Savitz L A, Kaluzny A D, Kelly D L
Department of Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill, USA.
J Healthc Manag. 2000 Sep-Oct;45(5):307-15; discussion 315-6.
The changing healthcare environment has created a sense of urgency for continuous innovation in clinical care processes. Managers and clinicians are investing unprecedented funds and energy in the development of various clinical process innovations (CPI) such as clinical pathways, electronic workstations, and various forms of information technology. While increasing attention has been paid to the development of such initiatives, our understanding of how best to disseminate and ensure their use is limited. In this first of two articles dealing with the dissemination and use of CPI in integrated delivery systems, we present a "life cycle" model of the dissemination process and suggest opportunities for managing CPI. The management of CPI requires more than just an understanding of the factors that may facilitate or impede its implementation and use. Managers require an understanding of the actual process so that they can assess the specific implementation stage at which the organization is presently operating, and design appropriate interventions that can affect the process. A future article will identify the factors that facilitate and inhibit the process and suggest some intervention strategies.
不断变化的医疗环境催生了对临床护理流程持续创新的紧迫感。管理人员和临床医生正在投入前所未有的资金和精力来开发各种临床流程创新（CPI），如临床路径、电子工作站以及各种形式的信息技术。虽然此类举措的开发已受到越来越多的关注，但我们对如何最好地推广并确保其应用的理解却很有限。在这两篇探讨综合医疗服务体系中CPI推广与应用的文章的第一篇中，我们提出了一个推广过程的“生命周期”模型，并给出了管理CPI的机会。对CPI的管理不仅仅需要了解可能促进或阻碍其实施与应用的因素。管理人员需要了解实际流程，以便他们能够评估组织目前所处的具体实施阶段，并设计出能够影响该流程的适当干预措施。未来的一篇文章将确定促进和抑制该流程的因素，并提出一些干预策略。
