Having a primary role in restoring and maintaining health, healthcare systems largely depend on organizations, people, and their competencies [1]. Particularly, performance of healthcare systems varies based on the structure, process and expected outcomes [2]. On a micro level, healthcare organizations such as hospitals and medical institutions remain at the nucleus of the healthcare system regardless of the type of funding and structure and the provided services to the general population [1]. The key indicator of hospital performance is the safe and consistent services provided to patients by medical and non-medical staff [3]. Therefore, coordination and communication within and between the teams is a must to develop cohesive functioning essential to provide quality medical care [4]. Healthcare organizations are always bound to modify their functioning due to sudden changes in prevalence of diseases and pandemics without compromising the quality of services [5]. Acquiring advanced technologies and creation and utilization of contemporary knowledge can help healthcare organizations to perform well without hindrance.
Learning organization is considered as a cumulative phenomenon that helps in personal and professional growth of individuals and teams and develops collective learning in an organization that leads to enhance individual as well as organizational performance [6]. Indeed, learning organization improves the efficiency and effectiveness of an organization through shared knowledge [7]. An organization that practices continuous learning of employees, bound to transform itself where employees continuously create, acquire, and share knowledge is called learning organization [8]. Learning organization and organizational learning has been used interchangeably in previous literature. However, there is a thin line which differentiates the two. According to Preskill and Torres learning organization focuses on characteristics, principles, and systems whereas organizational learning emphasizes on the process of learning [9]. However, in each level, individuals are the main agents that involve in learning organization or organizational learning and bring substantial changes. Ultimately, organizational learning is a process through which an organization develops new knowledge and understands from routine experiences of the employees. Organizational learning has the potential to change the behavior of employees and improve the organizational capability on policy and practical levels [10].
Learning organization is the first step towards obtaining dynamic knowledge that brings change among employees, whereas, in the context of a learning organization, knowledge is acquired and shared among employees via a system that develops capacity to improve performance [10]. Generally, learning organization is influenced by contextual factors such as culture. An organization that regards learning as absolutely critical for its business success is considered as equipped with learning culture [11]. Organizational culture is the characteristic of an organization which manifests the sharing of common values and beliefs among its employees [12]. Thus, learning organization culture develops skills within an organization to create, acquire, and transfer knowledge and enhance positive behavior to follow new medical practice or guidelines [13].
As changing environment forces every healthcare organization to enhance quality and safety of patients, practice of learning organization will improve the knowledge and skills of physicians and guide them to find better ways to work in coordination [14]. Collective learning among small groups or teams could lead to better performance of healthcare organization through shared knowledge and better understanding among teams [15]. In the context of healthcare services, members of the teams must convert their knowledge in actions and later evaluate actions on the knowledge gathered within the organization [7]. Reay and others argued that in healthcare services, physicians and managers first choose the correct knowledge from existing ones and adapt the knowledge to solve problems and find solutions at hand. This process can help in managing conflicts between management and medical professionals. The process of learning in healthcare is time consuming; yet it provides the precise way to cope with medical crises [16].
Components of Health Learning Organization Culture
The early studies on learning organization focused on five factor model developed by Senge including systems thinking, personal mastery, mental models, building a shared vision, and team learning [17]. Gomes and Wojahn conceptualized learning organization on the basis of four components as experimentation, interaction, risk, and dialogue, found that learning organizations have the capability to improve innovation performance [18]. Additionally, Halim and others included three components of learning organization as information acquisition, information interpretation, and behavioral and cognitive and found an important role of these factors in innovation culture and performance [19].
In the context of healthcare organization, Leufven and colleagues developed seven dimensions that measure organizational learning in low resources healthcare settings [4]. These seven dimensions are continuous learning, dialogue and inquiry, team learning and collaboration, embedded systems, empowerment, systems connections, and strategic leadership. Previous studies on organizational learning in healthcare settings included all top, middle, and lower level employees as part of the study [4,20,21]. However, a little is focused on the role of upper level employees of the hospitals to create an environment of organizational learning. Thus, the main objective of this study was to examine the effect of seven organizational learning components on learning organization culture in government, university, semi government, and private hospitals in Saudi Arabia. Therefore, the study excluded the dimension of strategic learning in conceptualization of strategic learning mainly focus on the support of leadership on learning and leadership models.
Saudi Healthcare System
In Saudi Arabia, the healthcare system is at cross roads where the old publicly funded system, regulated mainly by the government, is now under transition period to be privatized with less power of the government. Almost two-thirds of health provisions are funded by the government, under the regulation of the Ministry of Health. Semi-government agencies like Ministry of Defense, Ministry of Guard and Ministry of Interior contribute also in funding their health settings. Despite such services by the government, private sector and university hospitals contribute slightly in operating the Saudi healthcare system. As the government is under heavy transition periods by the new political leadership, it is expected the funding portion is flipped within decades [5]. As a result of each provision having different policies and priorities, a chasm now exists between knowledge and practice within each entity.
Despite there being separate health providers, the learning organization culture of each entity across the country has not been well-studied. However, learning organization is necessary to implement the strategies that could benefit the organization. In addition, working productivity is also dependent on improved working efficiency and environment that are by products of organization learning. Understanding learning organization culture in such contexts would enhance the resilience of the Saudi system and may enable it to better absorb the adverse effects of the economic and political shocks, especially under such transition periods.