Problems and promises of innovation: why healthcare needs to rethink its love/hate relationship with the new.
Problems and promises of innovation: why healthcare needs to rethink its love/hate relationship with the new.
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DOI：
10.1136/bmjqs.2010.046227
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发表时间：
2011-04
影响因子：
5.4
通讯作者：
Glasziou P
中科院分区：
文献类型：
--
作者：
Dixon-Woods M;Amalberti R;Goodman S;Bergman B;Glasziou P
创新通常被认为是积极的。本文表明，创新在质量改进中的作用更为复杂。作者确定了医疗保健创新的三个已知悖论。首先，一些创新扩散迅速，但价值未经证实或价值有限，或构成风险，而其他可能为患者带来好处的创新仍然缓慢实现吸收。第二，参与式合作方法可能是实现可持续的积极创新的最佳方式，但仅仅依靠这种方法可能会破坏积极创新。第三，改进显然取决于变化，但变化总是产生新的挑战。质量改进系统可能很难跟上创新的步伐，但对创新的评价往往过于狭隘，无法理解新做法或新技术的全系统影响。创新的问题提出了一个新的认识，有人认为，需要新的方法来解决这些问题。
Innovation is often regarded as uniformly positive. This paper shows that the role of innovation in quality improvement is more complicated. The authors identify three known paradoxes of innovation in healthcare. First, some innovations diffuse rapidly, yet are of unproven value or limited value, or pose risks, while other innovations that could potentially deliver benefits to patients remain slow to achieve uptake. Second, participatory, cooperative approaches may be the best way of achieving sustainable, positive innovation, yet relying solely on such approaches may disrupt positive innovation. Third, improvement clearly depends upon change, but change always generates new challenges. Quality improvement systems may struggle to keep up with the pace of innovation, yet evaluation of innovation is often too narrowly focused for the system-wide effects of new practices or technologies to be understood. A new recognition of the problems of innovation is proposed and it is argued that new approaches to addressing them are needed.
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