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医院单位创新研究:复杂适应系统方法。

Examining innovation in hospital units: a complex adaptive systems approach.

机构信息

Technology, Operations, and Information Management Division, Babson College, Babson Park, Wellesley, MA, 02457, USA.

Industrial Engineering and Management, Technion - Israel Institute of Technology, Haifa, Israel.

出版信息

BMC Health Serv Res. 2020 Jun 18;20(1):554. doi: 10.1186/s12913-020-05403-2.

Abstract

BACKGROUND

We are in an innovation age for healthcare delivery. Some note that the complexity of healthcare delivery may make innovation in this setting more difficult and may require more adaptive solutions. The aim of this study is to examine the relationship between unit complexity and innovation, using a complex adaptive systems approach in a hospital setting.

METHODS

We conducted a quantitative study of 31 hospital units within one hospital and use complex adaptive systems (CAS) theory to examine how two CAS factors, autonomy and performance orientation, moderate the relationship between unit complexity and innovation.

RESULTS

We find that unit complexity is associated with higher innovation performance when autonomy is low rather than high. We also find that unit complexity is associated with higher innovation performance when performance orientation is high rather than low. Our findings make three distinct contributions: we quantify the influence of complexity on innovation success in the health care sector, we examine the impact of autonomy on innovation in health care, and we are the first to examine performance orientation on innovation in health care.

CONCLUSIONS

This study tackles the long debate about the influence of complexity on healthcare delivery, particularly innovation. Instead of being subject to the influence of complexity with no means of making progress or gaining control, hospitals looking to implement innovation programs should provide guidance to teams and departments regarding the type of innovation sought and provide support in terms of time and management commitment. Hospitals should also find ways to promote and make successful pilot implementations of such innovations visible in the organization. A close connection between the targeted innovation and the overall success and performance of the hospital unit is ideal.

摘要

背景

我们正处于医疗保健提供的创新时代。有人指出,医疗保健提供的复杂性可能使这一领域的创新更加困难,可能需要更多的适应性解决方案。本研究旨在使用医院环境中的复杂适应系统 (CAS) 方法来检验单位复杂性与创新之间的关系。

方法

我们对一家医院内的 31 个医院单位进行了一项定量研究,并使用复杂适应系统 (CAS) 理论来检验两个 CAS 因素,自主性和绩效导向,如何调节单位复杂性与创新之间的关系。

结果

我们发现,当自主性较低而非较高时,单位复杂性与较高的创新绩效相关联。我们还发现,当绩效导向较高而非较低时,单位复杂性与较高的创新绩效相关联。我们的研究结果有三个明显的贡献:我们量化了复杂性对医疗保健部门创新成功的影响,我们检验了自主性对医疗保健创新的影响,我们是第一个检验绩效导向对医疗保健创新的影响。

结论

本研究解决了关于复杂性对医疗保健提供的影响的长期争论,特别是创新。医院不必在没有取得进展或控制的情况下受复杂性的影响,而应该为团队和部门提供有关所寻求的创新类型的指导,并在时间和管理承诺方面提供支持。医院还应该寻找方法,在组织中推广和展示此类创新的成功试点实施。目标创新与医院单位的整体成功和绩效之间的紧密联系是理想的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a09/7302354/8bba7f9ede30/12913_2020_5403_Fig1_HTML.jpg

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