Hospital learning from extreme weather events: using causal loop diagrams

Extreme weather events (EWEs) represent an important opportunity for hospital facilities managers to learn lessons to improve future hospital resilience. However, little is known about the process by which this occurs and how effectively this happens. These questions are addressed by an exploration of how individual hospital stakeholders learn about the performance of their facilities and share these lessons in the adaptation of future hospital disaster management plans. More specifically, the evidence of behavioural and social/collective learning is investigated amongst hospital stakeholders during EWEs. The data gathered from a case study of a major hospital network of four hospitals were qualitatively analysed within a constructionist ontology and interpretivist epistemology using causal loop diagrams (CLDs). This revealed how lessons were learned in the hospital network from collective stakeholder EWEs’ experiences. The findings highlight the need to develop appropriate processes and structures to capture, share and use facilities-related knowledge and embed new lessons learnt into future hospital disaster planning processes. Using Nonaka and Takeuchi's model of organizational knowledge creation, this paper presents new theoretical and practical insights for hospital facilities managers to build hospital resilience by better capturing the facilities-related lessons learnt in responding to an EWE.