Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada.
The Wilson Centre, Toronto, Canada.
J Health Organ Manag. 2021 Mar 30;ahead-of-print(ahead-of-print):177-94. doi: 10.1108/JHOM-07-2020-0292.
In this paper, we contribute to the theorizing of patient involvement in organizational improvement by exploring concepts of "learning from patients" as mechanisms of organizational change. Using the concept of metaphor as a theoretical bridge, we analyse interview data ( = 20) from participants in patient engagement activities from two case study organizations in Ontario, Canada. Inspired by classic organizational scholars, we ask "what is the organization that it might learn from patients?"
DESIGN/METHODOLOGY/APPROACH: Patient involvement activities are used as part of quality improvement efforts in healthcare organizations worldwide. One fundamental assumption underpinning this activity is the notion that organizations must "learn from patients" in order to enact positive organizational change. Despite this emphasis on learning, there is a paucity of research that theorizes learning or connects concepts of learning to organizational change within the domain of patient involvement.
Through our analysis, we interpret a range of metaphors of the organization, including organizations as (1) power and politics, (2) systems and (3) narratives. Through these metaphors, we display a range of possibilities for interpreting how organizations might learn from patients and associated implications for organizational change.
ORIGINALITY/VALUE: This analysis has implications for how the framing of the organization matters for concepts of learning in patient engagement activities and how misalignments might stymie engagement efforts. We argue that the concept and commitment to "learning from patients" would be enriched by further engagement with the sociology of knowledge and critical concepts from theories of organizational learning.
在本文中，我们通过探讨“从患者身上学习”作为组织变革机制的概念，为患者参与组织改进的理论化做出了贡献。我们使用隐喻的概念作为理论桥梁，分析了来自加拿大安大略省两个案例研究组织中参与患者参与活动的 20 名参与者的访谈数据。受经典组织学者的启发，我们提出了“它可能从患者身上学习到的组织是什么？”的问题。
设计/方法/途径：患者参与活动被用作全球医疗保健组织质量改进努力的一部分。这种活动的一个基本假设是，为了实施积极的组织变革，组织必须“从患者身上学习”。尽管如此强调学习，但在患者参与领域，将学习理论化或将学习概念与组织变革联系起来的研究却很少。
通过我们的分析，我们解释了一系列关于组织的隐喻，包括组织作为（1）权力和政治，（2）系统和（3）叙事。通过这些隐喻，我们展示了组织如何从患者身上学习以及相关的组织变革含义的多种可能性。
原创性/价值：这项分析对于患者参与活动中学习概念的组织框架以及不匹配如何阻碍参与努力的方式具有重要意义。我们认为，通过进一步参与知识社会学和组织学习理论的批判性概念，可以丰富“从患者身上学习”的概念和承诺。
