ABSTRACT

This research examines the role of organizational learning capacity in enhancing innovative performance in healthcare. Innovative performance in the health sector is critical for improving service quality, patient satisfaction and cost-effectiveness. The research was conducted with the data obtained from 15 participants from each of 100 health institutions, including hospitals, health centers, family health centers, private health clinics and other health service providers.

The findings revealed that system orientation and knowledge acquisition and utilization have a strong, positive and statistically significant impact on innovative performance. These results emphasize the importance of fostering learning capacity as a strategic approach to improve innovative performance in healthcare. However, the study also found that learning orientation and knowledge sharing and dissemination orientation did not have statistically significant effects on innovative performance. The model explains 25% of the variance in innovative performance, indicating a moderate explanatory power, and the overall model is statistically significant.

While this study addresses the relationship between organizational learning capacity and innovative performance in healthcare, future research is recommended to examine the impact of other factors such as leadership, organizational culture and employee motivation and to conduct comparative studies across different countries and healthcare organizations. Such studies will contribute to the development of more comprehensive strategies for enhancing innovative performance in healthcare.

Introduction

The purpose of this study is to examine the role of organizational learning capacity in building innovative performance in healthcare services. Innovative performance in the health sector is critically important for improving service quality, ensuring patient satisfaction, and creating cost-effectiveness (1). Innovative performance is directly related to the adoption of innovative practices such as digital transformation, process improvement, and patient-centered approaches in healthcare services (2). In this context, organizational learning capacity is considered a fundamental factor for healthcare institutions to adapt to changing environmental conditions and develop innovative solutions (3).

Organizational learning capacity is defined as an organization’s ability to acquire, share, interpret, and integrate knowledge into organizational processes (4). This capacity has been noted to play a critical role in enhancing innovative performance, especially in the healthcare sector. For example, Crossan and Apaydin (5) emphasized the impact of organizational learning on innovative performance, stating that this process is a fundamental element for organizational sustainability.

Organizational learning capacity encompasses processes that promote knowledge sharing among employees, continuous education, and the creation of a culture that encourages innovative thinking. These processes contribute to the sustainable development of innovative performance in healthcare services (6). The research aims to address the impact of organizational learning capacity on innovative performance in the healthcare sector at both national and international levels, evaluating the implications of this relationship on the effectiveness of healthcare services (7).

Additionally, this study aims to reveal how organizational learning capacity can be used as a strategic tool to enhance innovative performance in the healthcare sector. In this context, the paper will also discuss which organizational learning strategies healthcare institutions should adopt to improve their innovative performance (8).

The survey used in this study was applied in healthcare institutions such as hospitals, health centers, and similar places. Within this scope, the relationship between the organizational learning capacities and innovative performances of institutions providing services at different levels in the healthcare sector was examined.

The Importance of Innovative Performance in Healthcare Services

Innovative performance in healthcare services is critically important for healthcare institutions to adapt to changing environmental conditions, increase patient satisfaction, and enhance service quality. Innovative performance is considered a driving force necessary for improving both clinical and operational processes in the health sector (9). Particularly, innovative practices such as digitalization in healthcare services, artificial intelligence applications, telehealth services, and patient-centered approaches enable healthcare institutions to gain a competitive advantage and provide sustainable services (10).

Innovative performance encompasses not only technological innovations but also restructuring organizational processes, enhancing employee competencies, and creating a culture that prioritizes patient safety (11). The importance of innovative performance in the health sector has become more evident, especially during crisis periods such as the pandemic. During the Coronavirus disease 2019 pandemic, the capacity of healthcare institutions to develop innovative solutions played a critical role in enhancing the effectiveness of patient care processes and ensuring the resilience of health systems (12).

National-level studies show that healthcare institutions in Türkiye focus on digital transformation and process improvement projects to enhance their innovative performance (1). For example, the “Health Transformation Program” implemented by the Ministry of Health is considered an important step towards increasing innovative performance (13). At the international level, it is emphasized that innovative performance increases the cost-effectiveness of healthcare services and improves patient outcomes (8).

The study by Çömlek et al. (4) also highlighted that organizational learning capacity plays a critical role in enhancing hospitals’ innovative performance. In this context, it has been stated that organizational learning capacity is a strategic tool for organizations to adapt to environmental changes and develop innovative solutions.

In this context, the importance of innovative performance in healthcare services not only enhances the competitiveness of healthcare institutions but also greatly enhances public health improvement and health system sustainability.

Definition and Importance of Organizational Learning Capacity

Organizational learning capacity is defined as an organization’s ability to acquire knowledge, share this knowledge, interpret it, and integrate it into organizational processes (14). This capacity is critical for organizations to adapt to changing environmental conditions, develop innovative solutions, and gain a competitive advantage (15). Particularly in the healthcare sector, organizational learning capacity is regarded as a strategic tool for enhancing patient safety, service quality, and operational efficiency (16).

Unlike individual learning processes, organizational learning capacity includes knowledge management and collective learning at the organizational level. This process requires the creation of a culture that encourages knowledge sharing among employees, continuous education programs, and leadership approaches that support innovative thinking (17). In the healthcare sector, enhancing organizational learning capacity is of great importance, especially in reducing errors in patient care processes and improving service quality (18).

National-level studies show that healthcare institutions in Türkiye focus on information technologies, employee training, and process improvement projects to enhance their organizational learning capacity (1). For example, the “Quality Standards in Health” implemented by the Ministry of Health are considered an important step towards improving organizational learning capacity (13). At the international level, the impact of organizational learning capacity on innovative performance has been supported by studies conducted in high-performing health systems (8, 19).

In this context, organizational learning capacity not only enables healthcare institutions to produce solutions to current problems but also allows them to develop a proactive approach to future challenges. Therefore, enhancing organizational learning capacity is seen as an indispensable element for sustainable success in the healthcare sector.

Literature Review

The construction of innovative performance in healthcare services and the role of organizational learning capacity in this process have been widely addressed in both theoretical and practical studies. This section examines the fundamental theoretical approaches to innovative performance and organizational learning capacity, as well as significant findings in the literature.

The Concept of Innovative Performance and its Importance in the Healthcare Sector

Innovative performance is defined as an organization’s ability to develop innovative ideas, implement these ideas, and evaluate the results (20). In the healthcare sector, innovative performance plays a critical role in achieving goals such as improving patient care processes, reducing costs, and enhancing service quality (11). Innovative performance encompasses not only technological innovations but also the restructuring of organizational processes and the encouragement of employees to adopt innovative thinking (9).

Innovative performance is defined as an organization’s ability to develop new products, services, or processes. The importance of knowledge sharing in enhancing this performance is significant (21). Particularly in the healthcare sector, it has been shown that an organizational culture that promotes knowledge sharing positively affects innovative performance (22). In this context, it has been noted that factors such as leadership support and employee motivation should also be considered to understand the impact of organizational learning capacity on innovative performance (15).

National-level studies show that healthcare institutions in Türkiye focus on digital transformation and process improvement projects to enhance their innovative performance (1). For example, the “Health Transformation Program” implemented by the Ministry of Health is considered an important step towards increasing innovative performance (13). This program has promoted the adoption of innovative practices to improve quality in healthcare services and ensure patient satisfaction.

Digital transformation emerges as an important factor affecting organizational learning capacity and innovative performance. Vial stated that digital transformation accelerates organizations’ processes of acquiring and sharing knowledge, thereby enhancing innovative performance (23). Studies conducted in the healthcare sector show that digital transformation improves patient care processes and increases organizational efficiency (24). Additionally, in the study by Çömlek et al. (4), it was noted that digital transformation plays a mediating role in strengthening the relationship between organizational learning capacity and innovative performance.

At the international level, it is emphasized that innovative performance increases the cost-effectiveness of healthcare services and improves patient outcomes. For example, Papanicolas and Smith (8) stated that innovative performance is a critical factor in ensuring the sustainability of health systems. Furthermore, it is noted that digital health technologies and artificial intelligence applications play an important role in enhancing innovative performance (10).

Organizational Learning Capacity and Its Role in the Healthcare Sector

Organizational learning capacity is defined as an organization’s ability to acquire, share, and integrate knowledge into processes (14). This capacity is critical for organizations to adapt to changing environmental conditions and develop innovative solutions (15). In the healthcare sector, organizational learning capacity is regarded as a strategic tool for enhancing patient safety, service quality, and operational efficiency (16).

International literature has extensively addressed the impact of organizational learning capacity on innovative performance. Fiol et al. (19) noted that organizational learning improves organizations’ strategic decision-making processes and enhances innovative performance. Goh et al. (18) emphasized that organizational learning capacity is an important factor in enhancing the performance of healthcare institutions.

Research conducted in healthcare institutions in Türkiye confirms the impact of organizational learning capacity on innovative performance. For example, Güdük and Önder (1) revealed that organizational learning capacity is a significant factor in improving quality in healthcare services and developing innovative solutions. Additionally, the “Quality Standards in Health” developed by the Ministry of Health are considered an important step towards enhancing organizational learning capacity (13).

The Relationship Between Innovative Performance and Organizational Learning Capacity

The relationship between innovative performance and organizational learning capacity is a frequently studied topic in the literature. Damanpour et al. (25) noted that organizational learning processes play a critical role in enhancing innovative performance. Studies conducted in the healthcare sector show that organizational learning capacity supports knowledge sharing and collaboration processes necessary to enhance innovative performance (18).

It is observed that studies examining the impact of organizational learning capacity on innovative performance generally focus on different sectors. For example, Crossan and Berdrow (26) emphasized the impact of organizational learning capacity on innovative performance in the manufacturing sector, stating that studies related to the healthcare sector are limited. Therefore, this study, which examines the relationship between organizational learning capacity, digital transformation, and innovative performance in the healthcare sector, aims to fill an important gap in the literature.

International research confirms the impact of organizational learning capacity on innovative performance. For instance, Edmondson et al. (16) emphasized that organizational learning capacity is a critical factor in enhancing patient safety and service quality in the healthcare sector. Studies conducted in healthcare institutions in Türkiye also support these findings (1).

Gaps in the Literature and Research Needs

Although the impact of organizational learning capacity on innovative performance has been widely addressed in the literature, it is observed that studies specific to the healthcare sector are limited. Notably, the number of studies examining the impact of organizational learning capacity on innovative performance in healthcare institutions in Türkiye is quite low. Therefore, this research aims to contribute to the literature by addressing the impact of organizational learning capacity on innovative performance in the healthcare sector at both national and international levels.

Methodology

Sample, Procedure, and Measurements

In this research, a quantitative research model was used to examine the effect of organizational learning capacity on innovative performance in healthcare services. The study was conducted with 15 participants from each of 100 healthcare institutions. Surveys were conducted with healthcare professionals such as doctors, midwives, nurses, and chief physicians. Stratified sampling was preferred to ensure that all main groups (Doctors, Nurses, Midwives, Chief Physicians) were represented in the sample. The reason for selecting 15 people from each institution was to ensure sufficient responses needed for statistical analysis, manageable time and cost, and quick accessibility of the participants. The healthcare institutions involved in the study were defined as hospitals, health centers, family health centers, and clinics. The research aims to examine the relationship between the organizational learning capacities and innovative performance of these institutions. In this regard, data obtained from different types of healthcare institutions were used to test the hypotheses of the research.

To measure organizational learning capacity, the Organizational Learning Capability Scale developed by Teo and Wang (23) was used, and to measure innovative performance, the Innovative Performance Scale developed by Wang and Ahmed (27) was utilized. In the Turkish adaptation process, the factor structure of the scales was tested with exploratory factor analysis, and reliability, as shown, was assessed with Cronbach’s Alpha coefficient.

These scales formed the basis for examining the relationships between the organizational learning capacity and innovative performance of healthcare institutions. The main hypotheses of the research are as follows:

H1:         System orientation effects hospital innovative performance positively

H2:         Climate for learning orientation effects hospital innovative performance positively

H3:         Knowledge acquisition and utilization orientation and information effects hospital innovative performance positively

H4:         Information sharing and dissemination orientation effects hospital innovative performance positively

Demographic Data

The data in Table 1 reveal that female employees are predominant in the healthcare sector (75%) and that participants show a balanced distribution in terms of position, duration of employment, and types of healthcare institutions. The research reflects the demographic and professional diversity of employees in the healthcare sector by covering different professional groups and experience levels. This situation provides an important basis for the generalizability of the results.

Validity and Reliability Analysis

According to the results of the Table 2, the internal consistency of the scale was evaluated as “very good” with a Cronbach’s Alpha value of 0.85, indicating that the survey is a reliable measurement tool (28). The Kaiser-Meyer-Olkin test result is 0.78, showing that the data are suitable for factor analysis (29). In Bartlett’s Test of Sphericity, the chi-square value was found to be 350.45 with a p-value of 0.0001, indicating that there is a sufficient relationship between variables and that factor analysis can be conducted (30).

Factor Analysis

Exploratory factor analysis was conducted with the scales. Ideal fit was obtained with Varimax rotation. The survey questions loaded on five factors as expected. Twenty-one questions loaded as system orientation, climate for learning orientation, knowledge acquisition and utilization orientation, information sharing and dissemination orientation, and firm innovative performance. The factor loadings are shown in Table 3.

Explained total variance: 62.4%; 1: System orientation, 2: Climate for Learning Orientation, 3: Information Acquisition and Usage Orientation, 4: Knowledge Sharing and Dissemination Orientation, 5: Hospital Innovative Performance.

Correlation Analysis

According to the results of Table 4, significant relationships exist between the variables.

System Orientation

• Learning Orientation Climate has a high positive correlation (0.680) with Systems Orientation. This indicates the learning climate of a systems-    oriented approach.

• Information Acquisition and Usage Orientation (0.593): There is a medium-high positive relationship. A systems-oriented approach can be emphasized the acquisition and utilization of knowledge.

• Knowledge Sharing and Dissemination Orientation (0.539): There is a medium-high positive relationship. A system-oriented approach ensures knowledge sharing.

• Hospital Innovative Performance (0.362): There is a moderate positive relationship. A system-oriented approach can contribute to improved performance.

Climate for Learning Orientation

• System Orientation (0.680): As mentioned above, there is a strong relationship between learning climate and system orientation.

• Information Acquisition and Usage Orientation (0.646): There is a medium-high positive relationship between learning climate and knowledge acquisition and utilization.

• Knowledge Sharing and Dissemination Orientation (0.540): There is a moderate-high positive relationship. Climate encourages knowledge sharing.

• Hospital Innovative Performance (0.583): There is a medium-high positive relationship. Climate can contribute to improved performance.

Information Acquisition and Usage Orientation

• System Orientation (0.593): As mentioned above, information acquisition and management are strongly related to systems orientation.

• Climate For Learning Orientation (0.646): As mentioned above, the climate for learning is strongly related to information acquisition and retention.

• Knowledge Sharing and Dissemination Orientation (0.385): There is a moderate positive relationship. Information acquisition and utilization can be leveraged through knowledge sharing.

• Hospital Innovative Performance (0.373): There is a moderate positive relationship. Information acquisition and utilization lead to improved performance.

Knowledge Sharing and Dissemination Orientation

• System Orientation (0.539): As mentioned above, knowledge sharing occurs through system orientation.

• Learning Orientation for Climate (0.540): Knowledge sharing is facilitated by a learning climate.

• Information Acquisition and Usage Orientation (0.385): knowledge sharing occurs through knowledge acquisition and utilization.

• Hospital Innovative Performance (0.447): There is a moderate positive relationship. Knowledge sharing can contribute to improved performance.

Hospital Innovative Performance

• System Orientation (0.362): As mentioned above, system orientation can be incorporated into improved performance.

• Climate For Learning Orientation (0.583): As mentioned above, the performance of the learning climate is discussed or evaluated.

• Information Acquisition and Usage Orientation (0.373): Knowledge acquisition and utilization can, therefore, be included in advanced performance.

• Knowledge Sharing and Dissemination Orientation (0.447): Can be added to the above mentioned performance.

Regression Analysis

The regression analysis results are shown in Table 5.

System Orientation

• β=0.168: System orientation has a positive effect on hospital innovative performance.

• Significance (Sig.)=0.034: This effect is statistically significant because the p-value is less than 0.05. H1 accepted.

Climate for Learning Orientation

• β=0.080: Climate for learning orientation has a positive effect on hospital innovative performance.

• Sig.=0.520: This effect is not statistically significant because the p-value is greater than 0.05. H2 not accepted.

Knowledge Acquisition and Utilization

• β=0.630: Knowledge acquisition and utilization have a strong positive effect on hospital innovative performance.

• Sig.=0.000: Since the p-value is less than 0.01, this effect is highly statistically significant. H3 accepted.

Information Sharing and Dissemination Orientation

• β=-0.200, indicating that information sharing and dissemination orientation has a negative effect on hospital innovative performance.

• Sig.=0.170: This effect is not statistically significant because the p-value is greater than 0.05. H4 not accepted.

• R²=0.250: The model explains 25% of the variance of the dependent variable, (hospital innovative performance). This indicates that the model has a moderate level of explanatory power.

• F=21.150: The overall significance test of the model shows significance.

Conclusion

This research has revealed that organizational learning capacity plays an important role in enhancing innovative performance in healthcare services. The analyses conducted have shown that organizational learning capacity has a positive and significant effect on innovative performance. Correlation and regression analyses have concluded that organizational learning capacity explains innovative performance by 65%. These findings emphasize that enhancing organizational learning capacity is a critical strategy for improving innovative performance in the healthcare sector.

Healthcare institutions need to create an organizational culture that encourages knowledge sharing to enhance their innovative performance. This can be achieved through digital platforms and regular meetings. For example, cloud computing systems can increase collaboration by allowing employees to access information from anywhere. Additionally, mobile health applications can facilitate information sharing among employees and enable faster analysis of patient data. Such digital tools will support innovative performance by accelerating organizational learning processes.

Regular training and development programs should be organized to ensure that employees acquire new skills. Training should be prioritized, especially regarding technological innovations and patient-centered approaches. In this process, artificial intelligence-supported simulations and decision support systems can be utilized. For instance, employees can be trained in patient diagnosis and treatment planning using AI-based tools. Furthermore, big data analytics tools can equip employees with the ability to extract meaningful insights from patient data and develop innovative solutions.

Leadership and management support are critical for promoting and implementing innovative ideas. Leaders can monitor employee performance using electronic health record systems and facilitate the implementation of innovative ideas. Additionally, digital tools such as telemedicine and remote health services can support leaders in making patient care processes more efficient. Such leadership approaches will enhance innovative performance by increasing organizational learning capacity.

Finally, investments should be made in innovative technologies such as digitalization and artificial intelligence in healthcare services. Internet of things technology allows medical devices to connect with each other, enabling real-time monitoring and analysis of patient data. This not only enhances patient safety but also contributes to the development of innovative solutions. Additionally, robotic technologies can be used in surgical operations and logistics processes to increase the efficiency of healthcare services.

This research has examined the relationship between organizational learning capacity and innovative performance in healthcare services. However, some recommendations can be made for future research. The impact of other factors such as leadership, organizational culture, and employee motivation on innovative performance can be investigated. Additionally, comparative studies can be conducted across different healthcare institutions and countries to examine the impact of organizational learning capacity on innovative performance in a broader context. Qualitative research methods can be used to gain a deeper understanding of how employees contribute to innovative performance. Such studies will contribute to the development of more comprehensive and effective strategies for enhancing innovative performance in healthcare services.