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Do written mandatory accreditation standards for residential care positively model learning organizations? Textual and critical discourse analysis


Bell, E and Robinson, A and See, C, Do written mandatory accreditation standards for residential care positively model learning organizations? Textual and critical discourse analysis, International Journal of Nursing Studies, 50, (11) pp. 1446-1458. ISSN 0020-7489 (2013) [Refereed Article]

Copyright Statement

Copyright 2013 Elsevier Ltd.

DOI: doi:10.1016/j.ijnurstu.2013.01.011


Background: Unprecedented global population ageing accompanied by increasing com- plexity of aged care present major challenges of quality in aged care. In the business literature, Senge’s theory of adaptive learning organisations offers a model of organisational quality. However, while accreditation of national standards is an increasing mechanism for achieving quality in aged care, there are anecdotal concerns it creates a ‘minimum standards compliance mentality’ and no evidence about whether it reinforces learning organisations. Objective: The research question was ‘Do mandatory national accreditation standards for residential aged care, as they are written, positively model learning organisations?’. Method: Automatic text analysis was combined with critical discourse analysis to analyse the presence of learning concepts from Senge’s learning organisation theory in an exhaustive sample of national accreditation standards from 7 countries. The two stages of analysis were: (1) quantitative mapping of the presence of learning organisation concepts in standards using Bayesian-based textual analytics software and (2) qualitative critical discourse analysis to further examine how the language of standards so identified may be modelling learning organisation concepts. Results: The learning concepts ‘training’, ‘development’, ‘knowledge’, and ‘systems’ are present with relative frequencies of 19%, 11%, 10%, and 10% respectively in the 1944 instances, in paragraph-sized text blocks, considered. Concepts such as ‘team’, ‘integration’, ‘learning’, ‘change’ and ‘innovation’ occur with 7%, 6%, 5%, 5%, and 1% relative frequencies respectively. Learning concepts tend to co-occur with negative rather than positive sentiment language in the 3176 instances in text blocks containing sentiment language. Critical discourse analysis suggested that standards generally use the language of organisational change and learning in limited ways that appear to model ‘learning averse’ communities of practice and organisational cultures. Conclusion: The aged care quality challenge and the role of standards need rethinking. All standards implicitly or explicitly model an organisation of some type. If standards can model a limited and negative learning organisation language, they could model a well- developed and positive learning organisation language. In the context of the global aged care crisis, the modelling of learning organisations is probably critical for minimal competence in residential aged care and certainly achievable in the language of standards.

Item Details

Item Type:Refereed Article
Research Division:Human Society
Research Group:Policy and administration
Research Field:Health policy
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Health policy evaluation
UTAS Author:Bell, E (Associate Professor Erica Bell)
UTAS Author:Robinson, A (Professor Andrew Robinson)
ID Code:85325
Year Published:2013
Web of Science® Times Cited:5
Deposited By:UTAS Centre for Rural Health
Deposited On:2013-06-28
Last Modified:2014-05-08

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