Improving cross-learning in clinical teams using daily on-site reflective meetings

Nawal Khattabi^1*Ros Axel^2,3Reem Al Abdulmalik^1*Amal Al-Ali¹Erik Hollnagel^2,4,5,6,7

• ¹Primary Health Care Corporation, Doha, Qatar
• ²Jönköping Academy for Improvement of Health and Welfare, Jönköping, Sweden
• ³Futurum – Academy for Healthcare, Jönköping, Sweden
• ⁴Linköping University, Linköping, Sweden
• ⁵Macquarie University, Sydney, Australia
• ⁶École des Mines de Paris, Paris, France
• ⁷University of Southern Denmark, Southern Denmark, Denmark

Introduction: Learning is necessary to improve patient safety and quality in healthcare.Complying with the orthodox safety legacy (1), organizations have focused on learning from unsuccessful performances, such as accidents, incidents, or near-misses (2).However, contemporary safety thinking emphasizes the importance of learning from everyday work that goes well (3). This approach to learning is less common in the healthcare system and does not carry the same sense of urgency as learning from work that does not go well. Broadening an organization's learning strategies to include learning from everyday work requires adopting new methods and mindsets. Methods: This study describes the experience of implementing the Resilient Performance Enhancement Toolkit (RPET) in a multisite primary care organization. RPET was introduced through structured daily reflective meetings aimed at fostering cross learning, team adaptation and real-time reflection. Qualitative feedback and thematic observations were collected to explore its impact. Results: The use of RPET varied across 27 Health Centers (HC), with seven early adopters (29 teams) maintaining consistent practices despite pandemic disruptions. By 2023, meeting frequency stabilized, ranging from daily to monthly. Teams reported improvements in patient safety, communication, and team learning, while identifying challenges such as time constraints and interdepartmental coordination. Key benefits included enhanced teamwork, increased risk identification and improved staff morale.Embedding reflective practices into daily routines through RPET can strengthen organizational learning and resilience. This approach offers a practical method for shifting healthcare systems toward proactive, Safety-II aligned strategies that support continuous improvement in dynamic clinical environments.