Collective learning, change and improvement in health care: piloting a facilitated learning initiative with general practice teams

Abstract

Rationale, aims and objectives: Now, more than ever, the National Health Service (NHS) in Scotland, UK requires healthcare professionals to work together in highly effective ways to meet patient needs. This study examines the pilot stage of the Learning Practice Programme (LPP): a practical experiment to support multi-disciplinary general practice teams in cultivating the attributes of learning organisations. This paper builds on an earlier trial by extending the size and scope of the LPP to explore its relevance and transferability across a wider range of healthcare teams, contexts and facilitators. Methods: The LPP pilot paper reports on a range of qualitative data sources gathered using an action research approach. Overall the study gathered evidence from participant teams, facilitators and researchers and this paper particularly focuses on the data generated by participants. This includes anonymous written learning notes, mid-point review responses and semi-structured post-pilot interviews. Results: The LPP introduces teams to concepts, processes and tools they can use in practical ways to enhance shared learning and create more effective collective change in their practice. Participating teams found their established communication patterns were changed, redirected or deepened as a result of the learning activities. All teams designed and introduced ways to enhance their effectiveness in working and learning together. Practices where all members of the team engaged with the LPP had much greater success in achieving their self-designed goals compared with those who had varying commitment across their team members. Conclusion: Where teams have a basic willingness to learn and change together the LPP provides a process for them to design new ways of working together. All teams took steps to apply the principles of learning organisations and make effective changes to their existing practice; their efforts are a good enactment of the underlying spirit of the Scottish Government Quality Strategy, which calls for greater multi-professional working, shared decision-making and innovation in working practices to enhance the patient experience. The hope of the LPP is to empower teams to be proactive in clarifying what matters most to them as a professional healthcare team and how they can express that in the day-to-day service of their patient community.