Article Title

Organizational Learning in an Integrated Health System: Informing Operations for a Learning Health Care System

Publication Date



organizations, health care workforce, information technology, survey research and methods, engagement of stakeholders, health care organizations, hospitals, quality improvement


Background: Since 2013 a multidisciplinary group has been working to spur Geisinger Health System’s growth as a learning health care system (LHCS), using the Institute of Medicine (IOM) model as a guide. In March 2016 the group conducted a survey of staff to elicit perceptions and assess awareness of learning and aspects of the learning environment at Geisinger.

Methods: The target audience for the survey was identified by leadership and included clinical, research, administrative and information technology (IT) staff at the Geisinger Medical Center (GMC), the system’s flagship hospital. The survey was sent via email using Qualtrics software, and nonresponders received two weekly reminders.

Results: Of 559 contacted, 357 (63.9%) staff members responded, including clinical (n = 164), administration (n = 78), research (n = 23), IT (n = 5) employees and 87 others identifying with multiple areas. Most participants (62.5%) had not previously heard of IOM’s LHCS model. The majority of respondents characterized the environment at GMC (83.2%) and in their work unit (86.6%) as conducive to learning; however, 94.7% indicated that they were unlikely to participate in training or learning activities. The survey asked participants to assess the importance of LHCS functions to their work and to evaluate the current support they receive for these functions. Several functions were ranked as important to their work but in need of increased support: the ability to capture and view patient-reported data; the service request process; the ability to access data and use it without the assistance of a specialized data analyst; the capacity to track clinical outcomes; the ability to communicate with other providers simultaneously; and patient-centered care and patient engagement in quality improvement, innovation and research teams.

Conclusion: Although most respondents were unaware of the IOM model, the majority indicated that the GMC environment is conducive to learning. Further exploration is needed to determine why so few indicated a willingness to participate in learning activities. Areas where there is a gap between importance to work and current support offer a potential focus for future efforts to stimulate Geisinger’s growth as a LHCS. Survey results were presented at a GMC symposium on learning and patient engagement, and follow-up activities are in process.




July 31st, 2017


August 10th, 2017