Innovation & growth. America's most intrepid doctors are putting health care back into the home.
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Change in Nurse Education is occurring at such a rate that interest in the management of change is increasing. This article constructs an anatomy of an innovation and considers elements which helped and hindered the change process. The innovation was the development of a new RMN curriculum which was a cooperative venture between three health districts. Continuous assessment, student centered learning and a humanistic approach were all embodied in the innovation. By interviewing the Change agents the innovations are considered in a way which highlights internal and external resistances to change. The use of planning, personal effort and a collegial approach are noted as assisting factors when used within a humanistic framework and a normative re-educative change strategy. Ownership of the innovations is seen as a measure of the strategies success.
This paper examines the characteristics of the process of innovation as applied to a range of contraceptive technologies. Whereas the understanding of how and why innovation works or does not work has grown in the past few decades in such professional fields as electronics, aviation, and optics, only the first attempts are currently under way in medicine. Borrowing from other fields, this paper proposes a theoretical underpinning to the process of innovation as it would apply to the development of medical technology. Subsequently, it documents this process with regard to contraceptive technology (oral contraceptives, injectables, intrauterine devices, implants, and surgical contraception), providing a framework of first-, second-, and third-generation definitions of development. A number of observations about the importance of certain supply- and demand-side determinants of the direction and rate of medical innovation conclude the essay.
This article examines the adoption of physician impact analysis (PIA) among active treatment hospitals in Ontario, Canada. The influence of variables from three different levels of analysis (individual, organizational and contextual) were included as well as measures of key stakeholders' (Chief Executive Officer (CEO) and Medical Chief of Staff) assessments of the attributes of the innovation. A number of conclusions were drawn. First, by adding information about the perceived attributes of the innovation the model was able to account for a larger percentage of explained variance than has been seen in related work. Secondly, the adoption of PIA within a context of written guidelines agreed to by senior management, specifying process and structure concerns, is most likely in organizations which are large and where the CEO positively evaluates the innovation.
In the complex sport of American football, teams rely on playbooks as thick as the Manhattan phone directory. But when it comes to creating innovative growth businesses-which is at least as complicated as professional football--most companies have not developed detailed game plans. Indeed, many managers have concluded that a fog enshrouds the world of innovation, obscuring high-potential opportunities. The authors believe that companies can penetrate that fog by developing growth strategies based on disruptive innovations, as defined by Clayton Christensen. Such innovations conform to a pattern: They offer an entirely new solution; they perform adequately along traditional dimensions and much better along other dimensions that matter more to target customers; and they are not initially appealing to powerful incumbents. Companies can develop customized checklists, or playbooks, by combining this basic pattern with analysis of major innovations in their markets. The key early on is to focus not on detailed financial estimates--which will always guide companies toward the markets most hostile to disruptive innovations--but on how well the innovation fits the pattern of success. It's also crucial to encourage flexibility: Companies must be willing to kill projects that are going nowhere, exempt innovations from standard development processes, and avoid burdening project teams with extra financing, which can keep them heading in the wrong direction. Companies can create competitive advantage by becoming champions at defining the pattern of successful innovations and executing against it. But as that pattern becomes obvious--and others emerge-building a sustainable advantage on innovation competencies will again prove elusive.
The gap that persists between research and practice has been highlighted by nurse practitioners. In South Africa the research-practice gap is maximized by the lack of research facilities and research utilization projects in nursing education programmes. This paper considers conceptual, empirical and pragmatic issues in an attempt to explore the complexity of the influences that may affect the integration of research into nursing practice. Issues involved in a process of transferring research-based knowledge into innovative protocols for nursing practice are also dealt with.
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PURPOSE: To describe a model that guides nurses and other healthcare professionals through a systematic process for the change to evidence-based practice. The tremendous increases in clinical research and accessibility to research findings have prepared the way for the paradigm shift from traditional and intuition-driven practice to evidence-based practice. Although several models have emerged to guide practitioners in research utilization, practitioners continue to have difficulty synthesizing empirical and contextual evidence and integrating evidence-based changes into practice. ORGANIZING FRAMEWORK: The model is based on theoretical and research literature related to evidence-based practice, research utilization, standardized language, and change theory. In this model, practitioners are guided through the entire process of developing and integrating an evidence-based practice change. The model supports evidence-based practice changes derived from a combination of quantitative and qualitative data, clinical expertise, and contextual evidence. METHODS: The model was developed using sources identified on searches of Medline, CINAHL, and systematic reviews available on the Internet. Review topics were focused on evidence-based medicine and nursing, research utilization, and change process. Other sources included clinical expertise and quality-improvement information. CONCLUSIONS: Practitioners need skills and resources to appraise, synthesize, and diffuse the best evidence into practice. Patient outcomes must reflect discipline-specific and interdisciplinary accountabilities. Collaboration between researchers and practitioners within and among disciplines will enhance the diffusion of evidence-based practice innovations.