Discovery Core

发现核心 医疗保健组织的创新不会等待研究概念化、提出、资助、 执行，结果被传达和解释，更不用说在实践中应用了。全部14个CRN集成 医疗保健提供系统正在渗透到计划和研究法案的质量改进努力中，精益 方法论制定并反复学习流程重新设计和其他更改的组织计划 到临床实践。例如，2008年在全国范围内，Kaiser Permanente的表现有所改善 正在进行干预，以增加临床医生团队影响健康结果变化的能力 北加州、南加州和科罗拉多州的18个护理机构，90个护理团队，涉及700个 照顾者。根据试点结果，很可能将开始在所有区域的所有金伯利进程设施全面铺开。 在2010年。这种规模的试验如果作为一个研究项目开始，将仍处于提案起草阶段。所以 研究和组织变革的时间表明显不同。此外，对于质量改进和 在研究工作中，像这样的大型分布式组织往往不“知道他们所知道的”。 知识及其管理，以便促进共享，往往是不存在的或不成功的，即使在 通过人员调动、会议、演示和信息技术有系统地进行尝试。

Discovery Core Innovation in healthcare organizations does not wait for research to be conceptualized, proposed, funded, conducted, and the results communicated and interpreted, let alone applied in practice. All 14 CRN integrated healthcare delivery systems are percolating with Plan Do Study Act quality improvement efforts, LEAN Methodology organizational initiatives to enact and iteratively learn from process redesigns, and other changes to clinical practice. For example, nationally in Kaiser Permanente in 2008, a Performance Improvement intervention to increase the capacity of clinician teams to affect change in health outcomes is being piloted in Northern California, Southern California, and Colorado at 18 care facilities with 90 care teams involving 700 care providers. It is likely that based on pilot results, full roll-out across all KP facilities in all regions will begin in 2010. A trial of this scope, if begun as a research project, would still be in the proposal-drafting stage. So the timelines for research and organizational change differ markedly. Also, for both quality improvement and research efforts, large distributed organizations such as these often do not "know what they know."129 Transfer of knowledge and its management so that sharing is facilitated is often nonexistent or unsuccessful, even when systematically attempted through personnel transfers, meetings, demonstrations, and information technology.