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Chris Mc. Carthy, MPH, MBAEdward Coakley, RN, MSN, MA, Med. Abstract. The goal of this article is to provide a practical guide to unlocking the power of innovation within the nursing community. First the three intersecting components of the innovation process (the innovation itself, creativity, and the environment) are explored. Next conceptual perspectives, drawn from the work of both von Hippel and Christensen, are reviewed. This is followed by a description of innovation methods with particular emphasis on IDEO. Finally, specific examples of organizational structures to support innovation within healthcare institutions and across healthcare communities are highlighted. Throughout the article examples of healthcare innovation will be highlighted to illustrate the principles described in the article. Citation: Blakeney, B., Carleton, P., Mc. Carthy, C., Coakley, E., (May 3. Manuscript 1. DOI: 1. OJIN. Vol. 14. No. National Advisory Council for Nursing Research; History. The mission of the National Institute of Nursing Research. Man. 01. Key words: innovation, disruptive innovation, user- driven innovation, innovation methods, Transforming Care at the Bedside, IDEOHealthcare is relatively new to the science of innovation. The ability to support and sustain the innovative process is a significant challenge in today. Innovation can be viewed as a process for inventing something new or improving on that which already exists. Healthcare is relatively new to the science of innovation. Therefore healthcare leaders must look to other fields, such as the social sciences, engineering, and business including diverse industries, such as transportation and manufacturing, to develop an emerging science that can guide the innovative process in healthcare. The developing science of innovation tells us that there is a method to the innovative process that can be articulated, defined, measured, and framed within a variety of settings. The goal of this article is to provide a practical guide to unlocking the power of innovation within the nursing community. To meet this goal, the authors of this article will explore the components of the innovative process, review relevant conceptual perspectives, describe innovative methods, and highlight specific examples of organizational structures that support innovations within healthcare organizations. Components of the Innovative Process. School of Nursing; Community. Emory Continuing Education. Round 10 Healthcare Innovation Seed Grant Award Recipents. Other National Studies. In our work together we authors have come to see innovation as having three highly interdependent components: individual or team creativity, the innovation itself, and the environment in which the innovation is developed, introduced, and sustained. Creative ideas are critical to the process of innovation, but the ideas alone are insufficient. Although the innovation itself, whether an invention, a new process, or a new language, is derived from the creative process of the individual or People are creative when they can solve problems, develop products that solve problems, or raise issues in a way that is initially novel but eventually accepted in one or more environments. Similarly, a work is creative if it stands out at first in terms of its novelty but ultimately comes to be accepted within a field (Gardner, 1. The environment, including its social, cultural, and physical aspects, is critical for providing the creative opportunity in which the innovation can take hold. A corollary to this would be that unless an organization fosters innovation, no amount of individual creativity and inventiveness will produce sustainable innovations. The critical components of innovation, creativity, and environment and their intersection are illustrated in the Figure. These three components will provide the organization for the discussion of innovation below. Innovation: Conceptual Perspectives. This section will address the concept of innovation. It will also present conceptual perspectives related to the components of the innovative process, namely, the innovation, creativity, and the environment. Innovation. Kanter and Senge have both suggested that innovation is a process that brings creativity to measurable outcomes, actions, products, or processes (Kanter, Kao, & Wiersema, 1. Senge, 2. 00. 1). Christensen has added that . The often unspoken goal is to solve a problem. User- driven Innovation Model: von Hippel. User- driven innovation focuses on the ability of product users to adapt and customize products.. User- driven innovation focuses on the ability of product users to adapt and customize products, including devices, processes, and outcomes. In his compelling book on . Nurses frequently utilize this model when they adapt policies, procedures, devices, and environments to meet the immediate needs of patients (see Table 1). Users can develop innovations that are exactly what they want as long as they have the skills needed to customize a given product. User- driven innovators are often very willing to share their designs and ideas in what are known as Innovation Communities (von Hippel, 2. Because innovation efforts by users tend to be widely distributed, user innovators need to find ways to combine and leverage their efforts. This can be achieved by engaging in various forms of cooperation, such as networks and communities. An example of such a community is the Innovation Learning Network described later in this article. Online virtual communities are especially useful in offering structures and tools for their participants. These communities can increase the speed and effectiveness with which users and manufacturers are able to develop, test, and diffuse useful innovations. Table 1: User- Driven Innovation: Smart Drug- Infusion Pumps. One user- driven innovation developed at Massachusetts General Hospital (MGH) is the . Motivated by problems nationwide involving complex drug- dosing- calculation errors and inaccurately programmed drug- infusion pumps, a team came together to identify ways to prevent intravenous (IV) medication errors. Team members observed medication administration practices and identified both the points where errors were likely to occur and the specific causes of errors. They discovered two major issues: (a) difficulty getting detailed guidance regarding IV drug- delivery practices to providers at the time they needed it, and (b) lack of a foolproof way to prevent serious IV drug- dose- rate errors, and wrong- drug errors at the point of care. In collaboration with industry, the MGH team created the . This pump prevents errors by comparing the dose rate the clinician enters with the hospital- specific, predefined rate limits for that drug. If the programmed dose is outside of the limits, the system alerts the clinician and, in the case of certain drugs, the system will prevent the administration of the medication. Smart infusion pump technology has been adopted worldwide by all major infusion pump manufacturers (MGH, 2. Disruptive Innovations: Christensen. Disruptive innovation occurs by thinking differently and asking new and different questions in each situation. Most innovation involves improvements on existing products. Although these improvements are often of a limited nature, some are very significant. In contrast, certain innovations go further and reach the point of being . Christensen and colleagues have transformed the vocabulary and principles of innovation with their ground- breaking work on these . Disruptive innovation occurs by thinking differently and asking new and different questions in each situation. This process of disruptive innovation can be fostered and supported by nurse leaders as they encourage new and different thinking at the bedside. Traditionally industry has fostered innovation by listening to the most demanding consumers and attempting to respond to the current and future needs of these consumers. Often, however, over time the . The field then becomes ripe for a disruptive innovation. In disruptive innovation an important question to ask regarding a potentially new products is, . When one considers the . Initially, a disruptive innovation is not aimed at these established consumers, but rather at new consumers. Christensen (2. 00. It is . In the beginning, the quality was deemed . Over the course of the evolution of the mobile phone, the product became established in the market has now undergone incremental improvements. Perhaps this field is now ripe for a new, disruptive innovation. These clinics are based in convenient retail spaces, such as neighborhood drug stores or grocery stores, and offer a simple menu of walk- in services at affordable prices. These services might include diagnosis and treatment of minor illness, such as simple urinary tract infections, flu, upper respiratory infections and bronchitis, ear infections, insect bites, and/or immunizations. Typically, these clinics are staffed by nurse practitioners. Consumers who are looking for convenient and immediate access to the healthcare system for the treatment of these common health problems drive the demand for these clinics. The shortage of primary care physicians and the resultant long waits for appointments have added to an environment ripe for disruptive innovation. The retail clinic appeals to consumers as . In addition, it appeals to current non- consumers, such as the uninsured, willing to pay an affordable fee for the opportunity to address their common healthcare needs. To date, established leaders in the healthcare field have not embraced retail clinics. Some express concern regarding the fragmentation of care and difficulty ensuring the quality of care by stand- alone entities. In turn, the retail clinics are seeking greater integration with existing providers and are publishing quality metrics. By design, disruptive innovation challenges traditional thinking and can be expected to provoke controversy. Whatever the ultimate outcome of disruptive innovation, the disruption in and of itself is invaluable in stimulating dialogue, advancing innovative thinking, and transforming models of service delivery. Medical director - Wikipedia, the free encyclopedia. Within emergency medical services a medical director is a physician who provides guidance, leadership, oversight and quality assurance for the practice of local paramedics and EMTs within a predefined area. In North America, medical directors are typically board- certified in emergency medicine. The medical director is generally responsible for either the creation of protocols for treatment by paramedics or providing leadership to the group of physicians who assist with the provision of medical oversight depending on which model of service delivery and which model of medical control are operating. The medical director may also assist the EMS agency in extending its scope of practice. While this definition is a fair description of the role in North America, significant variations can occur in other countries and in other health care systems. Note: In the interest of clarity, medical directors exist in a variety of other settings in addition to EMS. It is largely a generic term for a physician who has responsibility for the medical control and direction of various types of organizations, including hospital departments, blood banks, clinical teaching services and others. This article focuses specifically on the role of the medical director with respect to the operation of EMS systems. Models of care. There is little about what we call EMS that is universally applicable. Instead, communities and medical practitioners tend to develop systemic arrangements that are based on an assessment of local need. In the delivery of what we commonly refer to as EMS in various countries, there are two major service delivery models, with a number of minor models or variations from the main models. The first model, and arguably the oldest, is generally described as the Franco- German model. While this model is generally referred to as Franco- German, this may be something of a misnomer, since there is ample evidence and documentation indicating that at the turn of the 2. North American hospital- based ambulances in larger centres were actually staffed by ambulance surgeons; physicians who actually responded in the ambulance and provided care in a manner which very much resembles the current Franco- German model. Medical control is on- line, immediate, and direct. The training of the Rettungsassistent is comparable to that of many North American paramedics, but they may be limited in their scope of practice. Paramedics may practice their advanced life support skills at all times when the physician with whom they work is physically present, but are by some seen as restricted in what they may do in his absence, a legal position mostly claimed by the physicians' lobby. Presently, there is a reform underway to expand the . As a result, in addition to conventional ambulances, most communities have physicians (called Notarzt) who respond directly to every life- threatening call to provide care. PedJobs: Physicians/Surgeons,, Ohio, Hospital Pediatrics- Fellowship Program Director at Nationwide Children's Hospital.This system does not recognize emergency medicine as a medical specialty, in the sense that North Americans understand it. In these cases, the 'emergency physician' is most commonly an anesthetist, or sometimes an internist or even a surgeon. In most places, there appears to be little interest in the development of emergency medicine as a specialty, although recent developments in Italy suggest that this attitude may be changing. Many patients will never be transported to hospital. In the French version of this model, even the triage of incoming requests for service is physician- led, with a physician, assisted by others, interviewing the caller and determining what type of response resource, if any, will be sent. The German version of this model uses what we would recognize as 'conventional' dispatch processes, with the physician being sent to calls as requested by the EMS dispatcher. The Franco- German model operates in most places in Europe and Russia, but not in the United Kingdom. In this model, the medical director is typically more of a leader of physicians, and an advisor on the training of, and quality control for, subordinate staff. In Germany, the term . This physician's role is to oversee EMS personnel in a defined area, typically a bigger city or county, and corresponds to the position of medical director. This model has evolved significantly since its origins in the late 1. It is interesting to note that the development of this role, the professionalization of emergency medical services, the profession of paramedic, and the medical specialty of emergency medicine, have all developed in a symbiotic relationship since they were first created. Prior to 1. 97. 9, there was no formal specialty training certification for emergency medicine, and indeed, prior to 1. U. S., although it may be argued that in the U. K. This has not always been the case. In the earliest days of paramedicine paramedics were required to contact a physician for formal orders for every single intervention that they performed. There were early examples of 'paramedics' who operated blindly, providing medications from numbered or colour- coded syringes as they were directed by the physician, with no real understanding of the interventions that they were performing. Control was absolute and immediate; there were examples of paramedics being trained, but not legally permitted to perform their skills, or in other cases, the performance of skills could only occur with a physician or nurse present, much like the existing Franco- German model. This was absolutely necessary in the earliest stages of paramedicine as, in the absence of formal licensing arrangements for paramedics, they often functioned as an extension of the physician's medical license. This type of arrangement persists to this day in some locations, such as the Canadianprovince of Ontario. This would ultimately evolve into a system in which most paramedics function almost purely on complex written protocols or standing orders committed to memory, often numerous pages in length, and contacting a physician only when standing orders have been exhausted. To begin with, the medical director is much more a leader of paramedics than of other physicians, although they generally perform a leadership role among the small group of physicians tasked with providing delegation to paramedics in the field. The medical director plays a key role in the professional development of paramedics as well. In almost all cases, the medical director will have, at a minimum, input into the curriculum of paramedic training at a local level. In actual practice, in a great many cases they will also teach some portions of the program, supervise clinical rotations of paramedics, and in some cases, even precept their initial field practice, prior to formal certification or licensing. In almost all cases, the medical director will be charged with the creation of all protocols and standing orders. Throughout the paramedic's career, the medical director will provide the mechanism for medical quality control, conducting chartaudits and reviewing medically related service complaints, and may often have the ability to de- certify individual paramedics for cause. Finally, medical directors will act as expert advisors to those in the EMS system administration and government administration, with respect to policies and legislation required by the EMS system, and in guiding its future direction. It is rare to see physicians in the field, unless they are precepting new paramedics or performing quality assurance activities, or are residents in emergency medicine training programs, gaining required field experience or conducting research. Medical directors and ED physicians will occasionally go into the field for large incidents, such as multi victim accidents and disasters to assume on site medical command. Autonomous practice. In such cases, individual paramedics may function in much the same manner as Physician assistants or Nurse Practitioners, assessing patients and making their own diagnoses, clinical judgments, and treatment decisions. In all such cases, a scope of practice is predetermined for the role, and within that scope of practice all treatment decisions are made and care rendered at the discretion of the individual paramedic.
Spangler, DDS Program Director. The Director of the SJMO General Practice Residency in Dentistry is Craig C. After graduation from the University of Michigan School of Dentistry, Dr. Here are the top 24 Program Director profiles at Hospital on LinkedIn. Get all the articles, experts, jobs, and insights you need. Welcome from Program Director. Our program is a well-established surgical residency, based in a community teaching hospital setting. We are located in the suburban Philadelphia area and are associated with the OPTI at the. In many cases, the scope of practice will focus more heavily on primary care, although providing a more comprehensive level of care, such as suturing, or the management of long- term conditions, such as diabetes or hypertension, than is normally permitted to the paramedic. In some jurisdictions, such practitioners even have the authority to both prescribe and dispense a limited and defined set of medications. In many cases, the practice of these individuals has gone well beyond what we normally consider to be the role of traditional EMS. There are locations in which these practitioners are providing E/R leadership after hours in small, rural hospitals (Australia and the U. K.), while in other locations these practitioners are actually taking night 'call' for group medical practices (U. K.). Most such training programs tend to feature very large components of hands- on clinical experience, generally conducted in the emergency room or similar environment, and usually in a one to one ratio with the physician. The medical director will have a major role in determining the permitted scope of practice, and will investigate practice- related complaints. Finally, the medical director (or other emergency physicians) may be responsible for providing the required medical 'back up' when the practitioner reaches the limit of their scope of practice. Crossover models. In Netherlands, for example, all paramedics are in fact registered nurses with one year of additional training, usually in anesthesia but other critical care training is also acceptable, who then complete an additional year of training in ambulance care. Students who searched for Program Director: Salary, Requirements and Career Overview found the following related articles and links useful. Bennett has been a faculty member with the Advocate Christ Family Medicine Center Residency Program since 1996. Bennett, an Illinois native, earned his bachelor's degree at. Before i die jenny downham espa. English before i fall ebook free delirium lauren oliver pdf english before i fall lauren oliver pdf free. Kirk Franklin - Before I Die Lyrics. Brothers and sisters. I'm feelin' real good 'cause it ain't over. Right before I die I gotta live. Live out my dreams. So I can be what He planned for me. Not just for me but so they can see. Much more of Him and less of. Right before I die I gotta. 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Adobe Premiere Elements Templates, free download. Adobe Premiere Elements Templates 4.0: Adobe Systems Inc. 1,746,000 recognized programs - 5,228,000 known versions. Free Intro Templates (Sony Vegas Pro 10; Adobe Premiere. 21 Broadcast Graphics Templates for Adobe Premiere Pro by. Top 10 FREE Outro Templates. Adobe Premiere Pro CS6 Free Download setup in single direct link. Add professional amazing effects in videos with latest features of Adobe Premiere Pro CS6. |
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December 2016
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