Organisational learning in hospital systems during the COVID-19 pandemic: a qualitative study

Objectives and design During the COVID-19 pandemic, hospitals were required to rapidly adapt processes, policies and care models. The crisis highlighted the need for organisational learning to navigate uncertainty and disruption. A descriptive qualitative study was undertaken to explore the experiences of Canadian hospitals during the COVID-19 pandemic including how learning took place. Semistructured interviews were conducted and analysed using a hybrid approach (deductive and inductive analysis) thematic analysis. Setting The study involved 118 participants from 6 hospital systems. Results Four themes emerged: (1) changing information at an accelerated pace, (2) feeling overwhelmed and mistrust in leadership, (3) transferring knowledge through multiple communication channels and (4) making sense of and adapting to emerging evidence from multiple sources collectively. Conclusions Hospitals engaged in rapid decision-making and learning to adapt during the COVID-19 pandemic. Our findings illustrate core concepts in organisational learning, sensemaking, boundary spanning and knowledge brokering. Key enablers included multidirectional information flow, diverse communication tools and the role of individuals translating evidence into practice. These insights can inform strategies to strengthen learning and adaptation in future healthcare crises.