Organizational Learning and Primary Care Nurses’ Work Performance and Well-Being: A Multilevel Linear Analysis in a Developing Country

Abstract

Aim. This study aims to investigate the level of organizational learning within urban Chinese Community Health Centres and reveal its potential association with primary care nurses’ work performance and well-being. Background. Globally, there is a push to establish learning healthcare systems for complex health reform challenges. Existing studies on organizational learning mainly focus on North American and European hospital settings, offering limited insights into primary care environments, particularly in developing countries. Design. Cross-sectional study. Methods. We recruited 175 nurses from 38 community health centres in four Chinese cities (Shanghai, Shenzhen, Tianjin, and Jinan) using convenience sampling. Trained research assistants conducted face-to-face surveys, measuring organizational learning with the Learning Orientation Scale. Nurse-level outcomes included self-directed learning, quality of care, organizational commitment, and work stress. Data analysis employed multilevel linear modelling. Results. The 38 community health centres displayed a relatively high level of organizational learning, and there was a positive and significant association between organizational learning within community health centres and nurses’ self-directed learning as well as the quality of care. However, there was no significant association between organizational learning and nurses’ organizational commitment or work stress. Conclusion. This study demonstrates a high-level organizational learning capacity in urban community health centres in China. It provides a new perspective on the potential relationship between CHCs’ organizational learning and primary care nurses’ well-being and work performance. Further research is needed to clarify unexpected findings and identify factors promoting organizational learning in primary care settings. Implications for Nursing Management. In China’s evolving primary care system, nurses play a vital role amidst physician shortages. Policy should prioritize internal management reform alongside structural changes. This study highlights the importance of fostering organizational learning in primary care settings. Strategic interventions should promote a learning culture in CHCs, which may enhance nurses’ self-directed learning and improve the quality of care.