This article appears in the August 2017 issue of Patient Safety Monitor Journal.
Editor’s note: Healthcare innovation involves doing something differently than how it’s normally done, whether it’s a new device, policy, or program. Many of these evidence-based practices, promising studies, and groundbreaking programs are never adopted outside their test facilities. Many fail to work or fall short of expectations when implemented elsewhere. And it’s often difficult to get buy-in from healthcare staff and leadership on a new way of doing things.
PSMJ spoke with Craig Deao, MHA, senior leader at Studer Group, about how to tell whether a new innovation can work at your facility and how to successfully implement it.
Q: Reading the news every day makes it seem like the healthcare field abounds with “proven methods” and “evidence-based” innovations that could improve healthcare. Is that the reality?
Deao: For the most part, yes. I remember reading in the IOM’s 2001 Crossing the Quality Chasm that “it takes an average of 17 years for new knowledge generated by randomized controlled trials to be incorporated into practice, and even then application is highly uneven.”
And [17 years] is just the median, so there’s still half the market that hasn’t adopted the practice. So there are tons of best practices that are nowhere near application yet. There’s a good case to be made that applying what is already known would drive an incredible amount of gains in quality (and lower cost). We see this every day in our work, where organizations are struggling with a specific metric yet have not hardwired known best practice.
On the other hand, it’s also true that not every problem can be solved by applying a rules-based solution that worked elsewhere. There are legitimate differences in context that require art as well as science. The art is about knowing the difference between adapting best practices (changing them to fit the context) versus wholly adopting them. The trick is adapting without messing up why it works in the first place. Too often we see organizations adapt best practices to the point that they’re no longer as effective. So, it’s a fine line to walk.
It’s not just about adopting best practices to achieve our goals, but I’d say that’d get us about 90% of the way there.
Q: How many innovations end up being adopted on a widespread scale in healthcare field?
Deao: Not enough. We often think of innovation as doing new things. But in healthcare, some of the best innovations are deciding what not to do—especially when the current practice has no evidence basis. The “Choosing Wisely” campaign is an excellent resource for both clinicians and patients that identifies lists upon lists of medical practices that should be questioned because they have no medical evidence to support their usage. Yet we still give too many antibiotics for colds and too many x-rays for low back pain.