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Innovative Realizations and Attributes of Academic Health Centers Throughout Canada
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Policy makers view academic healthcare organisations as important to healthcare innovation because they act as boundary-spanning organisations that integrate science and care institutional logics. Institutional logics are implicit and socially shared rules of the game that prescribe behaviour within a social group. This paper explores how individuals affiliated with academic healthcare organisations negotiate science and care institutional logics within their day-to-day work through a qualitative case study of research and healthcare within academic healthcare organisations in Vancouver, Canada. It highlights that there is less hybridisation of institutional logics than policy makers might hope: some researchers hosted in academic healthcare organisations are not part of the care institutional logic, others are not well integrated with the research institutional logic. Clinician–scientists often struggle to integrate the science and care institutional logics in their day-to-day work; other workers do integrate science and care institutional logics through experiments of nature but their research may not be viewed as high quality science. Because of poor hybridisation, academic healthcare organisations may not be as effective in facilitating healthcare innovation as policy makers assume.
Clinicians and health systems are facing widespread challenges, including changes in care delivery, escalating health care costs, and the need to keep up with rapid scientific discovery. Reorganizing U.S. health care and changing its practices to render better, more affordable care requires transformation in how health systems generate and apply knowledge. The "rapid-learning health system"-posited as a conceptual strategy to spur such transformation-leverages recent developments in health information technology and a growing health data infrastructure to access and apply evidence in real time, while simultaneously drawing knowledge from real-world care-delivery processes to promote innovation and health system change on the basis of rigorous research. This article describes an evolving learning health system at Group Health Cooperative, the 6 phases characterizing its approach, and examples of organization-wide applications. This practical model promotes bidirectional discovery and an open mind at the system level, resulting in willingness to make changes on the basis of evidence that is both scientifically sound and practice-based. Rapid learning must be valued as a health system property to realize its full potential for knowledge generation and application.
Unleashing Innovation: Excellent Healthcare for Canada: Final Report of the Advisory Panel on Healthcare Innovation
- D Naylor
- F Girard
Naylor, D., Girard, F. & Advisory Council on Healthcare Innovation. Unleashing Innovation: Excellent Healthcare for Canada: Final
Report of the Advisory Panel on Healthcare Innovation. (2015).