Patient-centered innovation in health care organizations

Hernandez, Susan E.; Conrad, Douglas A.; Marcus‐Smith, Miriam; Reed, Peter; Watts, Carolyn

doi:10.1097/hmr.0b013e31825e718a

Cited by 46 publications

(48 citation statements)

References 19 publications

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“…However, health systems are fragmented; increasing specialisation is leading to further fragmentation and disassociation [31, 54, 55]. Adoption of technological innovations also require change management, hospital restructure, and capacity building [56–58].…”

Section: Resultsmentioning

confidence: 99%

Priorities and challenges for health leadership and workforce management globally: a rapid review

Figueroa

Harrison

Chauhan

et al. 2019

BMC Health Serv Res

182

119

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Background Health systems are complex and continually changing across a variety of contexts and health service levels. The capacities needed by health managers and leaders to respond to current and emerging issues are not yet well understood. Studies to date have been country-specific and have not integrated different international and multi-level insights. This review examines the current and emerging challenges for health leadership and workforce management in diverse contexts and health systems at three structural levels, from the overarching macro (international, national) context to the meso context of organisations through to the micro context of individual healthcare managers. Methods A rapid review of evidence was undertaken using a systematic search of a selected segment of the diverse literature related to health leadership and management. A range of text words, synonyms and subject headings were developed for the major concepts of global health, health service management and health leadership. An explorative review of three electronic databases (MEDLINE®, Pubmed and Scopus) was undertaken to identify the key publication outlets for relevant content between January 2010 to July 2018. A search strategy was then applied to the key journals identified, in addition to hand searching the journals and reference list of relevant papers identified. Inclusion criteria were independently applied to potentially relevant articles by three reviewers. Data were subject to a narrative synthesis to highlight key concepts identified. Results Sixty-three articles were included. A set of consistent challenges and emerging trends within healthcare sectors internationally for health leadership and management were represented at the three structural levels. At the macro level these included societal, demographic, historical and cultural factors; at the meso level, human resource management challenges, changing structures and performance measures and intensified management; and at the micro level shifting roles and expectations in the workplace for health care managers. Conclusion Contemporary challenges and emerging needs of the global health management workforce orient around efficiency-saving, change and human resource management. The role of health managers is evolving and expanding to meet these new priorities. Ensuring contemporary health leaders and managers have the capabilities to respond to the current landscape is critical.

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Section: Resultsmentioning

confidence: 99%

Priorities and challenges for health leadership and workforce management globally: a rapid review

Figueroa

Harrison

Chauhan

et al. 2019

BMC Health Serv Res

182

119

View full text Add to dashboard Cite

show abstract

“…These are designed to act as community-based care networks ([ 3 , 4 ]). A major movement in policy making identifies the “patient-centered approach” as the key leverage for making the health care delivery system respectful of, and responsive to, the current needs and requirements ([ 5 – 8 ]). The patient-centered approach, while presenting clear statements, principles of care and operative practices, also leads to different care model designs within hospitals ([ 9 ]).…”

Section: Introductionmentioning

confidence: 99%

Evaluating organizational change in health care: the patient-centered hospital model

Fiorio

Gorli

Verzillo

2018

BMC Health Serv Res

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BackgroundAn increasing number of hospitals react to recent demographic, epidemiological and managerial challenges moving from a traditional organizational model to a Patient-Centered (PC) hospital model. Although the theoretical managerial literature on the PC hospital model is vast, quantitative evaluations of the performance of hospitals that moved from the traditional to the PC organizational structure is scarce. However, quantitative analysis of effects of managerial changes is important and can provide additional argument in support of innovation.MethodsWe take advantage of a quasi-experimental setting and of a unique administrative data set on the population of hospital discharge charts (HDCs) over a period of 9 years of Lombardy, the richest and one of the most populated region of Italy. During this period three important hospitals switched to the PC model in 2010, whereas all the others remained with the functional organizational model. This allowed us to develop a difference-in-difference analysis of some selected measures of efficiency and effectiveness for PC hospitals focusing on the “between-variability” of the 25 major diagnostic categories (MDCs) in each hospital and estimating a difference-in-difference model.ResultsWe contribute to the literature that addresses the evaluation of healthcare and hospital change by providing a quantitative estimation of efficiency and effectiveness changes following to the implementation of the PC hospital model. Results show that both efficiency and effectiveness have significantly increased in the average MDC of PC hospitals, thus confirming the need for policy makers to invest in new organizational models close to the principles of PC hospital structures.ConclusionsAlthough an organizational change towards the PC model can be a costly process, implying a rebalancing of responsibilities and power among hospital personnel (e.g. medical and nursing staff), our results suggest that changing towards a PC model can be worthwhile in terms of both efficacy and efficiency. This evidence can be used to inform and sustain hospital managers and policy makers in their hospital design efforts and to communicate the innovation advantages within the hospital organizations, among the personnel and in the public debate.

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“…There are a number of well-described facilitators and barriers to making patient-centered changes in health care (25-26), and throughout the process of program development, several of these facilitators and barriers were present. With supportive leadership, staff were able to innovate without fear of retribution if unexpected results arose.…”

Section: Discussionmentioning

confidence: 99%

Welcoming Feedback: Using Family Experience to Design a Pediatric Weight Management Program

Green

Wills

Mansfield

et al. 2018

Journal of Patient Experience

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Objective: To describe an approach using principles of experience-based codesign (EBCD) and quality improvement (QI) to integrate family experience into the development of a pediatric weight management program. Methods: Clinic development occurred in 3 plan, do, study, act (PDSA) cycles that were driven by family experience data. During these cycles, families were engaged in feedback sessions that informed program development. Staff reflected on feedback and designed and tested changes that would improve service delivery. Results: The first PDSA cycle resulted in the fundamental program parameters and a formalized patient engagement strategy. The second cycle focused on pilot programming, and feedback was used to develop the structured group program. During the third cycle, feedback sessions were embedded into the structured group programs. Program changes included focusing on health rather than weight-based outcomes, adjusting the timing of program offerings, increasing experiential learning opportunities, and providing more opportunities for peer support. Conclusions: Both EBCD and QI methodologies informed the process of family engagement and program development. This pragmatic approach might be useful for the development of other family-centered pediatric programs.

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Patient-centered innovation in health care organizations

Abstract: Patient-centered care innovation is a complex process. A general framework that could help managers and executives organize their thoughts around innovation within their organization is presented.

Cited by 46 publications

References 19 publications

Priorities and challenges for health leadership and workforce management globally: a rapid review

Priorities and challenges for health leadership and workforce management globally: a rapid review

Evaluating organizational change in health care: the patient-centered hospital model

Welcoming Feedback: Using Family Experience to Design a Pediatric Weight Management Program

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