Communities of practice in Alberta Health Services: advancing a learning organisation

Abstract

Background: 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. Methods: A 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. Results: CoPs 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 knowledgesharing activities perceived as supportive of organisational change, systems thinking, and the team learning practice critical to a learning organisation. Conclusion: CoPs 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.

Nurse champions as leaders for the implementation of CoACT Collaborative Care

“…17 The Unit Lead CoPs were chosen as critical pathways for information sharing by connecting Unit Leads working in geographic isolation with modest resource requirements. 2 The Unit Lead CoPs varied in frequency from weekly to once per month providing additional learning opportunities for members to explore ways to address local…”

“…AHS is the largest provincial health authority in Canada and serves 4.3 million residents with more than 850 hospitals, community clinics, and continuing care facilities. 2 AHS, similar to many healthcare organizations, is challenged with achieving the organizational goal of introducing evidence-based initiatives to create efficiencies in providing quality care and sustaining such changes. In order to implement the changes necessary across such a vast geographical area and adapt to subtle and overt differences across the zones and sectors, a purposeful implementation strategy was needed such as using a peer champion.…”

“…17 The Unit Lead CoPs were chosen as critical pathways for information sharing by connecting Unit Leads working in geographic isolation with modest resource requirements. 2 The Unit Lead CoPs varied in frequency from weekly to once per month providing additional learning opportunities for members to explore ways to address local challenges and solutions in implementing Collaborative Care. The Unit Lead CoPs provided an informal support structure that offered Unit Lead’s connection to others doing similar work and allow for the sharing and reflection of experiences.…”

Use of a Community of Practice for the Implementation of Evidence-based Practices for Heart Failure Within the United States Department of Veterans Affairs

“…[4] They enable the diverse wealth of knowledge embedded in people, local conditions and special circumstances to ow from practice domain groups to program and service areas, and into the larger system where it can effect organizational change. [5] In 1991 Lave and Wenger [6] developed the concept of the CoP. They suggested that learning takes place in social relationships rather than through the simple acquisition of knowledge.…”

Facilitating learning exchange and building a community of practice to accelerate social innovation in health

“…13 Although studies evaluating the impact of COPs on population health remain scarce, at the process level, COPs have been found to enable organisational change through the flow of knowledge from practice to programme and service areas, and into larger systems. 14 Promising interventions with COPs include a facilitator to enhance interaction, use of information technology to enable communication and provision of organisational infrastructures to promote uptake of new knowledge. 15 COPs for specific health programmes have employed different social media platforms and pathways such as podcasts and virtual meetings for continuous engagement and knowledge exchange with target groups.…”