The findings in this study suggest that understanding collective learning processes contributes to knowledge about technology adoption and organizational innovation, an area of research that has been conducted almost exclusively using an organization-level lens. Our study suggests an important role for a group-Level lens, with attention to how interdependent team members view a technology and the nature of the challenge it presents. How a technology is framed can make the challenge of learning compelling and exciting rather than threatening and painful. This study also calls attention to the role of team leaders rather than the role of senior management in leading change...they suggested that face-to-face leadership and teamwork can allow organizations to adapt successfully when confronted with new technology that threatens existing routines. These findings suggest the potential to impose an additional challenge on surgeons -- and other team and project leaders, who already carry the weight of many burdens. Adding to their need to be skilled individual contributors maintaining sophisticated technical expertise, they may also need to be skilled team leaders who can manage a project and create an environment I n which team learning can occur. Similarly, engineers are asked to be leaders in technical firms, which increasingly rely on teams to carry out strategically important projects, including adopting external innovations and developing new technologies internally. (Edmondson, Bohmer & Pisano, 2001, p. 685)
The work establishes a strong connection between learning context and adaptation to change in traditionally hierarchical models, of which the anesthesiology, nurse anesthetist team has been in the past. Learning curves and standards are expressed as integral to the development of seamless transition in technology by autonomous individuals who must work together for a common goal.
The findings of the final article reveal that though nurse anesthetists believe there is congruency in the safety culture in the institutions they work, they do not always feel like everything gets done the way it should to protect the patient. Though there are differences in the roles of aviators and nurse anesthetists the article does offer suggestions for how the hospital environment can be altered to better produce a safer place for workers and individual patients.
We found a few similarities between hospital personnel and navy aviators regarding specific safety climate features covered by the matched questions (Table 1, right column). In both sectors respondents were highly uniform in their belief that their institution is committed to and has a good reputation for safety. They both expressed concern about the level of resources provided for them to accomplish their jobs, although health care workers were even more concerned than aviators about the effect on safety of a loss of experienced personnel (Question 2). Nonetheless, for most questions on all aspects of safety climate we saw low rates of problematic response by naval aviators (generally under 10%) and a higher rate of problematic response in health care workers, by a factor of three or more (Table 1, right column). (Gaba, Singer, Sinaiko, Bowen & Ciavarelli, 2003, p. 173)
The value of a safety culture is essential to the establishment of clear and defined roles in autonomy, technology and transitions of both.
Each of these articles stress personal advocacy and the essential need for greater communication and teamwork to develop a safer transition and a more effective learning and caring environment for teams working together to develop skills for autonym of CRNAs. The information of each is slightly different but the messages are clear, there is work to be done and there are set best practices that can be utilized to do such work. The conclusions I draw from this analysis are that transitions are difficult, as we all know but that we can learn from exposure to successful changes in some settings to support the transition of nurse anesthetists into amore autonomous role in a dangerous and technologically evolving profession.
Edmondson, Amy C., Richard M. Bohmer, and Gary P. Pisano. "Disrupted Routines: Team Learning and New Technology Implementation in Hospitals." Administrative Science Quarterly 46.4 (2001): 685.
Gaba, David M., et al. "Differences in Safety Climate between Hospital…