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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Main Authors: Gørill Birkeli, Ellen Catharina Tveter Deilkås, Randi Ballangrud, Anne Karin Lindahl
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Health Services Research
Subjects:
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.
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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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