Brunel University, Uxbridge, London, United Kingdom.
Eval Health Prof. 2013 Mar;36(1):93-105. doi: 10.1177/0163278712449622. Epub 2012 Jun 13.
The focus of this article is on a range of concepts of evidence employed by health care innovators in pursuing service innovations and in demonstrating their success. In-depth, semi-structured interviews were conducted with 18 key informants in the United Kingdom who had won Health Service Journal awards for successfully implementing 15 service innovations. Four concepts of evidence were identified: (a) evidence of effectiveness-both direct and indirect, (b) evidence of efficiency, (c) evidence of innovation acceptance, and (d) evidence of relevance. The results suggest that the innovators articulated evidential concepts from the main approaches prevailing in the British National Health Service, namely clinical trials and improvement cycles. Most aspired to "better" evidence than they were able to obtain, while the approach to evidence gathering was very pragmatic and was more aligned with the improvement-cycle framework. Developing supporting mechanisms for assisting innovation evaluation is an important challenge if service innovation is to be routinely attempted and achieved in health care.
本文的重点是医疗保健创新者在追求服务创新和展示其成功时所采用的一系列证据概念。我们对英国的 18 位主要知情者进行了深入的半结构化访谈，这些知情者因成功实施了 15 项服务创新而获得了《卫生服务杂志》的奖项。确定了四个证据概念：（a）有效性证据——直接和间接的，（b）效率证据，（c）创新接受证据，以及（d）相关性证据。结果表明，创新者从英国国家卫生服务系统中主要流行的方法，即临床试验和改进周期中阐述了证据概念。大多数人渴望获得比他们能够获得的“更好”的证据，而证据收集的方法非常务实，与改进周期框架更为一致。如果要在医疗保健中常规尝试和实现服务创新，那么开发支持创新评估的辅助机制是一个重要挑战。
