Organizational learning in local health departments: A case study

Local health departments (LHDs) are exploring strategies to enhance accountability and quality in their work. Programs for national performance standards, accreditation, state certification, strategic planning, and performance management are among the tools LHDs use. How LHDs should address workforce development, leadership development, and management practices in this context has recently taken on greater significance. Research in LHDs related to performance has evaluated the national standards and quality improvement management programs. Research has also considered the LHD as a learning organization. Little research exists to demonstrate how LHDs may learn, which may offer new insights regarding quality improvement initiatives. This presentation describes a case study of organizational learning in a Wisconsin LHD. The purpose of the case study is to apply a theoretical framework to understanding how leadership, culture, and structure or organizational learning mechanisms might affect organizational learning in LHDs. A single case was selected to ensure a more in-depth exploration of organizational learning. Data collection involves three sources – interviews, observation, and documents – to facilitate detailed descriptions of LHD processes and practices. Interviews are being repeated at a second time period to verify findings and validate insights. Preliminary findings suggest that an open leadership approach with a team perspective creates a culture conducive to organizational learning, even when decision-making may be perceived differently by different staff groups. The presence of formal and informal structures for sharing, interpreting, and integrating information based on programs and the essential services may contribute positively to organizational learning in this LHD. Organizational competencies related to team building across organizational subcultures and promotion of structures for organizational learning may enhance accreditation efforts and management practices. A conceptual model of organizational learning will be proposed. This model may contribute to the translation of research on organizational learning to management practices in some LHDs.