Why organizations forget or retain lessons learned from a crisis over time: tracking COVID-19 lessons in an academic hospital in the Netherlands.

BACKGROUND: Previous research shows the need for empirical research on organizational forgetting. In this study, we explored the factors that explain organizational forgetting of lessons learned from a crisis. More specifically, we studied what lessons a hospital in the Netherlands learned from the COVID-19 outbreak and why these lessons have been forgotten (or retained) in the organization over three years’ time. METHODS: The study was carried out in two phases. In phase one, we drew on lessons learned by a hospital during the initial phase of the COVID-19 pandemic, based on a survey of all employees in August 2020. We selected four groups of lessons for further research: infection prevention measures, smart staff deployment, adequate decision-making, and interdepartmental collaboration. In phase two, three years later, we conducted 19 in-depth interviews with purposively sampled hospital employees. In the analysis, we explored if these lessons remained present in the organization and why they had been forgotten or retained over time using the organizational forgetting framework. RESULTS: We found that the hospital learned many lessons during COVID-19, which employees wished to retain. Whereas lessons learned on infection prevention measures and smart deployment of staff have largely been retained, lessons on swift decision-making and interdepartmental collaboration have largely been forgotten. We found evidence for challenges in dissemination, implementation, and storage of lessons, and organizational restructuring and a changing environment to be key drivers of organizational forgetting. Employee turnover and retrieval challenges did not emerge as important factors. However, they may become more important as more time passes after the crisis. CONCLUSIONS: This explorative study shows that although healthcare organizations may learn extensively from a crisis, they face difficulties with retaining lessons over time. Retaining lessons requires continuous monitoring and investment, even long after a crisis has ended. To retain lessons, healthcare organizations and their employees need to pay particular attention to the dissemination, implementation, and storage of lessons within and between divisions. Yet, more research on organizational forgetting is needed.