sábado, 10 de mayo de 2014

Recognizing the Importance of Innovation in Health Service Delivery | AHRQ Innovations Exchange

Recognizing the Importance of Innovation in Health Service Delivery | AHRQ Innovations Exchange

AHRQ Health Care Innovations

Recognizing the Importance of Innovation in Health Service Delivery

By Paul E. Plsek, MS, Paul E. Plsek & Associates, Inc.; Author, Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience; former member, Innovations Exchange Editorial Board
When it comes to health care service delivery, patients, payers, and politicians are asking for improved results: better access, faster diagnosis and treatment, more convenience, greater sensitivity to cultural differences and health disparities, and so on. But if we continue to do what we’ve always done, we will get the results we have always gotten. Nor is it enough to merely pursue incremental improvement. The challenges we face today call for more novel approaches—in other words, innovation!

We need innovation in health care service delivery that is on par with innovation in other aspects of the health care system. Although we can benefit from ongoing innovations in diagnostic technology, pharmaceuticals, surgical procedures, and medical devices, too often these are embedded in health care service delivery processes that do not provide timely, patient-centered, safe, effective, efficient, coordinated, and equitable access to the expected benefits.1

Consider, for example, a patient experiencing a variety of symptoms pointing to possible cardiac problems: unexplained fatigue, shortness of breath, and dizziness. Innovative, high-tech tools such as echocardiograms and computed tomography scans can help diagnose or rule out the underlying causes of such symptoms. Following diagnosis, an array of pharmaceuticals, medical devices, and surgical procedures—many of which did not exist only a decade ago—also are available. However, what has remained largely unchanged is the patient's often frustrating experience of scheduling appointments, finding their way through medical office buildings and hospitals, and waiting for test results and needed care.

We are capable of thinking differently. For example, we know that most patients face barriers to securing timely appointments and moving efficiently through the typical process of care. For years, leaders in health care hired more physicians or asked existing physicians to see more patients, which meant spending less time with each one. These incremental improvements undoubtedly helped. However, it was the innovative thinking behind advanced access (match capacity and demand, work down the backlog, do today’s work today, and so on), developed by Mark Murray and Catherine Tantau at Kaiser Permanente in the early 1990s, that has dramatically reduced waits throughout the system and so-called sleepless nights for patients.2

Further innovative approaches—“drive-throughs” for flu shots or other simple medical needs, having various specialists available by telephone for “curbside consults” while the patient is still in the primary care physician’s office, and having specialists visit patients in the emergency room rather than delaying the care in the hospital or community setting—are but a few of the many ideas that are being tested in parts of the health care system today.

In the wider context of general industry, innovation clearly has been linked with long-term success and organizational adaptability.3 The success of companies such as Apple, Google, Procter & Gamble, and Toyota illustrates this point. Studies have also shown that industry leaders who fail to maintain a steady flow of innovations inevitably experience setbacks.4

The imperative to think and do things differently is just as relevant in health care. The growing discontent of customers (patients as well as government and private payers), coupled with the challenge of delivering services in what is increasingly becoming a global marketplace, will bring to health care organizations the same demand for innovation that these factors have imposed on other industries.

Why is innovation important? Because patients, payers, and politicians are demanding it, and history shows that organizations that fail to deliver it will suffer.

About the Author

Mr. Plsek is an internationally recognized consultant on innovation in complex organizations. A former research engineer at Bell Laboratories and director of corporate quality planning at AT&T, Mr. Plsek now operates his own consulting practice and is the developer of the concept of DirectedCreativity.™ His health care clients have included the National Health Service (NHS) in England, Kaiser Permanente, the Veterans Health Administration, the SSM Health Care system, and the Mayo Clinic. Mr. Plsek is the chair of innovation at the Virginia Mason Medical Center in Seattle, an innovator-in-residence at MedStar Health (Washington, DC–Baltimore), director of the NHS Academy for Large-Scale Change in the United Kingdom, a former senior fellow at the Institute for Healthcare Improvement, an active research investigator, a popular conference speaker, and a former member of the Innovations Exchange Editorial Board. He is the author of dozens of peer-reviewed journal articles and seven books, including Creativity, Innovation and Quality; Edgeware: Insights from Complexity Science for Health Care Leaders; and Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience.

Disclosure Statement: Mr. Plsek is an independent management consultant who advises health care organizations on innovation strategy.


1Committee on Quality of Health Care in America, Institute of Medicine. Crossing the quality chasm: a new health system for the 21st Century. Washington DC: National Academies Press, 2001. Available at http://www.iom.edu/Reports/2001
External Link.

2Murray M, Bodenheimer T, Rittenhouse D, et al. Improving timely access to primary care: case studies of the advanced access model. JAMA. 2003;289(8):1042-6.[PubMed] Available at http://jama.jamanetwork.com/article.aspx?articleid=196025External Link.

3Henry D. Creativity pays. Here's how much. BusinessWeek. 23 April 2006. Available at: http://www.businessweek.com/stories/2006-04-23/creativity-pays-dot-heres-how-much.

4See, for example: Foster RN. Innovation: the attacker's advantage. New York: Summit Books; 1986; and Bower JL, Christensen CM. Disruptive technologies: catching the wave. Harvard Business Review. 1995;73(1):43-53.

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