Introduction

A learning organization is an organization that actively encourages and supports the continuous learning and development of its employees, with the goal of improving performance, increasing innovation, and adapting to change. The concept of a learning organization was first popularized by Peter Senge in his book “The Fifth Discipline” in 1990.

In a learning organization, learning is viewed as a strategic capability that is essential to achieving the organization’s goals and objectives. This involves creating a culture of continuous learning and improvement, where employees are encouraged to experiment, take risks, and learn from their successes and failures.

Learning organizations typically exhibit the following characteristics:

1. Shared vision and goals: The organization has a clear vision and set of goals that are communicated and embraced by all employees.
2. Open communication: The organization promotes open communication, collaboration, and the sharing of knowledge and ideas.
3. Empowerment: Employees are empowered to take ownership of their work and to make decisions that contribute to the organization’s success.
4. Continuous learning: The organization provides opportunities for continuous learning and development, through training, mentoring, coaching, and other forms of support.
5. Innovation: The organization encourages innovation and creativity, and rewards employees for taking risks and developing new ideas.

By becoming a learning organization, businesses can improve their ability to adapt to changing market conditions, enhance employee engagement and satisfaction, increase innovation, and ultimately achieve better business outcomes.

Peter Senge, in his book The Fifth Discipline, described learning organizations as places “where people continually expand their capacity to create the results they truly desire, where new and expansive patterns of thinking are nurtured, where collective aspiration is set free, and where people are continually learning how to learn together.” (Peter M. Senge, The Fifth Discipline (New York: Doubleday, 1990), p. 1.) This chapter offers several ways to create an environment of continually progress.

Motivational Theory

Herzberg’s Two-Factor Theory

“One More Time: How do You Motivate Employees”

When it comes to creating a sustainable future for your Respiratory Care department, focus on the basics. Let’s start with hygiene factors and these related questions:

• working conditions: How is the daily workload for each Respiratory Therapist?
• coworker relations: When walking into the break room, how does the atmosphere feel? Are hand-off reports adequate?
• rules (i.e. policies and procedures): Are there any policies not being enforced that should be enforced?
• quality of supervision: How are the supervisors perceived?
• compensation: Are surrounding hospitals paying betting salaries or offering better incentives?

This is not an exhaustive list of questions, but should help you start asking the right questions. Be sure to be honest in your answers; especially with quality of supervision and rules.

Developing a Staffing Plan

Great staffing plans center around the organizations strategic priorities, objectives, and goals. Staffing plans are used to create and execute strategies for recruitment, development, and retention of an organizations key assets – employees.

The following steps will guide you through calculating staffing needs and creating a strategic plan.

Step 1: Identify the organizations strategic objectives or goals

Step 2: Create an Organizational Chart and outline the following

• The number of employees
• The number of full time equivalents (FTE)
• Staff assignments
• Skills and competencies
• High performers
• Potential future leaders
• Low performers
• “Flight risks”
• Anticipate retirements
• Job descriptions
• Compensation

Step 3: Create a gap analysis

Become comfortable with ambiguous information.

Here is a list of items/questions to consider when creating a gap analysis:

• What are the organizations strategic objectives?
• What work needs to be done?
• What is the current revenue to FTE ratio compared to budget?
• How many FTEs do we need to get the work done (how is productivity measured?
  • Worked Hours per Unit of Service (WHPUOS)
  • Relative Value Units (RVU)
• What skills and/or experience are necessary?
• What skill gaps need to be filled?
• What are the current turnover rates?
• Are there expected mergers or acquisitions?
• Will new technology be introduced that will impact staffing?
• Are there economic changes?
• Who are the competitors?
• What are the current and projected labor expenses?
• What is the current unemployment rate?
• How many Respiratory Therapists will graduate from local schools?
• Identify the gaps between the current state and the desired future state
• What skills your workforce lacks
• What training is needed to fill those gaps
• Which skills need to be hired for
• Which employees have strong leadership skills and are good candidates for promotion
• Rethink your structure

Step 4: Forecast future staffing needs with the following questions: (Estimations and educated guesses are welcomed and required)

Step 5: Establish metrics (using your departmental and organizational goals) to measure your forecasted staffing plan success, examples include:

1. • Labor expense
   • Productivity
   • Employee engagement
   • Employee retention
   • Turnover rate
   • Patient experience
   • Length of stay (LOS)
   • Readmissions
   • Organizations quality indicators

Step 6: Develop succession plan, performance management program, and hiring strategy

Hiring for Sustainable Success

When hiring you need a consistent methodology and process to ensure that you conduct a full assessment of candidates. The best methodology is behavioral based interview questioning. In behavioral based interviews, the candidate is asked to provide specific examples and avoids  “If that happened, I would do this” response. If the candidate does not provide a specific example, ask them to clarify their response with a specific example from their experience. Past experiences are the best predictors of future success, so it is critical that you evaluate your candidates thoroughly to make the most informed hiring decision. All hiring decisions should be made with both the current state of your department and future state in mind. It is likely better

Hiring leaders

When hiring leaders, focus on the attributes that will continue to move Respiratory Care and healthcare forward.

Critical and Strategic Thinker

• Engages in rigorous problem solving, through defining the problem, data collection, and analysis
• Makes good decisions when faced with ambiguity and uncertainty
• Recognition of patterns in complex environment
• Communications complexities in a sense of simplicity
• Sees the big picture and has long-term perspective, while balancing against short-term realities

Understands and Shapes the External Environment

• Deeply knowledgeable about Respiratory Care and the competitive, political, and social environments which the organization operates
• Understands the importance of actively engaging with and shaping these environments
• Identifies, assesses, and builds relationships with key stakeholders
• Mobilizes and directs supporting capabilities in public affairs, communications, and government relations to achieve desired outcomes

Envisions and Enacts on the Future

• Creates and communicates compelling visions of exciting and achievable futures
• Mobilizes people and transforms organizations to realize the vision
• Catalyzes innovation and builds supporting capabilities
• Is a committed steward

Builds and Leads Inclusive Teams

• Understands the value of diversity in teams and gets the best out of all people
• Establishes trust and creates a culture of psychological safety to enable candid debate
• Builds consensus; decides when necessary
• Delivers outstanding results through others

Connects and Collaborates

• Recognizes the critical importance of integration and collaboration in achieving high performance
• Convenes and nurtures cross-system teams, and works effectively in “white spaces”
• Seeks win-win outcomes and puts the well-being of the patient and overall organization first
• Leads effectively across cultures

Builds Talent Internally and Externally

• Demonstrated personal accountability for developing future generations of leaders who reflect the diversity of communities we serve
• Engages actively with colleagues in assessing and developing executive talent, focusing on competencies and character
• Invests time in coaching and mentoring high potentials for success
• Is a role model, embodying the best cultural fit

Hiring Respiratory Therapists

When hiring Respiratory Therapists, remember that your goal when hiring leaders is the same as when you are hiring for respiratory therapists. You need employees that will move the profession of Respiratory Care forward. Use the same attributes as you would for a leader and modify them to fit the role of a Respiratory Therapist. This method will create a funnel for your future leadership needs.