Innovation Implementation in the Context of Hospital QI-Lessons Learned and Strategies for Success

Abstract

In 1999, the IOM reported that 98,000 people die each year due to medical errors. In the years following the report, the focus on hospital quality intensified nationally, with policymakers putting out evidence-based practice guidelines for improving healthcare quality. However, these innovations (evidence-based guidelines) being produced at policy levels, were not translating to clinical practice at the hospital organizational level easily, and stark variations continued to persist, in the quality of healthcare. Circa 2009, nearly a decade after release of the IOM report, the health organizational literature began referring to this challenge as “innovation implementation failure” in healthcare organizations (HCOs), i.e., failure to implement an evidence-based practice that is new to the HCO. This stream of literature drew upon management research, to explain why innovation implementation failure occurs in HCOs, and what could be done to prevent it. This paper conducts an integrative review of the literature on “innovation implementation” in hospitals & health systems over the last decade, since the spotlight was cast on “innovation implementation failure” in HCOs. The review reveals that while some studies have retrospectively sought to identify key drivers of innovation implementation, through surveys & interviews of practitioners (the “What”), other studies have prospectively sought to understand how innovation implementation occurs in hospitals & health systems (the “How’). Both make distinctive contributions to identifying strategies for success in innovation implementation. This paper synthesizes lessons learned from the literature, discusses the relevance of management research to innovation implementation in HCOs, and identifies future research avenues.