Work design drivers of organizational learning about operational failures
Subtitle: a laboratory experiment on medication administration
By: Anita L. Tucker
Contributors: Harvard Business School
Series: Working paper / Harvard Business School -- 13-044; Working paper (Harvard Business School) -- 13-044
Publisher: Harvard Business School
Published: 2013
Place of publication: Boston]
Language: eng
Number of pages: 36
Work titles: Fostering organizational learning
Description: Operational failures persist in hospitals, in part because employees work around them rather than attempt to prevent recurrence. Drawing on a process improvement tool--the Andon cord--we examine three work design components that may foster improvement-oriented behaviors: 1) blockages to prevent workarounds; 2) a support person to assist with problem-solving; and 3) education portraying operational failures as "waste" to be removed from the system. Using laboratory experiments, we test each component's impact on whether hospital nurses speak up about medication administration problems and contribute improvement ideas. We find that each component provides its own contribution to organizational performance. Blockages encourage people to suggest improvement ideas, while education sparks improvement suggestions even when there are no blockages. Blockages can backfire, however, if they are difficult to work around in a policy-compliant manner and problem-solving support is unavailable. Under these conditions, blockages led to a risky workaround associated with a 10X overdose of insulin. Risky workarounds can be mitigated with a readily-available support person, whose presence also elicits higher levels of speaking up about operational failures.
Notes: "November 2012. (Revised September 2013.)"--Publisher's Web site.

Revision of Fostering organizational learning: the impact of work design on workarounds, errors, and speaking up about internal supply chain problems.

Includes bibliographical references (pages 33-36).