A proactive learning approach toward building adaptive capacity during COVID-19: A radiology case study

• Published in: Applied ergonomics 2023-07, Vol.110, p.104009, Article 104009
• Main Authors: Hegde, Sudeep, Larsen, Ethan, Torbett, Olivia, Ponnala, Siddarth, Pohl, Erin, Sze, Raymond, Schaeubinger, Monica Miranda
• Format: Article
• Language: English
• Subjects: Child; COVID-19; Hospital adaptation; Humans; Learning; Pandemics; Proactive learning; Radiography; Radiology; Resilient health care
• ISSN: 0003-6870; 1872-9126; 1872-9126
• DOI: 10.1016/j.apergo.2023.104009

The COVID-19 pandemic has challenged organizations to adapt under uncertainty and time pressure, with no pre-existing protocols or guidelines available. For organizations to learn to adapt effectively, there is a need to understand the perspectives of the frontline workforce involved in everyday operations. This study implemented a survey-tool to elicit narratives of successful adaptation based on the lived experiences frontline radiology staff at a large multispecialty pediatric hospital. Fifty-eight members of the radiology frontline staff responded to the tool between July and October of 2020. Qualitative analysis of the free-text data revealed five categories of themes that underpinned adaptive capacity of the radiology department during the pandemic: information flow, attitudes and initiative, new and adjusted workflows, availability and utilization of resources, and collaboration and teamwork. Enablers of adaptive capacity included timely and clear communication about procedures and policies from the leadership to frontline staff, and revised workflows with flexible work arrangements, such as remote patient screening. Responses to multiple choice questions in the tool helped identify the main categories of challenges faced by staff, factors that enabled successful adaptation, and resources used. The study demonstrates the use of a survey-tool to proactively identify frontline adaptations. The paper also reports a system-wide intervention resulting directly from a discovery enabled by the findings based on the use of RETIPS in the radiology department. In general, the tool could be used in concert with existing learning mechanisms, such as safety event reporting systems, to inform leadership-level decisions to support adaptive capacity. •A proactive learning tool was implemented in a pediatric radiology deparment for workers to share narratives of adaptation at the start of the COVID-19 pandemic.•Fifty eight responses were received between July and October of 2020 that provided information on how staff at various organizational levels were coping with an unprecedented situation.•Analysis of the responses revealed exemplars and patterns relating to cross-level information flows, worker initiatives, adapted workflows, utilization of resources, and collaboration and coordination of work.•Organization Learning: based on findings relating to the efficacy of timely communications to staff, the radiology leadership expanded the scope of their regular informa