Communities of practice in Alberta Health Services: advancing a learning organisation

• Published in: Health research policy and systems Vol. 18; no. 1; pp. 86 - 12
• Main Authors: Auer, Anna M, Hanson, Patricia, Brady-Fryer, Barbara, Alati-It, Julie, Johnson, Allison L
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03-08-2020; BioMed Central; BMC
• Subjects: Alberta; Alberta Health Services; Canada; Case studies; Collaborative learning; Communities of practice; Community Health Services; Delivery of Health Care; Delivery of healthcare; Domains; Employees; Health care; Health care industry; Health organisation; Health region; Health services; Humans; Influence; Knowledge; Knowledge management; Learning; Local knowledge; Membership; Organizational change; Organizational Innovation; Service areas; Spheres of influence; Wealth; Alberta; Canada; Canada; Health organisation; Delivery of healthcare; Health region; Knowledge sharing; Knowledge management; Alberta Health Services; Systems integration; Communities of practice; Organisational change
• ISSN: 1478-4505; 1478-4505
• DOI: 10.1186/s12961-020-00603-y

In 2009, Alberta Health Services (AHS) became Canada's first and largest fully integrated healthcare system, involving the amalgamation of nine regional health authorities and three provincial services. Within AHS, communities of practice (CoPs) meet regularly to learn from one another and to find ways to improve service quality. This qualitative study examined CoPs as an applied practice of a learning organisation along with their potential influence in a healthcare system by exploring the perspectives of CoP participants.
A collective case study method was used to enable the examination of a cross-section of cases in the study organisation. Semi-structured interviews were conducted with 31 participants representing 28 distinct CoPs. Using Senge's framework of a learning organisation, CoP influences associated with team learning and organisational change were explored.
CoPs in AHS were described as diverse in practice domains, focus, membership boundaries, attendance and sphere of influence. Using small-scale resource investments, CoPs provided members with opportunities for meaningful interactions, the capacity to build information pathways, and enhanced abilities to address needs at the point of care and service delivery. Overall, CoPs delivered a sophisticated array of engagement and knowledge-sharing activities perceived as supportive of organisational change, systems thinking, and the team learning practice critical to a learning organisation.
CoPs enable the diverse wealth of knowledge embedded in people, local conditions and special circumstances to flow from practice domain groups to programme and service areas, and into the larger system where it can effect organisational change. This research highlights the potential of CoPs to influence practice and broad-scale change more directly than previously understood or reported in the literature. As such, this study suggests that CoPs have the potential to influence and advance widespread systems change in Canadian healthcare.