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利用蓝图促进数字健康计划中的组织间知识转移——对英国医院国家变革计划的定性探索。

Using Blueprints to promote interorganizational knowledge transfer in digital health initiatives-a qualitative exploration of a national change program in English hospitals.

机构信息

Institute for the Study of Science, Technology and Innovation, The University of Edinburgh, Edinburgh, UK.

Usher Institute, The University of Edinburgh, Edinburgh, UK.

出版信息

J Am Med Inform Assoc. 2021 Jul 14;28(7):1431-1439. doi: 10.1093/jamia/ocab020.

Abstract

OBJECTIVE

The Global Digital Exemplar (GDE) Program is a national attempt to accelerate digital maturity in healthcare providers through promoting knowledge transfer across the English National Health Service (NHS). "Blueprints"-documents capturing implementation experience-were intended to facilitate this knowledge transfer. Here we explore how Blueprints have been conceptualized, produced, and used to promote interorganizational knowledge transfer across the NHS.

MATERIALS AND METHODS

We undertook an independent national qualitative evaluation of the GDE Program. This involved collecting data using semistructured interviews with implementation staff and clinical leaders in provider organizations, nonparticipant observation of meetings, and key documents. We also attended a range of national meetings and conferences, interviewed national program managers, and analyzed a range of policy documents. Our analysis drew on sociotechnical principles, combining deductive and inductive methods.

RESULTS

Data comprised 508 interviews, 163 observed meetings, and analysis of 325 documents. We found little evidence of Blueprints being adopted in the manner originally conceived by national program managers. However, they proved effective in different ways to those planned. As well as providing a helpful initial guide to a topic, we found that Blueprints served as a method of identifying relevant expertise that paved the way for subsequent discussions and richer knowledge transfers amongst provider organizations. The primary value of Blueprinting, therefore, seemed to be its role as a networking tool. Members of different organizations came together in developing, applying, and sustaining Blueprints through bilateral conversations-in some circumstances also fostering informal communities of practice.

CONCLUSIONS

Blueprints may be effective in facilitating knowledge transfer among healthcare organizations, but need to be accompanied by other evolving methods, such as site visits and other networking activities, to iteratively transfer knowledge and experience.

摘要

目的

全球数字典范(GDE)计划是一项国家尝试,通过在整个英国国家卫生服务体系(NHS)内促进知识转移,来加速医疗保健提供者的数字化成熟度。“蓝图”-捕获实施经验的文档-旨在促进这种知识转移。在这里,我们探讨了蓝图是如何被概念化、制作和使用的,以促进 NHS 内的组织间知识转移。

材料和方法

我们对 GDE 计划进行了独立的国家定性评估。这涉及使用与提供者组织中的实施人员和临床领导者进行半结构化访谈、对会议进行非参与观察以及关键文件收集数据。我们还参加了一系列国家会议和会议,采访了国家项目经理,并分析了一系列政策文件。我们的分析借鉴了社会技术原则,结合了演绎和归纳方法。

结果

数据包括 508 次访谈、163 次观察会议和对 325 份文件的分析。我们发现,蓝图几乎没有按照国家项目经理最初设想的方式被采用。然而,它们以不同于计划的方式证明是有效的。除了为主题提供有用的初步指南外,我们还发现蓝图可以作为识别相关专业知识的一种方法,为提供者组织之间的后续讨论和更丰富的知识转移铺平道路。因此,蓝图的主要价值似乎在于它作为网络工具的作用。不同组织的成员通过双边对话共同制定、应用和维持蓝图-在某些情况下,还促进了非正式的实践社区。

结论

蓝图可能在促进医疗保健组织之间的知识转移方面有效,但需要伴随其他不断发展的方法,例如现场访问和其他网络活动,以迭代地转移知识和经验。

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