Healthcare innovation barriers: Results of a survey of certified professional healthcare risk managers

Abstract

Medical errors cause significant patient injuries, including deaths. Innovations designed to improve quality and reduce risk are numerous, as are the barriers that prevent innovation implementation. The purpose of this research was to analyze the relationships, if any, between the independent variables of hospital bed size and organizational structure, and the dependent variable barriers to three innovations: implementing a surgical safety checklist, preventing catheter-associated urinary tract infections, and adopting patient- and family-centered care. The findings strengthen and expand existing research and serve as the foundation for understanding barriers to implementation of three healthcare innovations. Future research should focus on organizational culture instead of innovation-specific barriers and should incorporate other independent variables, such as organizational profitability.

Innovation implementation in the context of hospital QI: lessons learned and strategies for success

“…At the organizational level, several articles have [25][26][27][28][29]36,37 Other studies that have used frameworks like the Barriers Scale and Middle Manager's role in innovation implementation have also found support for individual components of the Innovation Implementation Framework, like "presence of a champion" and "support from management." [30][31][32][33][34] At the clinician level, applications of frameworks like Disruptive Innovation theory, Deskilling and Adaptation, and Sense-Making theory, among others, have helped to demonstrate the crucial role of "innovation-values fit" for enabling behavior change and innovation implementation among frontline clinicians. [44][45][46] Also, several retrospective studies have stressed the role of "innovation attributes" as an important contextual variable in understanding implementation success.…”

“…It also articulated the need for future research on the role of contextual variables, like culture of patient safety, for innovation implementation. 34,54 Similarly, André and Sjøvold 56 used the Systematizing Person-Group Relations framework to compare the factors characterizing the work environment in a hospital unit that successfully implemented change to a unit that was unsuccessful. The framework applies six different dimensions, …”

Innovation Implementation in the Context of Hospital QI-Lessons Learned and Strategies for Success

“…[30][31][32][33] Even studies that did not explicitly incorporate the Helfrich et al framework have found support for its components. [34][35][36][37][38][39][40][41]54 For example, Bunting 34 compared the perceptions of implementation barriers among hospital risk managers by bed size and organizational structure for three innovations: surgical safety checklist, catheter-associated urinary tract infections, and patient-and family-centered care. The study used the "Barriers Scale," to measure barriers related to adoption, organizational, innovation, and communication.…”

“…It also articulated the need for future research on the role of contextual variables, like culture of patient safety, for innovation implementation. 34,54 Similarly, André and Sjøvold 56 used the Systematizing Person-Group Relations framework to compare the factors characterizing the work environment in a hospital unit that successfully implemented change to a unit that was unsuccessful. The framework applies six different dimensions, each representing different behavior in a work environment: synergy, withdrawal, opposition, dependence, control, and nurture.…”

Patient safety: This is public health

“…Others are broader, but include patient safety as a key component. The field of healthcare risk management, for instance, has evolved from its historical roots in financial risk to take on a more proactive approach in which patient safety improvement is the “number one goal.” The Certified Professional in Healthcare Risk Management designation associated with the American Society for Healthcare Risk Management, and the Certified Professional in Healthcare Quality designation associated with the National Association for Healthcare Quality fall under this category, and both are widely held among patient safety practitioners.…”