The report, Formalised Informality: An action plan to spread proven health innovations, was prepared for the Ministry of Health by Dr Jonathan Lomas.
Dr Lomas was the inaugural Chief Executive Officer of the Canadian Health Services Research Foundation; an award-winning organisation founded in 1997 to support evidence-informed decision-making in the health sector, and was invited to New Zealand in 2007 to undertake an evaluation of the current environment for the spread of innovation in New Zealand’s health system.
This report discusses innovation spread and the challenges associated with achieving the right balance in attitudes, processes, structures and culture of innovation. In some areas New Zealand’s health sector leads the world in health innovations such as priority-setting to manage wait times for publicly funded elective services and interventions to reduce health inequalities for indigenous peoples. He suggests in this report that there is currently an absence of a national or regional vehicle dedicated to sharing innovation across the health sector. This report provides a proposed action plan for addressing the barriers to improved spread of innovation.
In July 2007, the Ministry of Health established the Sector Capability and Innovation (SCI) Directorate to have a national role in supporting the spread and adoption of effective innovations and improvements that lead to improved system performance in the priority areas. Dr Lomas suggested Health Target areas as being a useful starting point for emphasis. There is also much opportunity to join up existing hubs of innovation and improvement activity both at local and regional levels.
This report provides a valuable contribution for SCI as the Ministry meets with health sector leaders to define our role and future work programme. It is a conversation starter between the Ministry and the health sector.
Early in 2008 the Ministry will meet with DHB and other health sector leaders to identify and discuss their priorities that will ultimately feed into SCI’s work plan. The goal is to have a comprehensive work plan for SCI working with others published by June 2008.
Key Results
Key Messages
- The spread of proven innovation involves co-ordinating and integrating the three phases of the innovation chain: production/evaluation, dissemination, and adoption.
- The innovation chain is only as strong as its weakest link, so support is needed for activities across all three phases.
- The effective spread of innovation is determined more by inter-personal and interorganisational interaction than by structures and technology – like rugby, innovation spread is a contact sport.
- Innovations abound, but there is a lack of focus and no co-ordinated evaluation capacity to identify which innovations are worthwhile.
- The focus for an innovation agenda should be performance improvements on the declared health targets of the Ministry.
- A co-ordinated infrastructure for innovation evaluation and spread could emerge from collaborating with the Ministry of Research, Science and Technology on its imminent Health Innovation in Practice initiative.
- More networks and face-to-face exchanges (‘formalised informality’) will build interorganisational and inter-personal relational capital to grease the wheels of innovation dissemination.
- Creating a national institute as a clearing-house for proven innovations and to support innovation spread should wait until networks and exchanges have built more relational capital.
- Those working in the system are not knowledgable in how the adoption of proven innovation relies on local application of effective change management principles.
- Short- and long-term training programmes are needed on innovation-driven change management for managers and clinicians.
- The Ministry’s new Sector Capability and Innovation Division should take the lead to develop and facilitate the frameworks and opportunities for spreading proven innovations for health.