Knowledge sharing and organizational learning in the context of hospital infection prevention

Pavani Rangachari

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Recently, hospitals that have been successful in preventing infections have labeled their improvement approaches as either the Toyota Production System (TPS) approach or the Positive Deviance (PD) approach. PD has been distinguished from TPS as being a bottom-up approach to improvement, as against top-down. Facilities that have employed both approaches have suggested that PD may be more effective than TPS for infection prevention. This article integrates organizational learning, institutional, and knowledge network theories to develop a theoretical framework for understanding the structure and evolution of effective knowledge-sharing networks in health care organizations, that is, networks most conducive to learning and improvement. Contrary to arguments put forth by hospital success stories, the framework suggests that networks rich in brokerage and hierarchy (ie, top-down, "TPS-like" structures) may be more effective for learning and improvement in health care organizations, compared with a networks rich in density (ie, bottom-up, "PD-like" structures). The theoretical framework and ensuing analysis help identify several gaps in the literature related to organization learning and improvement in the infection prevention Context. This, in turn, helps put forth recommendations for health management research and practice.

Original languageEnglish (US)
Pages (from-to)34-46
Number of pages13
JournalQuality management in health care
Issue number1
StatePublished - Jan 1 2010

ASJC Scopus subject areas

  • Leadership and Management
  • Health(social science)
  • Health Policy
  • Care Planning


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