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创新实践的组织维度:门诊物理治疗实践中支持创新采用过程的定性研究。

Organizational Dimensions of Innovative Practice: A Qualitative Investigation of the Processes Supporting Innovation Adoption in Outpatient Physical Therapy Practice.

作者信息

Sabus Carla, Spake Ellen

机构信息

Dep. of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, 3901 Rainbow, Mail Stop 2002, Kansas City, KS 66160, USA. Tel 913-588-6736; fax 913-588-4568.

出版信息

J Allied Health. 2018 Spring;47(1):25-34.

Abstract

BACKGROUND

The ability to innovate and adapt practice is a requirement of the progressive healthcare provider. Innovative practice by rehabilitation providers has largely been approached as personal professional development; this study extends that perspective by examining innovation uptake from the organizational level. The varied professions can be expected to have distinct qualities of innovation adoption that reflect professional norms, values, and expectations. The purpose of this qualitative study was to describe the organizational processes of innovation uptake in outpatient physical therapy practice.

DESIGN

Through nomination, two outpatient, privately owned physical therapy clinics were identified as innovation practices. Eighteen physical therapists, three owners, and a manager participated in the study.

METHODS

The two clinics served as case studies within a grounded theory approach. Data were collected through observation, unstructured questioning, work flow analysis, focus group sessions, and artifact analysis. Data were analyzed and coded among the investigators.

RESULTS

A theoretical model of the innovation adoption process in outpatient physical therapy practice was developed. Elements of the model included (1) change grounded in relationship-centered care, (2) clinic readiness to accept change, and (3) clinic adaptability and resilience.

CONCLUSIONS

A social paradigm of innovation adoption informed through this research complements the concentration on personal professional development.

摘要

背景

创新和调整实践的能力是不断进步的医疗服务提供者的一项要求。康复服务提供者的创新实践在很大程度上被视为个人职业发展;本研究通过从组织层面考察创新的采用情况来拓展这一视角。不同的专业可能会有不同的创新采用特质,这些特质反映了专业规范、价值观和期望。这项定性研究的目的是描述门诊物理治疗实践中创新采用的组织过程。

设计

通过提名,两家门诊私人物理治疗诊所被确定为创新实践诊所。18名物理治疗师、3名诊所所有者和1名经理参与了该研究。

方法

这两家诊所作为扎根理论方法中的案例研究。数据通过观察、非结构化提问、工作流程分析、焦点小组讨论和工件分析收集。数据在研究人员之间进行分析和编码。

结果

建立了门诊物理治疗实践中创新采用过程的理论模型。该模型的要素包括:(1)基于以关系为中心的护理的变革;(2)诊所接受变革的准备情况;(3)诊所的适应性和恢复力。

结论

通过本研究得出的创新采用的社会范式补充了对个人职业发展的关注。

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