Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Diffusion of Innovation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources
PubMed1995

Analysis of telemedicine from an organizational perspective.

OBJECTIVES: To conduct an in-depth case analysis of the University of Kansas Telemedicine Program in order to identify organizational and communications elements that may be hindering the program's effectiveness. METHODS: A case analysis was done, employing a combination of methodologies (direct observation, interview, and survey) involving extensive data collection from telemedicine program personnel throughout the state of Kansas. Analysis of this program's organizational communication focused on structure and boundaries, definitions and goals, leadership and decision making, and membership and roles. RESULTS: Significant organizational communication deficits were identified. These included a dearth of perceived central leadership, lack of information about the technology itself, poorly designed and cumbersome means for scheduling and utilizing telemedicine technology, absence of explicit strategic goals; and poor communication in introducing this technology to medical personnel and to the public. Other important findings were: organizational members expanded the scope of this organization beyond the providing of a simple consultation; the perception that decision making falls into the hands of almost everyone but the referring physician; and the role that language (or lack of common terminology) plays in confusion about this innovation. CONCLUSION: Organizational factors may be critical determinants of success or failure of a telemedicine program. Innovations in telemedicine technology need to be matched by innovations in organizational communication and structure. Findings from this study can be applied to existing or planned programs. Examples include redefinition of the roles and responsibilities of certain personnel, increasing the efficiency and decreasing the complexity of the consultation scheduling process, clarification and formalization of leadership and decision making, and development of a universal terminology of telemedicine.

Academic Medical Centers↗
PubMed2001

Preparing for the future through genetics nursing education.

PURPOSE: To determine recommendations for curriculum change that are indicated by innovations in genetics. METHODS: Both quantitative and qualitative. The sample (n = 356) consisted of nurses identified as experts in genetics (n = 228) and nurses identified as potential users of genetics education (n = 128). Nurses' opinions of core components of a genetics curriculum were elicited via a mailed survey questionnaire. Participants also provided demographic information and completed the Jones Innovativeness Scale (1997). FINDINGS: Recommended content in genetics education for practicing nurses was identified by both groups of nurses. Innovativeness characterized 3% of the respondents. Ninety-eight percent of respondents said that adopting genetics education is important. In total, 398 items were identified as potential consequences of education that incorporates genetic information. CONCLUSIONS: Identified content provides a template for genetics education programs for nurses. Genetics nursing education was perceived to have positive outcomes for both nurses and clients.

Adult↗
PubMed1995

Evaluation and implementation of a research-based falls assessment innovation.

The MFS is a research-based practice innovation designed to identify patients at risk for falling. With careful selection of falls cut-off scores, it offers an effective method for identifying most patients at risk for falling. Necessary frequency of falls assessment may vary among different populations. It is important to remember that a falls assessment instrument needs to be accompanied by a strong falls prevention program.

Accidental Falls↗
PubMed2004

Innovative technologies offer new tools for DM in rural and underserved areas.

The possibilities presented by teleconferencing equipment and Internet-based applications are well-known, but scientists are now looking at the value of wearable devices that can transmit specific data regarding body functions such as energy intake and expenditure, and even sleep. The idea is to arm diabetics, the chronically obese, and disease managers with the kind of real-time information that can influence lifestyle choices when they really count.

Algorithms↗
PubMed2002

Family physicians' selection of informal peer consultants: implications for continuing education.

INTRODUCTION: Studies of physicians' preferred sources of clinical information suggest that many rely heavily on advice from colleagues. This study examines the criteria that a sample of physicians used to select informal educational consultants, the characteristics of participants adhering to these criteria and those of the peers they consult, and the participants' approaches toward evaluating information gathered from peers. METHOD: In-depth interviews were conducted with 45 family physicians from three mid-sized Ontario cities. A typology of participants' approaches for selecting informal peer consultants was developed from participants' selection criteria. Seven themes emerged from analysis across the interviews, and three types of approaches to selecting peer consultants are characterized with respect to these themes. RESULTS: When seeking clinical information, most participants reported that their first resource was informal consultation with peers. Fifty-four percent turned to readily available and approachable peers, and 24% asked only those peers they considered to be experts. The remaining participants (22%) searched the literature before or in conjunction with consulting expert specialists or innovators. Participants who sought advice from their most readily accessible peers asked for advice most frequently, rarely consulted innovators, and were least critical of the advice they received. DISCUSSION: The profiles of those who sought clinical information from their most accessible peers suggested that the quality of informal peer consultations could be improved through explicit guidelines within formal continuing education programs. Longitudinal studies are needed to examine the effectiveness of this strategy in increasing the translation of research into family physicians' clinical practices and patient outcomes.

Diffusion of Innovation↗
PubMed2006

Inventing our future: training the next generation of surgeon innovators.

Current surgical care and technology has evolved over the centuries from the interplay between creative surgeons and new technologies. As both fields become more specialized, that interplay is threatened. A 2-year educational fellowship is described which teaches both the process and the discipline of medical/surgical device innovation. Multi-disciplinary teams (surgeons, engineers, business grads) are assembled to educate a generation of translators, who can bridge the gap between scientific and technologic advances and the needs of the physician and the patient.

Child↗
PubMed1998

A framework for analyzing and improving nurse practitioners' access to research literature.

Advanced practice nurses are charged with basing their practice on research by evaluating and engaging in research studies. Review of research, however, is often hampered by the difficulty in accessing research. The breadth and depth of the literature on innovation and information dissemination demonstrate that nurse practitioners' (NPs) access to and use of the research literature are not trivial matters. This paper suggests some guidelines that may make research more accessible to the NP community. Because the issue is viewed as a problem of access, a seminal work on patients' access to healthcare services is employed to frame the discussion and proposed solutions.

Diffusion of Innovation↗
PubMed1994

Healthcare reform: innovations at the state level. Coopers & Lybrand Health Decisions Resource Group.

States are struggling to devise politically acceptable ways to curb rising healthcare costs while improving access for their uninsured residents. In general, their reform strategies attempt to increase access to quality healthcare services, reform the health insurance industry, and control healthcare costs. Additionally, states have enacted laws that provide reform in the areas of medical malpractice, the health planning process, provider availability and scope of practice, the pharmaceutical industry, and the Medicaid program.

Delivery of Health Care↗
PubMed2006

What is surgery?

Progress in surgical science has been characterized by a continuous cycle of innovation from bedside to bench to bedside. Beginning 30,000 years ago with the first bone needles to surgical lasers and robotics of today, each quantum leap has resulted from the convergence of technical advances and creative surgeons, but always defined by an attitude of care toward the sick. One of the most innovative pediatric surgeons, Dr. Mark Ravitch, elucidated some simple yet profound principles in the precise answer to the question "What is Surgery?" This section outlines some simple concepts summarized as "Ravitch's Rules," which provide a useful framework for clarity in understanding the past and illuminating the road ahead. Surgeons must be thoughtful in how they define themselves and their craft, ignoring technological advances at their own peril.

Diffusion of Innovation↗
PubMed1993

Supporting future surgical innovation. Lung transplantation as a case study.

OBJECTIVE: Using lung transplantation as a case study, this article addressed the problem of supporting innovative clinical surgery in an era of increasing pressures for cost containment. SUMMARY BACKGROUND DATA: After sporadic attempts at lung transplantation during the 1960s and 1970s, its clinical development began in earnest during the early 1980s. As a result of a wide range of incremental advances, the results have improved significantly. The Health Care Financing Administration, however, has not yet issued a national policy covering lung transplants and has left the coverage decision to the discretion of its regional contractors. METHODS: The authors surveyed the major commercial insurers, the Blue Cross Blue Shield Association, and a sample of Medicare intermediaries to evaluate the coverage of lung transplantation. They also interviewed the National Heart, Lung, and Blood Institute and industrial firms about their support for clinical research. RESULTS: Government and industry funding were limited, and the development and assessment of lung transplants have been financed predominantly by academic institutions through cross-subsidization from patient care and teaching funds. The major private payers and Blue Cross Blue Shield decided to cover this procedure in the early 1990s. Coverage decisions by Medicare intermediaries, however, revealed considerable variability. Moreover, the absence of a specific diagnosis-related group for lung transplants had considerable consequences for institutions in all-payer states, in which payments appeared to be considerably lower than the mean costs of a transplant procedure (about $110,000). CONCLUSIONS: This analysis indicated that there was a growing disparity between the increasing demand for outcomes data about new procedures and the limited resources available for supporting the development and assessment of new operations. It this disparity is not addressed, the rate of surgical innovation may be jeopardized, and timely outcomes data may not be acquired. It was concluded that provisional coverage within a predetermined research protocol may be a promising mechanism to remedy this situation, providing timely assessment of new procedures before widespread application.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1994

Innovation in health care: developments in NHS trusts.

Essential parts of the R&D in virtually all UK biomedical innovations are executed within teaching hospitals, which are undergoing major organizational changes as part of the ongoing NHS reforms. Examines the impact of the changing structural and regulatory environment on the process of biomedical innovation management of two groups of technologically novel projects with the NHS. Finds that regulatory changes were tending to centralize and formalize innovation management, but that end users were playing an active role in directing the course of new treatment development. Problems of allocation of R&D resources within teaching hospitals were still unresolved, although some evidence from the London teaching hospitals suggested that hospital managers were able to deal with conflicting demands where they perceived that research excellence could be an asset rather than a cost.

Decision Making, Organizational↗
PubMed2000

How organizational factors contribute to innovations in service delivery.

Twelve staff members from three community centers providing services to people with mental retardation were interviewed about the implementation of a new approach to service delivery that utilized Essential Lifestyle Planning. Findings indicate that although the innovation proposed and the technical assistance provided were quite similar, the outcomes varied greatly across the three sites. By highlighting the importance of organizational factors, such as timing and agency supports, these findings provide direction for future training and technical assistance activities of those who promote change in service-delivery philosophy and methods.

Adult↗
PubMed1989

Improving primary health care through technological innovation.

As a result of policy changes and developments on the demand side, the importance of technology in primary health care will grow fast. An approach to the implementation of new technologies in primary health care is presented in this article. First we describe the main problems in Dutch primary health care. The second step is to identify new technologies which are becoming available. Subsequently, the interface between these problems and their possible technological resolution has to be found. The fact that a technological innovation appears to be a solution is not sufficient reason for introducing it. There are all kinds of reasons why an innovation that has proved useful in the hospital situation, for example, might be of doubtful use in primary health care. Accordingly, the next step is to assess whether a technological solution to a problem in primary health care is indeed an improvement. To acknowledge the particular situation of primary health care, a scheme has been developed that may be used to determine criteria of evaluation.

Communication↗
PubMed2006

Ethical issues in evidence-based surgery.

Evidence-based medicine, although ostensibly concerned with the research evidence underlying claims of efficacy for surgical procedures,has a direct connection with the ethics of surgical decision making. Questions of whether new procedures should ever be performed on patients outside of a formal research protocol, what the patient should be told about the uncertainties inherent in the use of nonvalidated innovative procedures, when formal evaluation is necessary, what form that evaluation should take, and how the burdens and results of such research can be distributed fairly all involve balancing competing ethical principles. Good ethics requires good facts, and evidence from well-controlled experiments provides best information upon which to base decisions in these areas and to build ethical surgical practice.

Clinical Trials as Topic↗
PubMedDate not supplied

Nurse-managed centres: an innovative structure for nursing education and care.

The development of nursing centres in the USA began in the late 1800s with the concept of community-based nursing care provided by district and visiting nurses. Primary roles included health promotion and safeguarding hygiene in addition to caring for the sick. Established in 1893, the Henry Street Settlement in New York, a public health nursing system providing direct access to health care, became a model for other agencies in the USA.

Community Health Centers↗
PubMedDate not supplied

Prevalence of safer needle devices and factors associated with their adoption: results of a national hospital survey.

OBJECTIVES: In this study, we collected and analyzed the first data available on the extent of the adoption of safer needle devices (engineered sharps injury protections [ESIPs]) by U.S. hospitals and on the degree to which selected factors influence the use of this technology. METHODS: We gathered data via a telephone survey of a random sample of 494 U.S. hospitals from November 1999 through February 2000. RESULTS: Although 83% of the sample reported some ESIP adoption, adoption was inconsistent across types of devices. All of the appropriate units in 52% of the facilities had adopted needleless intravenous delivery systems, but the hospitals used other types of ESIPs less often. A respondent's perception that the cost of ESIPs would not be a problem for the hospital was the best predictor of adoption of ESIPs in the facility, explaining 8% of the variance. Other predictors of adoption included the size of the hospital and the presence or absence of state legislative activity on the needlestick issue. CONCLUSIONS: Smaller hospitals may require special encouragement and assistance from outside sources to adopt expensive risk-reduction innovations such as ESIPs. Although use of ESIPs is the mandated and preferred way to protect workers from needlesticks, complete adoption of this technology will depend on the support of the social systems in which it is used and the people who use it.

Attitude of Health Personnel↗
PubMed2006

To use technology better.

Although technological innovation can improve health outcomes, the precise magnitude of the contribution and its value are not easily measured. The findings reported by Jonathan Skinner and colleagues temper the favorable conclusions reached by observing correlations between improvement in heart attack outcomes over time with spending on medical products and services. Improvements in health care depend not only on producing better technologies, but also on using technology better.

Acute Disease↗
PubMed1995

Mechanical ventilation innovations: the manufacturer's perspective.

Manufacturers develop products that fit the corporate vision and maximize their return on investment. The expense and time required by the FDA regulatory approval process have a negative impact on product innovation. I propose the following approach: Reduce the amount of documentation required for a PMA or 510(k). Reduce approval times through cooperative interaction among manufacturers, clinicians, and the FDA throughout the product-development process. Allow independent agencies to provide product approvals. Efficacy assessment guidelines should be a function of the level of risk and the claims made for the marked device.

Consumer Product Safety↗