Abstract
BackgroundIn 2009, Alberta Health Services (AHS) became Canada’s first and largest fully integrated healthcare system, involving the amalgamation of nine regional health authorities and three provincial services. Within AHS, communities of practice (CoPs) meet regularly to learn from one another and to find ways to improve service quality. This qualitative study examined CoPs as an applied practice of a learning organisation along with their potential influence in a healthcare system by exploring the perspectives of CoP participants.MethodsA collective case study method was used to enable the examination of a cross-section of cases in the study organisation. Semi-structured interviews were conducted with 31 participants representing 28 distinct CoPs. Using Senge’s framework of a learning organisation, CoP influences associated with team learning and organisational change were explored.ResultsCoPs in AHS were described as diverse in practice domains, focus, membership boundaries, attendance and sphere of influence. Using small-scale resource investments, CoPs provided members with opportunities for meaningful interactions, the capacity to build information pathways, and enhanced abilities to address needs at the point of care and service delivery. Overall, CoPs delivered a sophisticated array of engagement and knowledge-sharing activities perceived as supportive of organisational change, systems thinking, and the team learning practice critical to a learning organisation.ConclusionCoPs enable the diverse wealth of knowledge embedded in people, local conditions and special circumstances to flow from practice domain groups to programme and service areas, and into the larger system where it can effect organisational change. This research highlights the potential of CoPs to influence practice and broad-scale change more directly than previously understood or reported in the literature. As such, this study suggests that CoPs have the potential to influence and advance widespread systems change in Canadian healthcare.
Highlights
In 2009, Alberta Health Services (AHS) became Canada’s first and largest fully integrated healthcare system, involving the amalgamation of nine regional health authorities and three provincial services
The five disciplines in Senge’s framework, viewed from a practice perspective, were used in data analysis to interpret and map Community of Practice (CoP) influences associated with team learning and organisational change [29, 30]
Practice domain Practice domains of the CoP members represented a broad cross-section of the following areas of expertise within the study organisation: quality improvement, employee engagement, project management, patient safety, patient relations and concerns, patient- and familycentred care and services, frontline management and supervision, organisation-wide support services, and data analysis
Summary
In 2009, Alberta Health Services (AHS) became Canada’s first and largest fully integrated healthcare system, involving the amalgamation of nine regional health authorities and three provincial services. Within AHS, communities of practice (CoPs) meet regularly to learn from one another and to find ways to improve service quality This qualitative study examined CoPs as an applied practice of a learning organisation along with their potential influence in a healthcare system by exploring the perspectives of CoP participants. In 2008, the Government of Alberta’s Ministry of Health took unprecedented legislative action to mandate the amalgamation of its RHAs into a single governance and management authority, creating Alberta Health Services (AHS) [2]. This amalgamation established Canada’s first fully integrated health service entity, the study organisation for this research. This service integration aligns with Canada’s rising imperative to provide better healthcare at lower cost [3, 4]
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