Learning From Excellence in a Hospital Unit

One measure to improve patient safety, is to focus on improvements based on learning from errors (Safety-I). However, it is advocated that learning also should be based on situations where work goes well (Safety-II). Learning from Excellence (LfE) is an English initiative to learn from what works well and provide positive feedback to staff to increase resilience. LfE was implemented in a unit of a South-eastern Norwegian hospital trust between November 2022 and May 2023, using readily available resources from www.learningfromexcellence.com.

The qualitative data will be derived from five semi-structured focus group interviews, with nurses, physicians and change team representants. A descriptive design will be applied, and the data will be analysed using a more deductive, reflexive thematic analysis. Data from the focus group interviews will be taped on a recorder and stored at a secured computerised research place at Akershus University Hospital.

The gained knowledge from the focus group interviews in this study may provide in-depth knowledge on healthcare professionals' experiences in the novel field of learning from excellence, regarding the outcomes: learning, quality improvement work and resilience and culture in the workplace.

The quantitative part consist of aggregated data reports derived from the annual Norwegian hospital survey, which is a measure to explore connections between working environment, patient safety and Health-Environment-Safety in Norwegian hospitals, with a 5-point Likert response scale. From this report we derive answers from 20 questions, submittet before (March 2021 and 2022) and after (March 2023 and 2024), regarding the themes: Work engagement (n= 6), Team-collaboration (n=5) Patient safety climate (n=6) Working conditions (n=3). Thus, the study uses a longitudinal quasi-experimental pre-post intervention design, with a non-equivalent comparison unit.

The gained knowledge from the surveys may provide information if and how the method of Learning from excellence method impact the perceived:

• patient safety climate
• work engagement
• team-collaboration
• working conditions

Inclusion criteria

Qualitative study:

• Nurses who had been working for at least six months on the premises
• Physicians who had either received or captured and reported peer excellence

Inclusion criteria

Quantitative study:

All nurses working on the premises who have answered questions in the annual hospital survey, between March 2021 and March 2024. Answers are collected on unit-level, not individual level.

Exclusion criteria

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