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]
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.