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At least 1,081 records · Page 60Linked to original sources
PubMed1993

TQM as a managerial innovation: research issues and implications.

TQM is a managerial innovation that is likely to have profound consequences on the delivery of health services. As an innovation, it is important that attention be given to the fundamental research issues associated with implementation and impact. Using a variance and process perspective, selected research issues are identified within organizations and among work units within these organizations. The variance perspective at both the organizational and work unit level considers the explanation of impact and adoption at a particular point in time. The process perspective considers the particular steps or events in the overall adoption process. The managerial implications for each perspective are discussed.

Diffusion of Innovation↗
PubMedDate not supplied

Services marketing for the enlightened manager.

A marketing focus emphasizes the customer's perspective rather than the supplier's internal perspective. The needs of the customer determine what services are brought to the market and how they are supplied, marketed, and sold. The marketing orientation differs drastically from the production orientation on a number of key sales and marketing criteria. For example, technical innovation is seen as a means of locating new opportunities for firms with a marketing orientation, whereas a firm with production orientation sees innovation as a mechanism for cutting costs. Biomedical equipment service managers who adopt these marketing principles understand the subtle differences between products and services, and in doing so have become enlightened marketers. Enlightened service marketers define and articulate their services to the customer and provide the customer with good knowledge of the service(s) to be delivered, before they are actually delivered. The customer is able to achieve a comfort level with the service provided before it is provided.

Administrative Personnel↗
PubMed2003

Tracing technology in the Association of Academic Health Sciences Libraries.

From the beginning of the association, technology and the Association of Academic Health Sciences Libraries (AAHSL) have been intertwined. Technology was the focus of one of the first committees. Innovative applications of technology have been employed in the operations of the association. Early applications of mini-computers were used in preparing the Annual Statistics. The association's use of network communications was among the first in the country and later applications of the Web have enhanced association services. For its members, technology has transformed libraries. The association's support of the early development of Integrated Advanced Information Management Systems (IAIMS) and of its recent reconceptualization has contributed to the intellectual foundation for this revolution.

Cooperative Behavior↗
PubMedDate not supplied

'Mom & me' and healthy bones. An innovative approach to teaching bone health.

Poor bone health may lead to osteoporosis and an increased risk for fracture later in life. Peak bone mass, which is one of the most important determinants of developing osteoporosis, is accrued largely by the age of 18. Therefore, actions to maximize peak bone mass need to be taken during the childhood years. Because 80% of those affected with osteoporosis are women, it is important that young girls receive information on how to reduce their risk for this disorder. The authors have developed an educational program to help young girls learn about bone health. The specifics of the program are described in this article.

Adolescent↗
PubMedDate not supplied

Connection, regulation, and care plan innovation: a case study of four nursing homes.

We describe how connections among nursing home staff impact the care planning process using a complexity science framework. We completed six-month case studies of four nursing homes. Field observations (n = 274), shadowing encounters (n = 69), and in-depth interviews (n = 122) of 390 staff at all levels were conducted. Qualitative analysis produced a conceptual/thematic description and complexity science concepts were used to produce conceptual insights. We observed that greater levels of staff connection were associated with higher care plan specificity and innovation. Connection of the frontline nursing staff was crucial for (1) implementation of the formal care plan and (2) spontaneous informal care planning responsive to changing resident needs. Although regulations could theoretically improve cognitive diversity and information flow in care planning, we observed instances of regulatory oversight resulting in less specific care plans and abandonment of an effective care planning process. Interventions which improve staff connectedness may improve resident outcomes.

Diffusion of Innovation↗
PubMedDate not supplied

Evidence-based nursing practice: are we there yet?

The volume of evidence for nursing practice has increased as a result of research and scientific discoveries. Yet we are still struggling with the dilemma of how to get evidence into nursing practice. Estimates are that it takes 20 years before innovations are fully put into use. Research is one type of knowledge to be used in practice. Nursing and patient care would benefit from moving more toward knowledge based on research and evidence. This article reviews barriers to and facilitators of using evidence in nursing practice and discusses a model for promoting the systematic use of evidence in practice. The author also offers suggestions for increasing the evidence base of nursing practice. Using evidence in nursing practice is important for all nurses, but requires more that the attention of the individual nurse.

Diffusion of Innovation↗
PubMedDate not supplied

'Follow-on biologics': ensuring continued innovation in the biotechnology industry.

Congress adopted legislation in 1984 to encourage pharmaceutical companies to develop new drugs, while simultaneously allowing competitors to bring cheaper generic versions to market. More than twenty years later, Congress may be faced with a similar balancing act for biologics. When Congress takes up this issue, it must focus on the substantial differences that exist between biologics and drugs. It should also evaluate the patent law, which is yielding increasingly narrow patents. If additional measures are not adopted in light of the intersection of these factors, then any legislation allowing for "follow-on" biologics could stifle development of new medicines from biotechnology.

Biological Products↗
PubMedDate not supplied

The bias against new innovations in health care: value uncertainty and willingness to pay.

This paper offers a model for the bias found in willingness-to-pay valuations against new treatments. For example, this bias provides an explanation for patient preferences that make it difficult for formularies to take treatments off their lists, even when newer treatments would appear to be clearly preferable. The appeal of the model, which is based on imperfect information, is that it is consistent with rational preferences and rational behavior by patients, which are necessary for standard models and methods related to decision theory, cost-effectiveness, and efficiency.

Attitude↗
PubMed2005

Making the healthcare system safer with innovation and technology.

The way to move ahead with high-quality healthcare and patient safety is to "practice, innovate, assess, readjust, and practice some more," the administrator of the Agency for Healthcare Research and Quality (AHRQ), Carolyn Clancy, MD, said last month at the opening of the agency's 2005 patient safety and health information technology conference. This issue of The Quality Letter for Healthcare Leaders highlights several of those initiatives--ranging from improvement of the discharge process to enhancement of a Web portal that puts health plan members in the driver's seat to observing variations in patient flow--where the power of data is affecting safety and quality.

Delivery of Health Care↗
PubMed2006

The role of telemedicine in fostering health-care innovations to address problems of access, specialty shortages and changing patient care needs.

The integration of advanced technologies into health-care services promises to aid society in its transition to a coordinated, systems approach which is focused on disease prevention, enhanced wellness, chronic disease management, decision support, quality and patient safety. By incorporating such technologies, clinicians will be able to manage the growing volumes of medical information, research and decision support analytical tools. The deployment of advanced technologies will minimize the barriers of distance and geography to enhance access and facilitate the delivery of integrated health care. This will support and enhance the goals of the US federal Healthy People 2010 initiative.

Delivery of Health Care, Integrated↗
PubMed2005

Chronic disease management in rural and underserved populations: innovation and system improvement help lead to success.

Successful implementation of disease management (DM) is based on the ability of an organization to overcome a variety of barriers to deliver timely, appropriate care of chronic illnesses. Such programs initiate DM services to patient populations while initiating self-management education among medication-resistant patients who are chronically ill. Despite formidable challenges, rural health care providers have been successful in initiating DM programs and have discovered several ways in which these programs benefit their organizations. This research reports on six DM programs that serve large rural and underserved populations and have demonstrated that DM can be successfully implemented in such areas.

Chronic Disease↗
PubMedDate not supplied

Innovations in population intervention research capacity: the contributions of Canada on the Move.

The Canada on the Move project developed within a dynamic context and in response to an expressed need for increased capacity to support research involving population-level interventions. This article describes a) the movement to create an organized approach to chronic disease prevention in Canada, b) the emerging science of population-level intervention, c) the development of Canadian infrastructure to support population intervention science, and d) the contribution of Canada on the Move in developing a health research platform and, opportunistically, instigating a study which included assessment of the population impact of a commercial marketing initiative.

Body Weight↗
PubMed2005

Measuring provider attitudes toward evidence-based practice: consideration of organizational context and individual differences.

Mental health provider attitudes toward adoption of innovation in general and toward evidence-based practice (EBP) in particular are important in considering how best to disseminate and implement EBPs. This article explores the role of attitudes in acceptance of innovation and proposes a model of organizational and individual factors that may affect or be affected by attitudes toward adoption of EBP. A recently developed measure of mental health provider attitudes toward adoption of EBP is described along with a summary of preliminary reliability and validity findings. Attitudes toward adoption of EBP are discussed in regard to provider individual differences and the context of mental health services. Finally, potential applications of attitude research to adoption of EBP are discussed.

Adolescent↗
PubMed2004

Advanced technologies in plastic surgery: how new innovations can improve our training and practice.

Over the last two decades, virtual reality, haptics, simulators, robotics, and other "advanced technologies" have emerged as important innovations in medical learning and practice. Reports on simulator applications in medicine now appear regularly in the medical, computer science, engineering, and popular literature. The goal of this article is to review the emerging intersection between advanced technologies and surgery and how new technology is being utilized in several surgical fields, particularly plastic surgery. The authors also discuss how plastic and reconstructive surgeons can benefit by working to further the development of multimedia and simulated environment technologies in surgical practice and training.

Case Management↗
PubMed1984

Health education practice and the literature.

A body of meaningful research on the effectiveness of some health education interventions is developing. The emerging health education literature changes the value of innovation for health educators. The growing availability of well-researched methods requires that health educators favor tested programs over innovation in most circumstances. But it is largely up to leaders in the field of health education to assure that, as the literature becomes more meaningful, health educators have access to that meaning. This could be accomplished in part by an ongoing program of small conferences among leading health educators designed to produce clear statements on the practice implications of new research findings. The availability and promotion of these perspectives on health education practice would help health educators deliver research-based programs despite the demand for trivia they frequently face.

Attitude↗
PubMed2001

Implementing computerized technology: an organizational analysis.

Why do some organizations succeed and others fail in implementing the innovations they adopt? To begin to answer this question, the authors studied the implementation of manufacturing resource planning, an advanced computerized manufacturing technology, in 39 manufacturing plants (number of individual respondents = 1,219). The results of the plant-level analyses suggest that financial resource availability and management support for technology implementation engender high-quality implementation policies and practices and a strong climate for implementation, which in turn foster implementation effectiveness--that is, consistent and skilled technology use. Further research is needed to replicate and extend the findings.

Computer Systems↗
PubMed1989

Innovation: frameworks for leadership during change.

Planning for development of skills needed to accomplish the desired change requires reviewing the information obtained as the leader worked to develop shared meaning and to activate the change process. Assessment of the environment and the concerns of individuals asked to participate in the change provides a wealth of information about skills individuals possess and skills they will need to develop in order to carry out the proposed change. The frameworks described here may serve as useful guideposts for nurse leaders. This article provides only highlights of each approach. In order to apply these frameworks effectively, the prospective leader is urged to consult the original sources for full descriptions of each approach.

Adaptation, Psychological↗
PubMed2000

Innovations in design and technology. The story of hip arthroplasty.

The current study reviews the early history of surgeon-initiated trial and error development in hip joint arthroplasty and the subsequent methodological evolution to proper criteria for hypothesis testing using bioengineers and other research scientists. The interplay and relationships to industry, universities, scientific organizations, and the Food and Drug Administration with respect to device development in hip arthroplasty are reviewed. The ethics of and responsibilities to involved parties are outlined, citing the history of many contemporary developments. Examples are provided from the evolution and introduction of unsuccessful innovations, and the problems inherent in the current methodology of the approval process from the Food and Drug Administration using the 5-10K, Investigative Device Exemption, and the Pre-Market Approval protocols. The pros and cons of randomized trials for devices are outlined with the conclusion that they are not appropriate for device introduction. The proper, rational methodology for introduction of new devices is a phased-in clinical trial process after pertinent bench testing. Finally, the ethical dilemmas created by managed care are addressed. Industry involvements of the surgeon-spokesmen are cited.

Device Approval↗