van Biessum Clariska, van den Berg Bellis, van Erp Kim, Vermunt Paulien, Ket Johannes, Nies Henk, Beersma Bianca
Vilans, Center of Excellence for Care and Support, PO Box 8228, Utrecht, 3503 RE, The Netherlands.
Faculty of Social Sciences, Department of Organization Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1105, Amsterdam, 1081 HV, The Netherlands.
BMC Health Serv Res. 2025 Apr 30;25(1):621. doi: 10.1186/s12913-025-12674-0.
Maintaining high-quality care in nursing homes is challenging. An ageing population and labour market shortages have created an imbalance in the supply and demand of care, and the focus of care has transitioned from quality of care to quality of life. This study explores how the 'learning organization' (LO) concept could contribute to a new quality paradigm in nursing homes, by 1) examining its efficacy and operationalization for and 2) identifying the elements most relevant to the nursing home setting.
We use Arksey and O'Malley's scoping framework to answer the research questions and address gaps in the literature, guided by theories on the learning organization from Senge (The fifth discipline: The art and practice of the learning organization, 1990) and Watkins and Marsick (Sculpting the learning organization: Lessons in the art and science of systemic change, 1993). Literature searches (in Scopus, Medline, Web of Science, Business Source Elite, and ERIC) were performed from inception through 19 August 2024, in collaboration with a medical information specialist. Eligibility was limited to studies on learning organizations or organizational learning (OL) in nursing homes. Study aims, definitions, descriptions, key terms, theories, and operationalizations were mapped descriptively.
From 2,292 abstracts, 14 articles were included. Ten studies reference Senge (The fifth discipline: The art and practice of the learning organization, 1990) and/or Watkins and Marsick (Sculpting the learning organization: Lessons in the art and science of systemic change, 1993) in defining and describing a learning organization and organizational learning. Together, the studies reveal six elements of learning organizations in nursing homes: individual and collective learning, individual and interpersonal abilities, an adaptive and responsive culture, transformational leadership, organizational knowledge development, and systems thinking. All studies highlight organizational performance improvement as the primary aim of a learning organization, with only a few operationalizations (n = 3) examining the concept's full scope; most examine only single aspects.
To help nursing homes effectively adapt, the learning organization could offer a promising concept. However, current research is limited. The included studies provide insight into key elements of learning organizations and their benefits for organizational performance and job satisfaction. Future research should develop a consistent method of operationalization based on the six key elements most relevant for nursing homes transitioning to learning organizations. This approach should consider the interconnected nature of these elements, with systems thinking as the foundation.
在养老院维持高质量护理具有挑战性。人口老龄化和劳动力市场短缺导致了护理供需失衡，护理重点已从护理质量转向生活质量。本研究探讨“学习型组织”（LO）概念如何通过以下方式为养老院的新质量范式做出贡献：1）检验其对养老院的有效性和可操作性；2）确定与养老院环境最相关的要素。
我们使用阿克斯和奥马利的范围界定框架来回答研究问题并填补文献空白，以圣吉（《第五项修炼：学习型组织的艺术与实践》，1990年）以及沃特金斯和马西克（《塑造学习型组织：系统变革的艺术与科学课程》，1993年）关于学习型组织的理论为指导。与医学信息专家合作，从数据库建立至2024年8月19日在Scopus、Medline、科学引文索引、商业资源精英版和教育资源信息中心进行文献检索。纳入标准仅限于关于养老院学习型组织或组织学习（OL）的研究。对研究目的、定义、描述、关键词、理论和可操作性进行描述性映射。
从2292篇摘要中，纳入了14篇文章。十项研究在定义和描述学习型组织及组织学习时引用了圣吉（《第五项修炼：学习型组织的艺术与实践》，1990年）和/或沃特金斯和马西克（《塑造学习型组织：系统变革的艺术与科学课程》，1993年）的观点。这些研究共同揭示了养老院学习型组织的六个要素：个体和集体学习、个体和人际能力、适应性和响应性文化、变革型领导、组织知识发展和系统思维。所有研究都强调组织绩效提升是学习型组织的主要目标，只有少数研究（n = 3）考察了该概念的全貌；大多数研究仅考察了单个方面。
为帮助养老院有效适应，学习型组织可能是一个有前景的概念。然而，目前的研究有限。纳入的研究提供了关于学习型组织关键要素及其对组织绩效和工作满意度益处的见解。未来的研究应基于与向学习型组织转型的养老院最相关的六个关键要素，开发一种一致的可操作性方法。这种方法应考虑这些要素的相互联系性质，并以系统思维为基础。
