Sometimes the kind of learning that is needed in an organisation, as discovered through an organisational inquiry, is simple. If we want to achieve outcome O and we know that action A leads to O but that A is not being done properly, then we know we have to increase training in A and supervision of it. If we discover that A does not lead to O1(desirable) but O2(irrelevant or undesirable)
■ Organisational learning: 1
then we change the operating practice from A1to A2. This process is called single loop learning.19
For example, within the discussion of Five Whys on page 84 (Case 2), in the right hand column of Table 2.1 we see that a locum pharmacist has misunderstood a procedure and is interpreting it too strictly. Ensuring that the locum understands the procedure and how to interpret it is an example of single loop learning.
There are occasions, however, when upon inquiry we realise that the set of assumptions that lead us to believe that O1is a desirable outcome, or that it can be achieved in anything like the way envisaged, needs to be challenged.
Here, instead of implementing a simple change we may need to introduce a change to a whole system. This is called double loop learning.
In the answers to subsequent ‘Why?’s in Table 2.1 we find a number of systems that need to be changed if this situation is not to happen again in the future. Making changes to those systems is an example of double loop learning.
Inevitably, when systemic changes are needed certain doubts and questions arise:
• How did the people involved not spot sooner that these changes needed to be made?
• What can we do to increase from now on people’s ability to identify these changes, to develop their capacity for double loop learning?
When such questions are asked and answers sought, whereby people reflect on their capacity to learn about learning, the resulting process is called deutero learning.20
In the Five Whys example we have been considering, as senior people in the department reflect on why they had not felt willing or able to challenge the norm which had grown up, of not inducting locums properly, they become aware that they have chosen not to do so and this awareness will enable them to do so in future. This is deutero learning at work.
A Model I theory-in-use is often appropriate where single loop learning will suffice. But for double loop learning Model II is necessary.
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19 A term borrowed by Argyris from electrical engineering and cybernetics.
20 A term first introduced by Bateson (1973).
In Episode 3.1 of the case that follows we see a number of able individuals in a PCT, all striving to offer good services, analysing the situation they are in, and devising courses of action that address the problems as they see them. All these courses of action require the cooperation of others, however, and this cooperation is proving hard to find.
As you read the case see whether you think there is any indication of organisational malaise.
If so, what instances are there of the following symptoms within the PCT:
(a) hopelessness?
(b) cynicism?
(c) distancing and blaming others?
(We will be looking at these symptoms of malaise between the PCT and other organisations in Episode 3.2.)
According to Argyris and Schön, we can expect a situation of organisational malaise to be preceded by pattern of organisational defensiveness:
Model I behaviour > bypass and cover up > bypass and cover up are undiscussible > organisational malaise.
You will recall that features of Model I behaviour include the following:
• attributing negative motives to others
• making negative assessments of their performance
• selecting data and leaping up the ladder of inference to do this
• not testing these assumptions, largely because they are untestable
• advocating your own position, opposing the position they advocate, advocating harder in the face of opposition
• saving the other’s face by finding excuses or by blaming others.
As you read you might like to identify and make note of instances of Model I behaviour, of bypass and cover up, and of this process being undiscussible. On a more positive note, you could look for evidence of behaviour more associated with Model II.
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Experimenting with organisational learning: diagnosing a situation within an organisation
Characters
Board members of North City Primary Care NHS Trust (PCT)
Sarah Trent – Chair. Sarah is Operations Director for an IT software company, and also Chair of the Board of Trustees of a local charity.
Anne Howard – Chief Executive Jake Manning – Non-executive Director Yvonne Smith – Director of Commissioning
Karen Lyons – Director of Modernisation and Services Helen Young – PEC Chair
Leaders of other organisations in the local health economy
Colin Everett – Chief Executive of St Edward’s Hospital NHS Trust, a two-star District General Hospital
Setting
North City PCT has a budget of £150million with which to provide services for 130,000 people. Together with South City PCT it covers the whole of the area served by the City Council, a unitary authority. It purchases acute services from two hospital trusts: St Edward’s, a local hospital offering a broad range of secondary services to people living within the city; and the County Hospital, a teaching hospital also offering many secondary services and a specialist provider of tertiary services across a much wider area (to some 90 PCTs in all).
North City is a two-star PCT, as is South City. Both PCTs were established 2 years ago.