Rob Fromberg

When I was in school, I divided my classes into two categories.


One category I called “bucket” classes: You brought in an empty bucket, and the teacher filled it, usually through a lecture.

The other category I called “practice” classes.For those classes, the students put some concept to work through exercises or discussion.

“Bucket” classes were easy in some ways. It wasn’t too hard to jot down the key points from the lecture, read a bit in a textbook, and review notes before taking a test. In those classes, I certainly felt the effort of cramming new information into my head—the more information, the better the grade—but I rarely felt that my way of thinking had changed in any substantive way.

In "practice" classes, the quantity of facts I learned in the classroom was significantly less. But the quality of learning seemed higher; I could feel my thought processes changing and growing as I applied concepts repeatedly throughout the semester. In addition, I learned more at home, because home was the place where, through reading, I absorbed a lot of the material to be practiced, rather than the place where I emptied my bucket of facts in anticipation of the next class meeting.

In “Becoming a Learning Organization: The Role of Healthcare IT,” the cover story in this month’s hfm, John Glaser and J. Marc Overhage make a similar point about how organizations learn. They distinguish between acquiring information for one-time improvement and using information to instill fundamental change in the way an organization functions:

“Single-loop learning” is adjusting an action to solve or avoid a mistake based on observations of the outcomes of the action. “Double-loop learning” goes a step further: It corrects the underlying causes behind a problematic action or accentuates actions that contribute to superior performance.

As the authors point out, technology is a critical tool to fuel organizational learning: “The industry as a whole has made some gains in automating core healthcare transactions, leveraging clinical decision support, and implementing analytics to assess provider performance.” But true learning does not take place unless the technology, and the information it yields, is put into practice on a regular basis, and the authors acknowledge that is a challenge: “[M]uch work remains in ensuring that best practices are routinely followed and new knowledge is defined.”

 The dimension of change in health care—for individuals, organizations, and the system as a whole—requires more than just facts poured into a bucket. It requires that we apply the analytics necessary to transform data into information, and that we have the creativity, discipline, openness, and courage to use that information to change behavior at every level.

Each article in this issue of hfm presents both new ways of thinking and practical ways to apply those new concepts to make them part of a changing—and higher performing—healthcare organization and system. At HFMA, we like to think that every day we are helping individuals and organizations put new ideas into practice for lasting change.

Publication Date: Friday, February 01, 2013

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