or DRG's was an unanticipated change at the beginning of this study but became significant, not only to this hospital, and had national impact on the entire health care industry. The association between the processes of change and learning became the basis of analysis for this study. However, the focus was not on individual learning, but rather on organizational learning. Organizational learning was further distinguished as either single loop or double loop learning. Whereas single loop learning fosters change within the existing norms of the organization, double loop learning extends the process of change beyond the current cultural boundaries. Cases A, B and C, therefore, were analyzed from the conceptual framework of single and double loop learning. Whereas, Case A represented an example of single loop learning. Cases B and C represented the need for double loop learning. Finally, the role of change agent revealed an interesting relationship between the issue of empowerment and an executive level strategic interactional pattern. This strategic interactional pattern was postulated as normative to the hospital's response to either single or double loop learning situations.
GEORGE, MARIE ANGELELLA, "ORGANIZATIONAL LEARNING WITHIN A HOSPITAL SETTING: A CASE STUDY (CHANGE, BEHAVIOR, PARTICIPANT OBSERVATION, DEVELOPMENT)" (1985). Dissertations available from ProQuest. AAI8603639.