Gusmão Louredo Fernanda de Sousa, Raupp Eduardo, Araujo Cláudia Affonso Silva
Federal University of Rio de Janeiro COPPEAD Institute of Administration, Rio de Janeiro, Brazil.
Health Serv Manage Res. 2024 Feb;37(1):16-28. doi: 10.1177/09514848231154758. Epub 2023 Jan 29.
There is pressure on healthcare organizations to provide high-quality care to all patients while innovating the way care is delivered. As they take on the challenge of delivering high-quality, innovative services, any gains made tend to stall before a radical change impacts key outcomes given the difficulty in sustaining innovations over time.
A systematic search was performed in 5 electronic databases using the PRISMA structure that resulted in 1313 articles, of which 260 were duplicated, leaving 1053 articles. After reading their abstracts, 877 had an inadequate scope for analysis because they did not deal with research on the sustainability of innovations. After a full assessment of the remaining 176 articles, only 10 studies met the inclusion criteria with the snowball strategy generating one additional paper, leading to 11 empirical studies. A theoretical discussion and the proposition of a framework were used to analyze the data.
Studies in university hospitals shed light on determining sustainability factors of innovations not yet fully explored such as the meaning given by individuals to innovation, culture, partnerships, and multidisciplinary collaboration, which complement the literature. This research sought to contribute to the dialogue between management theory and practice in studies on the sustainability of health innovations based on experiences observed in university hospitals. Health managers can verify how sustainability relates to the challenges presented and identify a path that helps them overcome the limitations imposed on the process. The literature shows that the understanding of sustainability as a mediating dimension can collaborate in sustained innovations in order to allow managers to identify actions related to the individual-organization dimension that may be compromising the process and thus act in a more efficient, assertive way in determining the factors that sustain ongoing innovations.
A relevant point is that innovation sustainability needs to be an objective to be achieved where managers/individuals must incorporate this perspective of innovation continuity since the beginning of the process, otherwise this may represent a greater propensity for discontinuity. This analysis can potentially be applied in university hospitals, but it can also be applicable to other types of hospitals and public or private institutions as long as it is an organization that adopts, implements, and seeks to sustain innovations in service delivery.
医疗保健组织面临着向所有患者提供高质量护理的压力，同时还要创新护理提供方式。在他们应对提供高质量创新服务的挑战时，鉴于难以长期维持创新，任何取得的进展往往在根本性变革影响关键结果之前就停滞不前。
使用PRISMA结构在5个电子数据库中进行了系统检索，共检索到1313篇文章，其中260篇重复，剩余1053篇文章。阅读摘要后，877篇文章因未涉及创新可持续性研究而分析范围不足。在对其余176篇文章进行全面评估后，只有10项研究符合纳入标准，通过滚雪球策略又增加了1篇论文，最终得到11项实证研究。运用理论探讨和框架命题对数据进行分析。
大学医院的研究揭示了尚未充分探索的创新可持续性因素，如个人对创新的理解、文化、伙伴关系和多学科协作，这些补充了现有文献。本研究旨在基于大学医院的观察经验，为健康创新可持续性研究中的管理理论与实践对话做出贡献。卫生管理人员可以验证可持续性与所面临挑战的关系，并确定一条有助于他们克服该过程中所受限制的路径。文献表明，将可持续性理解为一个中介维度可以促进持续创新，以便管理人员能够识别与个人 - 组织维度相关的可能影响该过程的行为，从而以更有效、果断的方式确定维持现有创新的因素。
一个相关要点是，创新可持续性需要成为一个要实现的目标，管理人员/个人必须从过程开始就纳入这种创新连续性的视角，否则这可能意味着更大的中断倾向。这种分析可能适用于大学医院，但只要是采用、实施并寻求维持服务提供创新的组织，也可应用于其他类型的医院以及公共或私立机构。
