Discovery Core

发现核心

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.