Implementing Learning from Excellence in a postanaesthesia care unit: a qualitative study of healthcare professionals’ experiences after six months
Abstract Background Prevailing efforts to ensure patient safety have primarily focused on learning from errors and adverse events (Safety-I). However, it is advocated that complex systems also learn from success (Safety-II) and focus on healthcare professionals’ well-being at work to increase resili...
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BMC
2025-04-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-025-12626-8 |
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| author | Gørill Birkeli Ellen Catharina Tveter Deilkås Randi Ballangrud Anne Karin Lindahl |
| author_facet | Gørill Birkeli Ellen Catharina Tveter Deilkås Randi Ballangrud Anne Karin Lindahl |
| author_sort | Gørill Birkeli |
| collection | DOAJ |
| description | Abstract Background Prevailing efforts to ensure patient safety have primarily focused on learning from errors and adverse events (Safety-I). However, it is advocated that complex systems also learn from success (Safety-II) and focus on healthcare professionals’ well-being at work to increase resilience. Learning from Excellence is a British initiative designed to learn from successful practices and provide positive feedback to the staff. It has gained enthusiastic followers in several countries, including Norway. However, how it influences learning, well-being and quality improvement, has not been studied in-depth. This study intends to address these gaps. Thus, this study aimed to describe healthcare professionals’ experiences with Learning from Excellence six months after its implementation in a postanaesthesia care unit. Methods A qualitative descriptive design was applied. Learning from Excellence was implemented in a postanaesthesia care unit of a Norwegian university hospital between November 2022 and May 2023. Six semi-structured focus group interviews were conducted, from May to June 2023, with a convenience sample of nurses (n = 17) and physicians (n = 7). The data were analysed through inductive reflexive thematic analysis. The study adhered to the COREQ guidelines. Results This study reports four prominent themes encapsulating healthcare professionals’ experiences with Learning from Excellence. These themes were termed as follows: 1) ‘Facilitates a more positive working climate’, including sub-themes ‘Helps spread positive feedback’ and ‘Feeling seen and motivated’; 2) ‘Why don’t I get any ‘likes’?’; 3) ‘Organisational learning is challenging’, including sub-themes ‘Hesitating to report’ and ‘Provides mostly superficial learning’; and 4) ‘Success inspires quality improvement project’. Conclusions Implementing LfE mostly contributed to a positive working climate in a postanaesthesia care unit. For LfE to be worth implementing, it is essential to improve organisational learning, while minimising the negative effects of LfE, such as exclusivity issues. Trial registration ClinicalTrials.gov NCT05794490; first registered on March 4, 2023. |
| format | Article |
| id | doaj-art-1e8cd2c461e34606a57ec86846a0e571 |
| institution | OA Journals |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-1e8cd2c461e34606a57ec86846a0e5712025-08-20T02:25:35ZengBMCBMC Health Services Research1472-69632025-04-0125111610.1186/s12913-025-12626-8Implementing Learning from Excellence in a postanaesthesia care unit: a qualitative study of healthcare professionals’ experiences after six monthsGørill Birkeli0Ellen Catharina Tveter Deilkås1Randi Ballangrud2Anne Karin Lindahl3Division of Surgery, Akershus University HospitalHealth Services Research Unit, Akershus University HospitalFaculty of Medicine and Health Sciences, Department of Health Sciences, Norwegian University of Science and TechnologyDivision of Surgery, Akershus University HospitalAbstract Background Prevailing efforts to ensure patient safety have primarily focused on learning from errors and adverse events (Safety-I). However, it is advocated that complex systems also learn from success (Safety-II) and focus on healthcare professionals’ well-being at work to increase resilience. Learning from Excellence is a British initiative designed to learn from successful practices and provide positive feedback to the staff. It has gained enthusiastic followers in several countries, including Norway. However, how it influences learning, well-being and quality improvement, has not been studied in-depth. This study intends to address these gaps. Thus, this study aimed to describe healthcare professionals’ experiences with Learning from Excellence six months after its implementation in a postanaesthesia care unit. Methods A qualitative descriptive design was applied. Learning from Excellence was implemented in a postanaesthesia care unit of a Norwegian university hospital between November 2022 and May 2023. Six semi-structured focus group interviews were conducted, from May to June 2023, with a convenience sample of nurses (n = 17) and physicians (n = 7). The data were analysed through inductive reflexive thematic analysis. The study adhered to the COREQ guidelines. Results This study reports four prominent themes encapsulating healthcare professionals’ experiences with Learning from Excellence. These themes were termed as follows: 1) ‘Facilitates a more positive working climate’, including sub-themes ‘Helps spread positive feedback’ and ‘Feeling seen and motivated’; 2) ‘Why don’t I get any ‘likes’?’; 3) ‘Organisational learning is challenging’, including sub-themes ‘Hesitating to report’ and ‘Provides mostly superficial learning’; and 4) ‘Success inspires quality improvement project’. Conclusions Implementing LfE mostly contributed to a positive working climate in a postanaesthesia care unit. For LfE to be worth implementing, it is essential to improve organisational learning, while minimising the negative effects of LfE, such as exclusivity issues. Trial registration ClinicalTrials.gov NCT05794490; first registered on March 4, 2023.https://doi.org/10.1186/s12913-025-12626-8Adverse eventsFocus groupsLearning health systemPatient safety climatePatient safety culturePostoperative care |
| spellingShingle | Gørill Birkeli Ellen Catharina Tveter Deilkås Randi Ballangrud Anne Karin Lindahl Implementing Learning from Excellence in a postanaesthesia care unit: a qualitative study of healthcare professionals’ experiences after six months BMC Health Services Research Adverse events Focus groups Learning health system Patient safety climate Patient safety culture Postoperative care |
| title | Implementing Learning from Excellence in a postanaesthesia care unit: a qualitative study of healthcare professionals’ experiences after six months |
| title_full | Implementing Learning from Excellence in a postanaesthesia care unit: a qualitative study of healthcare professionals’ experiences after six months |
| title_fullStr | Implementing Learning from Excellence in a postanaesthesia care unit: a qualitative study of healthcare professionals’ experiences after six months |
| title_full_unstemmed | Implementing Learning from Excellence in a postanaesthesia care unit: a qualitative study of healthcare professionals’ experiences after six months |
| title_short | Implementing Learning from Excellence in a postanaesthesia care unit: a qualitative study of healthcare professionals’ experiences after six months |
| title_sort | implementing learning from excellence in a postanaesthesia care unit a qualitative study of healthcare professionals experiences after six months |
| topic | Adverse events Focus groups Learning health system Patient safety climate Patient safety culture Postoperative care |
| url | https://doi.org/10.1186/s12913-025-12626-8 |
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