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PubMed2004

Modeling the use of innovations in private treatment organizations: the role of absorptive capacity.

Few studies have identified the organizational characteristics that are associated with the transfer of research-based treatment techniques into practice. One potentially fruitful concept is absorptive capacity, referring to an organization's ability to seek and utilize information, which may be positively associated with the use of innovative treatment techniques. This paper examines the associations between an additive measure of innovation use and three measures of absorptive capacity: environmental scanning, collection of satisfaction data, and the level of workforce professionalism. Data from a nationally representative sample of 322 privately funded substance abuse treatment centers indicate that treatment organizations use a greater number of innovations when they engage in more environmental scanning, survey referral sources, and third party payers for satisfaction, and have a more professional workforce. These results indicate the importance of absorptive capacity in predicting organizational innovativeness.

Attitude of Health Personnel↗
PubMed1997

Translating ideas into actions: entrepreneurial leadership in state health care reforms.

States are often touted as "laboratories" for developing national solutions to social problems. In this article we examine the appropriateness of this metaphor for comprehensive health care reform and attempt to draw lessons about policy innovation from recent state actions. We present evidence from six states that enacted major pieces of health care legislation in the late 1980s or early 1990s: Massachusetts, Oregon, Florida, Minnesota, Vermont, and Washington State. The variation in design casts doubt on the proposition that states can invent plans and programs for other states and the federal government to adopt for themselves. Instead, we argue that it is more accurate to think of states as specialized political markets in which individuals and groups develop and promote innovative products. We examine the factors that might create receptive markets for comprehensive health care reforms and conclude that the critical factor these states shared in common was skilled and committed leadership from "policy entrepreneurs" who formulated the plans for system reform and prominent "investors" who contributed substantial political capital to the development of the reforms. We illustrate different strategies that leaders in these states used to carry out the entrepreneurial tasks of identifying a market opportunity, designing an innovation, attracting political investment, marketing the innovation, and monitoring its early production.

Diffusion of Innovation↗
PubMed1994

Innovation under federal health care reform.

Health care reform, which seeks to expand coverage and control spending, contains mixed messages for innovators. Policies that advance reform goals are likely to shift resources away from hospitals, specialists, and expensive procedures and toward areas such as prevention and primary care where innovation may yield greater health improvements per dollar spent. The size of these effects depends critically on the extent of cost containment achieved. Constraining spending will be politically difficult because it requires that consumers forego some possible health benefits in return for lower costs. In a climate of cost containment, systematic evaluation of new technology is vital to identify and expand coverage to worthwhile innovations and to assure a fair hearing for innovators.

Cost Control↗
PubMed1996

Factors confounding the development of innovative roles and practices.

Nurse educators are critically examining current educational practices and considering new paradigms for curriculum, teaching and learning. At the same time, society's health and nursing needs are changing and the knowledge, skills and values which form the substance of the curriculum must also be reformulated. The result, at every level of nursing education, is the development, in whole or in part, of many new and different programs. Teachers are expected to teach differently; students to learn differently, and graduates to practice differently. This article, using data collected from a 4-year evaluation of an innovative nursing education program in Canada, urges nurse educators to be cautious as they engage in program and curriculum development and revision. Using student narrative data, it focuses on a number of factors which can complicate and confound faculty and curriculum intentions to develop innovative teacher, learner and nurse roles and practices.

Canada↗
PubMed2000

The Innovative Ward Project: promoting innovation in health service delivery.

An Innovative Ward Project was undertaken as part of the planning for redevelopment of the Princess Alexandra Hospital. Two inpatient units (one medical and one surgical) became pilot areas for developing, implementing and evaluating innovative approaches to service delivery. The project focused on the key areas related to structural environment, information technology and redesign of work practices. This paper provides an overview which includes the key elements utilised to foster innovation. The challenges of disseminating and adopting successful innovations beyond the Innovative Wards are discussed.

Communication↗
PubMed2004

Innovations in knowledge transfer and continuity of care.

In summary, the transfer of continuity-of-care innovations to practice is a complex process. Knowledge transfer is complex in and of itself, and in the case of continuity-of-care innovations this complexity is compounded by the need to simultaneously target multiple sectors, settings, agencies, and providers. Although there are a number of knowledge transfer theories/models, their use in guiding implementation activities is not yet commonplace. If the health-care system and patients/clients are to benefit from continuity-of-care research, researchers and implementers will need to become better versed in the knowledge transfer literature, experiment with these frameworks when implementing innovations, and test their usefulness with different innovations in different contexts.

Continuity of Patient Care↗
PubMed1995

[Public health as a social innovation].

Public Health is a social innovation of the modes how society deals with health risks before and after their occurrence. In this paper the essence of this innovation is sketched out with regard to the four stages of the Public Health Action Cycle (assessment, policy formulation, assurance, evaluation). Based on both literature surveys and own research findings several critical aspects of innovation are identified at each of these stages. At present, the bottle-neck of the intended social innovation seems to be the implementation, stabilisation, and generalisation of interventions.

Diffusion of Innovation↗
PubMed1994

Adoption of innovations by Canadian radiologists.

The purpose of this study was to determine the factors that help or hinder the adoption of new procedures and practices by Canadian radiologists. Canadian radiologists were asked, by means of a mail survey, for information about innovations in practice adopted during the previous 2 years or planned for the next 2 years. Surveys were sent to the 1077 practising radiologists registered in the Canadian Association of Radiologists as of Sept. 30, 1991; 325 responded (30.2%). The responses were correlated with demographic information obtained in the same survey and through the Maintenance of Competence Program of the Royal College of Physicians and Surgeons of Canada. Magnetic resonance imaging (MRI) was more likely to be adopted in larger communities (those with a population of more than 500,000), computed tomography in medium-sized and larger communities (more than 100,000), mammography in medium-sized and smaller communities (500,000 or less) and ultrasonography (US) in smaller communities (100,000 or less). Radiologists with a faculty appointment at a university were more likely to adopt MRI and digital imaging, whereas those with no faculty status were more likely to adopt US and structural changes to a practice. The authors conclude that the size of the community in which a practice is located and the practitioner's faculty status both play a role in the adoption of innovations.

Canada↗