Insourcing Health Care Innovation

Asch, David A.; Terwiesch, Christian; Mahoney, Kevin; Rosin, Roy

doi:10.1056/nejmp1401135

Cited by 49 publications

(34 citation statements)

References 0 publications

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“…Hectic‐chaotic workplaces may become more efficient by engaging the frontlines in clinical redesign using a plan‐do‐study‐act approach via an expert performance improvement team or via work‐flow mapping by the local clinical team. (Asch et al, ; Hemker & Solomon, ; Linzer et al, ; Linzer et al, ; Shanafelt & Noseworthy, ; Sinsky et al, ) The time required for administrative/clerical work on the EHR could be reduced if stakeholders refrained from adding additional administrative/clerical tasks until assessing the value relative to the impact on frontline work‐flow and well‐being. Once added, it could be regularly reviewed, revised, reduced, eliminated, simplified, streamlined, or automated.…”

Section: Discussionmentioning

confidence: 99%

Cross‐sectional survey of workplace stressors associated with physician burnout measured by the Mini‐Z and the Maslach Burnout Inventory

Olson¹,

Sinsky

Rinne³

et al. 2019

Stress and Health

148

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Rising physician burnout has adverse effects on healthcare. This study aimed to identify remediable stressors associated with burnout using the 10‐item Mini‐Z and the Maslach Burnout Inventory (MBI), and to compare performance of the Mini‐Z's single‐item burnout metric against the 22‐item MBI. Surveys were emailed to 4,118 clinicians affiliated with an academic health system; 1,252 clicked the link, and 557 responded (completion rate 44%). Four hundred seventy‐five practicing physicians were included: academic faculty (372), hospital employed (52), and private practitioners (81). Prevalence of burnout via the MBI was 56.6%. Predictors of burnout were poor control over workload [OR = 8.24, 95% CI 4.(81, 14.11)], inefficient teamwork [OR = 7.61, 95% (CI 3.28, 17.67)], insufficient documentation time [OR = 5.83, 95% (CI 3.35, 10.15)], hectic‐chaotic work atmosphere [OR = 3.49, 95% (CI 2.12, 5.74)], lack of value‐alignment with leadership [OR = 3.27, 95% (CI 2.12, 5.74)], and excessive electronic medical record time at home [OR = 1.99, 95% CI (1.21, 3.27)]. Academic faculty experienced more burnout than private practitioners (59.9% vs. 42.0%, p = 0.013). Odds of burnout associated with stressors were generally concordant via Mini‐Z's burnout metric versus the MBI. The Mini‐Z is a brief, valid method to identify stressors associated with burnout and guide interventions.

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Section: Discussionmentioning

confidence: 99%

Cross‐sectional survey of workplace stressors associated with physician burnout measured by the Mini‐Z and the Maslach Burnout Inventory

Olson¹,

Sinsky

Rinne³

et al. 2019

Stress and Health

148

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“…[38] While development teams conduct multiple usability testing cycles systematically, each session can be concisely summarized in a rapid fashion for tool iteration and to serve as a growing body of key feedback for the design team throughout the development process. This combined approach allows new development projects to efficiently iterate and optimize from usability data while preserving the potential for these projects to produce deeper insights via thorough qualitative analysis to inform further tool development and usability research by way of academic-focused dissemination.…”

Section: Discussionmentioning

confidence: 99%

Bridging the Gap Between Academic Research and Pragmatic Needs in Usability: A Hybrid Approach to Usability Evaluation of Health Care Information Systems (Preprint)

Mann¹,

Chokshi²,

Kushniruk³

2018

Preprint

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BackgroundTechnology is increasingly embedded into the full spectrum of healthcare. This movement has benefitted from the application of software development practices such as usability testing and agile development processes. These practices are frequently applied in both commercial/operational and academic settings, however the relative importance placed on rapid iteration, validity, reproducibility, generalizability and efficiency differs between the two settings and the needs and objectives of academic versus pragmatic usability evaluations. ObjectiveThis paper explores how usability evaluation typically varies on key dimensions (e.g., rapidity, validity, reproducibility) in pragmatic versus academic settings and proposes a hybrid approach aimed at satisfying both pragmatic and academic objectives. MethodsWe outline the characteristics of pragmatic versus academically-oriented usability testing in healthcare, describe the tensions and gaps resulting from differing contexts and goals, and present a model of this hybrid process along with two case studies of digital development projects in which we demonstrate this integrated approach to usability evaluation. ResultsCase studies illustrate design choices characteristic of our hybrid approach to usability evaluation. ConclusionsDesigned to leverage the strengths of both pragmatic and academically-focused usability studies, a hybrid approach allows new development projects to efficiently iterate and optimize from usability data while preserving the ability for these projects to produce deeper insights via thorough qualitative analysis to inform further tool development and usability research by way of academic-focused dissemination.

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“…One of them is going in the wrong direction with a seemingly promising approach and scaling up well before we know the approach will actually work 6. Premature scaling is expensive.…”

Section: Innovation Is Too Costlymentioning

confidence: 99%