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PubMed1995

Research review: a comparison of two theories of resistance to innovation in baccalaureate level health information management programs.

Health information management (HIM) practitioners and educators must keep abreast of changing technologies in the health care environment as well as in education. The study reported compared two explanations of resistance to innovation to determine which one best explains the variance in receptivity and proposed innovations among faculty members in HIM programs. The psychological explanation holds that organization members' receptivity to change is a function of their personalities. The sociological explanation holds that members respond to specific innovations and that they do so in terms of whether the innovation would increase or reduce their present status. The 138 faculty members of all HIM baccalaureate degree programs in the United States were queried to measure their receptivity to computer-assisted instruction and televised courses. The data were collected using four semantic differential scales. The findings revealed that status variables accounted for the greatest variance in receptivity for each innovation. Significant relationships between selected status variables and receptivity to each innovation were found. The data indicated that the respondents were moderately receptive to the innovations of computer-assisted instruction and televised courses. The study also concluded that faculty were inclined to have a positive attitude toward change.

Attitude to Computers↗
PubMed2002

The World Bank's innovation market.

Large, tradition-bound organizations can make space for radical, low-cost (and therefore low-risk) innovations. Just ask executives at the World Bank. The story of this best practice begins in 1998, when a young new-products group at the international funding agency proposed holding an Innovation Marketplace to capture novel ideas within the Bank for alleviating poverty. The forum, which eventually was opened to external participants, let people informally present their antipoverty ideas to potential funding sources. Funders could move among hundreds of booths and evaluate proposals for, say, a program that would provide postdisaster reconstruction insurance in developing countries or a vaccination development initiative. The marketplace truncated the Bank's standard project-review processes, which often stretched to a year or more, and gave funders permission to make commitments in the tens of thousands of dollars, rather than in the tens of millions more typical of Bank-financed projects. The marketplace concept met with some skepticism at the beginning. Some senior executives at the Bank felt no group had the right to spend the agency's money without following its well-established resource allocations process. But the marketplace team believed an open process for allocating grants would produce more breakthrough ideas in the long run than a centralized one. In this article, the authors describe how the new-products team brainstormed to create a market for ideas, how it got senior management's support, and how it has expanded on the original concept for these innovation marketplaces. The program's success, they contend, offers hope both for the world's poor and for business leaders looking to find new ideas under the hard crust of corporate dogma, conformance, and bureaucracy.

Cooperative Behavior↗
PubMed2000

Innovations in section 1115 demonstrations.

This article discusses how States have taken advantage of the flexibility afforded under section 1115 research and demonstration authority. It describes how States have used Section 1115 authority to develop innovations in outreach and enrollment, eligibility requirements, access, benefits, quality assurance, payment, safety net providers, and special needs populations. It concludes by discussing the future challenges that all the players in Medicaid demonstration projects are facing.

Diffusion of Innovation↗
PubMed2006

Baldridge award criteria structure encourages strategic innovation.

Guided by the criteria established for the Malcolm Baldridge National Quality Award, St. Luke's Hospital in Kansas City, MO, and Baptist Hospital, in Pensacola, FL, have regularly sustained industry leading successes in reduced employee turnover, increased patient satisfaction, improved outcomes, and financial stability over the last five years.

Awards and Prizes↗
PubMed2000

Moral decisions regarding innovation. The case method.

Little consideration has been given to the ethics of innovation in surgery despite the major role of innovation in orthopaedic practice. We propose that a series of cases of increasing ethical complexity may serve as a classification system and assist orthopaedists in thinking about the ethical dimensions of other cases.

Biomedical Technology↗
PubMedDate not supplied

The Emory experience.

The administrative nursing staff was asked to identify innovative technology that supported the mission and philosophy of the Emory Health Care System. The Directors of Nursing identified multiple high technology systems that enhance financial strength, innovation, leadership, people and workplace, and knowledge management. These systems are presented in this article.

Bed Occupancy↗
PubMed1991

Healthcare: considerations for changing practice.

Changes are rampant in the healthcare industry. Some are economically driven while others occur because of revisions in the national health policy, mandates of third party payors to alter reimbursement policies, and efforts of consumers to influence health professional's practices. As a result, healthcare institutions must monitor the quality and the cost effectiveness of their product. Yet, implementing a Quality Assurance (QA) program necessitates numerous changes on the part of all who work within an institution. A healthcare organization's leaders must have the ability to respond rapidly to the domino effects of change. For some institutions, this may mean modifying a long-standing infrastructure, purchasing new biotechnology, reorganizing staffing patterns, or revising management practices. Hence, it is important for health care providers to understand the change process. Likewise, health professionals should be aware of, and anticipate the potential responses to change. Because humans are motivated by different forces, there is need for a repertoire of strategies to address these individual needs. Ultimately, these efforts can facilitate the implementation of change. Overview of the Content: In this submission I will define common terms associated with change theory. This is followed by an overview of Lewin's and Rogers' theories of change. Subsequently, the models are applied to a household innovation (microwave oven). Finally, strategies to implement changes, specifically QA activities, are provided for the reader's consideration. The information herein is useful for management, education, as well as hypothesis development relative to research on change in healthcare.

Delivery of Health Care↗
PubMed1995

Insurance coverage for experimental technologies.

As the number and cost of new technologies grow, it is increasingly important that we develop sound policies for payment for those technologies while their clinical impacts are being defined. Such policies need to balance social interests in promotion of innovation, early access to promising technology, patient safety, control of health care costs, and return on investment. We present a rationale, policy options, and a proposal for insurance coverage of experimental technology.

Decision Making, Organizational↗
PubMed2002

The framework of pathology: good laboratory practice by quantitative and molecular methods.

Combined confocal laser scan microscopy (CLSM) and Fourier analysis (FA) by non-pathologists of dermal collagen bundle orientation recently gave results superior to subjective evaluation by experts. According to Good Laboratory Practice (GLP) criteria, combined CLSM/FA has not yet been adequately tested to replace current collagen evaluation, but this will not take long. Non-pathologists (clinicians) will then have taken over a laboratory test historically belonging to pathology. A general trend in this direction may develop, because pathologists seem not always to care enough about clinical significance, reproducibility and prognostic value, and new demands for innovative methods. Quantitative image analysis (QIA) and molecular methods are reproducible, inexpensive, and easy to perform; they often have greater value than classical evaluations and their cost-benefit ratio is good. However, their acceptance is not as widespread as one would expect and theoretical reasons which have been advanced do not provide a satisfactory explanation. A formal implementation study was therefore performed, in which an attempt was made to modernize a classical pathology laboratory. An external customer satisfaction investigation showed that 96% of the clinicians were 'very satisfied' (the highest rating possible) with the completed innovations, contrasting with low satisfaction at the beginning. Lack of primary innovative leadership among pathologists was judged to be the dominant cause preventing implementation. Pathologists should focus on carefully reacting to new clinical needs, using GLP criteria. Reproducibility and predictive accuracy should be major themes in any pathology practice.

Clinical Laboratory Techniques↗
PubMed2005

Managing knowledge and technology to foster innovation at the Ohio State University Medical Center.

Biomedical knowledge is expanding at an unprecedented rate-one that is unlikely to slow anytime in the future. While the volume and scope of this new knowledge poses significant organizational challenges, it creates tremendous opportunities to release and direct its power to the service of significant goals. The authors explain how the Center for Knowledge Management at The Ohio State University Medical Center, created during the academic year 2003-04, is doing just that by integrating numerous resource-intensive, technology-based initiatives-including personnel, services and infrastructure, digital repositories, data sets, mobile computing devices, high-tech patient simulators, computerized testing, and interactive multimedia-in a way that enables the center to provide information tailored to the needs of students, faculty and staff on the medical center campus and its surrounding health sciences colleges. The authors discuss how discovering, applying, and sharing new knowledge, information assets, and technologies in this way is a collaborative process. This process creates open-ended opportunities for innovation and a roadmap for working toward seamless integration, synergy, and substantial enhancement of the academic medical center's research, educational, and clinical mission areas.

Academic Medical Centers↗
PubMed1998

Scanning the horizon for emerging health technologies. Conclusions from a European Workshop.

To share the existing, albeit limited, experience among nations and to explore the feasibility of international collaboration on the identification and early evaluation of health care technologies, an workshop was arranged in September 1997. Twenty-seven policy makers and researchers from twelve countries attended the meeting and concluded that: the policy environment in most European countries is characterized by insufficient data on safety, effectiveness, and cost-effectiveness of health care innovations; that an early warning system is perceived as an essential mechanism for facilitating communication among policy makers, technology experts, and health professionals; and that collaboration on early warning activities might be even more useful than traditional collaboration in health technology assessment.

Diffusion of Innovation↗
PubMed1993

Management development and change in a demanding health care environment.

The problems facing many US health care organizations may prove critical for survival for many of them. Outlines the nature of the problems: increased patient demand, tensions among personnel, technological innovation, cost-conscious purchasers of care, the need to improve cost-efficiency, and barriers to change within organizations. This last presents a number of problems that may often seem intractable and are peculiar to this type of organization.

Diffusion of Innovation↗
PubMedDate not supplied

Creating market opportunities: innovation is the key.

If innovation is so easy and has such great rewards, then why is everyone not doing it? Many healthcare executives may say they just do not have the time. Some may say that the daily pressures and constant firefighting on the job sap their energy. Others may reason that they do not have the resources. These are all valid responses. However, innovation, especially our proposed evolutionary innovation, can start on a small scale and does not have to be the responsibility of one person. For example, 3M encourages employees to set aside a modest percentage of their time to explore new ideas and projects. In addition, some organizations (in and out of healthcare) have adopted "no meeting Fridays" to give staff a chance to reflect and challenge the status quo. An even simpler approach is to throw away the standard agenda for a scheduled meeting and use the time for an informal group-innovation discussion. There is a saying, "If you want things to stay the same, then something is going to have to change." The healthcare industry is changing and will continue to change, despite the best efforts on the contrary. Those who resist the tide of change should heed the parable of the boiled frog, which Peter Senge (1990), in his book The Fifth Discipline, identified as one of the many reasons for eliminating organizational learning disabilities. The lesson of the parable is simple: if you put a frog in boiling water, it will jump out; but if you put it in cold water and gradually turn up the heat, it will let itself be slowly boiled to death because it does not perceive any immediate danger. Are you aware of the gradual market threats to your organization, and are you willing to innovate before the threats reach the "boiling point"? I hope this series has introduced you to some concepts in strategic marketing. More importantly, I hope it has provided some marketing approaches that you can consider, pursue, and apply in your organization.

Diffusion of Innovation↗
PubMed2006

Healthy endothelium: the scientific basis for cardiovascular health promotion and chronic disease prevention.

The vascular endothelium plays a critical role both in health and in the pathogenesis of chronic diseases, including cardiovascular disease. This review explores the underlying role of normal endothelial function in core public health interventions for health promotion and in the prevention and control of cardiovascular disease and its risk factors, as well as the application of endothelial science toward innovative public health programs and further research. Increased collaboration among basic scientists, clinician-investigators, prevention research centers, and all public health practitioners is needed to facilitate the translation of the endothelial science into practice.

Animals↗
PubMed1998

Accelerating technology transfer: new relationships for academia, industry and government.

The budget deficit, reduction in Defense spending and the lack of return in the "peace dividend" has resulted in reduced federal funding for research. A number of programs have attempted to remedy the problem, with the use of collaborative funding as one of the major solutions. However, within the medical research community, there continues to be a very long technology transfer cycle. By mimicking the processes of non-medical high technology research and employing a number of these innovative solutions to medical research could afford the pathway to success. A template of how this could be accomplished through cooperative efforts of academia, industry and government is presented by using examples of success and failure in the past.

Academic Medical Centers↗
PubMed1999

Ambulatory anesthesia and surgery in America: a historical background and recent innovations.

This article describes the history of ambulatory surgery and anesthesia in the United States. The innovations in surgical instrumentation and techniques, newer anesthesia drugs and techniques, as well as insurance provider changes that have led to an increase in the numbers and types of surgeries performed in outpatient settings in the United States, are detailed.

Ambulatory Surgical Procedures↗
PubMed2002

What kind of evidence is it that Evidence-Based Medicine advocates want health care providers and consumers to pay attention to?

BACKGROUND: In 1992, Evidence-Based Medicine advocates proclaimed a "new paradigm", in which evidence from health care research is the best basis for decisions for individual patients and health systems. Hailed in New York Times Magazine in 2001 as one of the most influential ideas of the year, this approach was initially and provocatively pitted against the traditional teaching of medicine, in which the key elements of knowing for clinical purposes are understanding of basic pathophysiologic mechanisms of disease coupled with clinical experience. This paper reviews the origins, aspirations, philosophical limitations, and practical challenges of evidence-based medicine. DISCUSSION: EBM has long since evolved beyond its initial (mis)conception, that EBM might replace traditional medicine. EBM is now attempting to augment rather than replace individual clinical experience and understanding of basic disease mechanisms. EBM must continue to evolve, however, to address a number of issues including scientific underpinnings, moral stance and consequences, and practical matters of dissemination and application. For example, accelerating the transfer of research findings into clinical practice is often based on incomplete evidence from selected groups of people, who experience a marginal benefit from an expensive technology, raising issues of the generalizability of the findings, and increasing problems with how many and who can afford the new innovations in care. SUMMARY: Advocates of evidence-based medicine want clinicians and consumers to pay attention to the best findings from health care research that are both valid and ready for clinical application. Much remains to be done to reach this goal.

Decision Making↗