From pilot project to system solution: innovation, spread and scale for health system leaders

BMJ Leader ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 87-90 ◽  
Author(s):  
James Shaw ◽  
Joshua Tepper ◽  
Danielle Martin
Keyword(s):  
Health System ◽  
Pilot Project ◽  
Leadership Strategies ◽  
Health Innovations ◽  
Conceptual Clarity ◽  
System Solution ◽  
System Leaders ◽  
Broad Community

Promoting the scale and spread of effective health innovations requires dedicated action from health system leaders. In order to maximise the effects of leadership strategies to promote the spread and scale of health innovations, conceptual clarity and well-defined strategies are essential. In this commentary, we propose definitions of the concepts of ‘innovation’, ‘spread’ and ‘scale’, and explain how these concepts can be used by health system leaders to generate interest, excitement and commitment for specific innovations from a broad community of stakeholders. We then outline two strategies from the community organising literature that leaders can use to promote spread and scale.

Responsible innovation in health and health system sustainability: Insights from health innovators’ views and practices

2021 ◽  
pp. 095148482110486
Author(s):  
Pascale Lehoux ◽  
Hudson P Silva ◽  
Robson Rocha de Oliveira ◽  
Renata P Sabio ◽  
Kathy Malas
Keyword(s):  
Health System ◽  
System Level ◽  
Responsible Innovation ◽  
Inclusive Design ◽  
Specific System ◽  
Design Processes ◽  
Health Innovations ◽  
Intensity Of Care ◽  
Context Specific ◽  
System Sustainability

Although healthcare managers make increasingly difficult decisions about health innovations, the way they may interact with innovators to foster health system sustainability remains underexplored. Drawing on the Responsible Innovation in Health (RIH) framework, this paper analyses interviews ( n=37) with Canadian and Brazilian innovators to identify: how they operationalize inclusive design processes; what influences the responsiveness of their innovation to system-level challenges; and how they consider the level and intensity of care required by their innovation. Our qualitative findings indicate that innovators seek to: 1) engage stakeholders at an early ideation stage through context-specific methods combining both formal and informal strategies; 2) address specific system-level benefits but often struggle with the positioning of their solution within the health system; and 3) mitigate staff shortages in specialized care, increase general practitioners’ capacity or patients and informal caregivers’ autonomy. These findings provide empirical insights on how healthcare managers can promote and organize collaborative processes that harness innovation towards more sustainable health systems. By adopting a RIH-oriented managerial role, they can set in place more inclusive design processes, articulate key system-level challenges, and help innovators adjust the level and intensity of care required by their innovation.

scholarly journals Re-imagining Research: A Bold Call, but Bold Enough? Comment on "Experience of Health Leadership in Partnering with University-Based Researchers in Canada: A Call to ‘Re-Imagine’ Research"

2019 ◽  
Author(s):  
Bev J. Holmes
Keyword(s):  
Health System ◽  
Health Systems ◽  
Research Area ◽  
Evidence Use ◽  
Health System Change ◽  
Health Leadership ◽  
System Leaders ◽  
Change Projects ◽  
High Level ◽  
Partnership Models

Many articles over the last two decades have enumerated barriers to and facilitators for evidence use in health systems. Bowen et al’s article "Response to Experience of Health Leadership in Partnering with University-Based Researchers: A Call to ‘Re-imagine Research’" furthers the debate by focusing on an under-explored research area (health system design and health service organization) with an under-studied stakeholder group (health system leaders), by undertaking a broad program of research on partnerships, and, based on participant responses, by calling for re-imagining of research itself. In response to the claim that the research community is not providing expertise to this pressing issue in the health system, I provide four high level reasons: partnerships mean different things to different people, our language does not reflect the reality we want, our health systems have yet to fully embrace evidence use, and complexity is easier to talk about than act within. Bowen et al’s study, and their broader program of research, is well-placed to explore these issues further, helping identify appropriate researcher-health system leader partnership models for various health system change projects. Given the positive shifts identified in this study, and the knowledge that participants demonstrate about what needs to change, the time is right for bold action, re-imagining not only research, but healthcare, such that the production and use of evidence for better health is embraced and supported.

scholarly journals A Rapid Process for Identifying and Prioritizing Technology-Based Tools for Health System Implementation (Preprint)

2018 ◽  
Author(s):  
Emily R Dibble ◽  
Bradley E Iott ◽  
Allen J Flynn ◽  
Darren P King ◽  
Mark P MacEachern ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
Review Process ◽  
New Technology ◽  
Rapid Review ◽  
Current Evidence ◽  
Review Panel ◽  
Environmental Scan ◽  
System Leaders ◽  
Evidence Review

BACKGROUND Health system decisions to put new technologies into clinical practice require a rapid and trustworthy decision-making process informed by best evidence. OBJECTIVE This study aimed to present a rapid evidence review process that can be used to inform health system leaders and clinicians seeking to implement new technology tools to improve patient-clinician decision making and patient-oriented outcomes. METHODS The rapid evidence review process we pioneered involved 5 sequential subprocesses: (1) environmental scan, (2) expert panel recruitment, (3) host evidence review panel, (4) analysis, and (5) local validation panel. We conducted an environmental scan of health information technology (IT) literature to identify relevant digital tools in oncology care. We synthesized the recent literature using current evidence review methods, creating visual summaries for use by a national panel of experts. Panelists were taken through a 6-hour modified Delphi process to prioritize tools for implementation. Findings from the rapid evidence review panel were taken to a local validation panel for further rapid review during a 3-hour session. RESULTS Our rapid evidence review process shows promise for informing decision making by reducing the amount of time and resources needed to identify and prioritize adoption of IT tools. Despite evidence of improved patient outcomes, panelists had substantial concerns about implementing patient-reported outcome tracking tools, voicing concerns about liability, lack of familiarity with new technology, and additional time and workflow changes such tools would require. Instead, clinicians favored technologies that did not require clinician involvement. CONCLUSIONS Health system leaders can use the rapid evidence review process presented here to usefully inform local technology adoption, implementation, and use in practice.

scholarly journals Use of EHR-Based Pediatric Quality Measures: Views of Health System Leaders and Parents

2019 ◽  
Vol 35 (2) ◽  
pp. 177-185
Author(s):  
David M. Hartley ◽  
Susannah Jonas ◽  
Daniel Grossoehme ◽  
Amy Kelly ◽  
Cassandra Dodds ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health System ◽  
Health Care Quality ◽  
Quality Measures ◽  
Care Quality ◽  
Quality Data ◽  
High Confidence ◽  
System Leaders ◽  
Using Data

Measures of health care quality are produced from a variety of data sources, but often, physicians do not believe these measures reflect the quality of provided care. The aim was to assess the value to health system leaders (HSLs) and parents of benchmarking on health care quality measures using data mined from the electronic health record (EHR). Using in-context interviews with HSLs and parents, the authors investigated what new decisions and actions benchmarking using data mined from the EHR may enable and how benchmarking information should be presented to be most informative. Results demonstrate that although parents may have little experience using data on health care quality for decision making, they affirmed its potential value. HSLs expressed the need for high-confidence, validated metrics. They also perceived barriers to achieving meaningful metrics but recognized that mining data directly from the EHR could overcome those barriers. Parents and HSLs need high-confidence health care quality data to support decision making.

scholarly journals Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Multi-Country Analysis

2021 ◽  
Author(s):  
Janet E. Squires ◽  
Alison M. Hutchinson ◽  
Mary Coughlin ◽  
Kainat Bashir ◽  
Janet Curran ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Health System ◽  
The United States ◽  
Assessment Tools ◽  
Primary Role ◽  
Structured Interviews ◽  
Stakeholder Perspectives ◽  
Country Level ◽  
Conceptual Clarity ◽  
Level Of Experience

Background: Context is recognized as important to successful knowledge translation (KT) in health settings. What is meant by context, however, is poorly understood. The purpose of the current study was to elicit tacit knowledge about what is perceived to constitute context by conducting interviews with a variety of health system stakeholders internationally so as to compile a comprehensive list of contextual attributes and their features relevant to KT in healthcare. Methods: A descriptive qualitative study design was used. Semi-structured interviews were conducted with health system stakeholders (change agents/KT specialists and KT researchers) in four countries: Australia, Canada, the United Kingdom, and the United States. Interview transcripts were analyzed using inductive thematic content analysis in four steps: (1) selection of utterances describing context, (2) coding of features of context, (3) categorizing of features into attributes of context, (4) comparison of attributes and features by: country, KT experience, and role. Results: A total of 39 interviews were conducted. We identified 66 unique features of context, categorized into 16 attributes. One attribute, Facility Characteristics, was not represented in previously published KT frameworks. We found instances of all 16 attributes in the interviews irrespective of country, level of experience with KT, and primary role (change agent/KT specialist vs. KT researcher), revealing robustness and transferability of the attributes identified. We also identified 30 new context features (across 13 of the 16 attributes). Conclusion: The findings from this study represent an important advancement in the KT field; we provide much needed conceptual clarity in context, which is essential to the development of common assessment tools to measure context to determine which context attributes and features are more or less important in different contexts for improving KT success.

PP22 How Do Health System Leaders Use Evidence To Inform Action?

2018 ◽  
Vol 34 (S1) ◽  
pp. 74-75
Author(s):  
Matthew D Mitchell ◽  
C Michael White ◽  
Jeanne-Marie Guise ◽  
Lionel Bañez ◽  
Craig Umscheid ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Process Improvement ◽  
Systematic Reviews ◽  
Predictive Analytics ◽  
Structured Interview ◽  
Healthcare Research ◽  
System Quality ◽  
Study Results ◽  
System Leaders

Introduction:The US Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) program sponsors the development of systematic reviews to inform clinical policy and practice. The EPC program sought to better understand how health systems identify and use this evidence.Methods:Representatives from eleven EPCs, the EPC Scientific Resource Center, and AHRQ developed a semi-structured interview script to query a diverse group of nine Key Informants (KIs) involved in health system quality, safety and process improvement about how they identify and use evidence. Interviews were transcribed and qualitatively summarized into key themes.Results:All KIs reported that their organizations have either centralized quality, safety, and process improvement functions within their system, or they have partnerships with other organizations to conduct this work. There was variation in how evidence was identified, with larger health systems having medical librarians and central bureaus to gather and disseminate information and smaller systems having local chief medical officers or individual clinicians do this work. KIs generally prefer guidelines, especially those with treatment algorithms, because they are actionable. They like systematic reviews because they efficiently condense study results and reconcile conflicting data. They prefer information from systematic reviews to be presented as short digestible summaries with the full report available on demand. KIs preferred systematic reviews from reputable entities and those without commercial bias. Some of the challenges KIs reported include how to resolve conflicting evidence, the generalizability of evidence to local needs, determining whether the evidence is up-to-date, and the length of time required to generate reviews. The topics of greatest interest included predictive analytics, high-value care, advance care planning, and care coordination. To increase awareness of AHRQ EPC reviews, KIs suggest alerting people at multiple levels in a health-system when new evidence reports are available and making reports easier to find in common search engines.Conclusions:Systematic reviews are valued by health system leaders. To be most useful they should be easy to locate and available in different formats targeted to the needs of different audiences.

Artificial intelligence-based imaging analytics and lung cancer diagnostics: Considerations for health system leaders

2020 ◽  
pp. 084047042097506
Author(s):  
Amy Zarzeczny ◽  
Paul Babyn ◽  
Scott J. Adams ◽  
Justin Longo
Keyword(s):  
Artificial Intelligence ◽  
Lung Cancer ◽  
Health System ◽  
Knowledge Exchange ◽  
Healthcare Spending ◽  
Cancer Diagnostics ◽  
Financial Investment ◽  
Lung Cancer Diagnosis ◽  
System Leaders ◽  
Healthcare Innovation

Lung cancer is a leading cause of cancer death in Canada, and accurate, early diagnosis are critical to improving clinical outcomes. Artificial Intelligence (AI)-based imaging analytics are a promising healthcare innovation that aim to improve the accuracy and efficiency of lung cancer diagnosis. Maximizing their clinical potential while mitigating their risks and limitations will require focused leadership informed by interdisciplinary expertise and system-wide insight. We convened a knowledge exchange workshop with diverse Saskatchewan health system leaders and stakeholders to explore issues surrounding the use of AI in diagnostic imaging for lung cancer, including implementation opportunities, challenges, and priorities. This technology is anticipated to improve patient outcomes, reduce unnecessary healthcare spending, and increase knowledge. However, health system leaders must also address the needs for robust data, financial investment, effective communication and collaboration between healthcare sectors, privacy and data protections, and continued interdisciplinary research to achieve this technology’s potential benefits.

Dissemination to Health System Leaders

10.28929/087 ◽  
2017 ◽  
Author(s):  
Leah Tuzzio ◽  
David Chambers ◽  
Ellen Tambor ◽  
Jerry Suls ◽  
Beverly Green ◽  
...  
Keyword(s):  
Health System ◽  
System Leaders
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