Conceptualizing the learning organization in nursing homes: a scoping review.

backgroundMaintaining 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.

methodsWe 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.

resultsFrom 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.

conclusionsTo 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.