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What is the impact of healthcare innovation on measurable outcomes of healthcare organisation performance? A systematic review
  1. Caoimhe Madden1,
  2. Róisín O'Malley1,
  3. Emily O'Dowd2,
  4. Paul O'Connor1,
  5. Sinéad Lydon3,
  6. Jared Gormly4,
  7. Dara Byrne1
  1. 1Irish Centre for Applied Patient Safety and Simulation (ICAPSS), University of Galway, Galway, Ireland
  2. 2Department of Surgical Affairs, Royal College of Surgeons, Galway, Ireland
  3. 3School of Medicine, University of Galway, Galway, Ireland
  4. 4National Doctors Training and Planning (NDTP), Health Service Executive, Dublin, Ireland
  1. Correspondence to Dr Caoimhe Madden, Irish Centre for Applied Patient Safety and Simulation (ICAPSS), University of Galway, Galway, Ireland; caoimhe.madden{at}universityofgalway.ie

Abstract

Objective The lack of quantitative evidence of effectiveness has been cited as a notable shortcoming of initiation and diffusion of innovations in healthcare. Therefore, this review aimed to synthesise research assessing the impact of healthcare innovations on measurable outcomes of healthcare organisation performance.

Design A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources Systematic searches were conducted across three electronic databases, namely MEDLINE, CINAHL and PsycINFO.

Eligibility criteria for selecting studies Articles were required to: (a) be published in an English-language, peer-reviewed journal since 2000; (b) describe the application of a specific innovation within a secondary healthcare setting; (c) report data on the summative evaluation of the impact of the innovation on healthcare outcomes, using an outcome measure in line with Level Four of Kirkpatrick’s Evaluation Hierarchy (ie, a measure of organisation performance) and (d) consist of a research design that allowed for evaluation of innovation impact on outcome measures by means of a comparator.

Results Innovations targeting organisational change were most commonly implemented. Innovations generally had a positive impact, evident in almost two-thirds of the outcome measures assessed across the included articles. Innovation impact was predominantly measured via health utilisation metrics and medical-clinical indicators, with safety outcomes and patient/family perceptions less frequently assessed.

Conclusion There is evidence to show that innovations result in discernible change in organisational importance, including on important metrics such as finance and healthcare utilisation. Bundling outcome measures are recommended to provide a more complete picture of the true impact of innovation on healthcare organisation performance.

  • quality of health care
  • population
  • patient care
  • health planning
  • health services research

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • Twitter @JaredGormly

  • Contributors CM is the author responsible for the overall content as the guarantor. CM was involved in concept design, conducted searches, completed data extraction, quality appraisal and wrote the manuscript. RO'M completed data extraction, quality appraisal and reviewed the manuscript. EO'D completed data extraction, quality appraisal and reviewed the manuscript. PO'C was involved in concept design, designed the search strategy and reviewed the manuscript. SL was involved in concept design, designed the search strategy and reviewed the manuscript. JG was involved in concept design, secured funding and reviewed the manuscript. DB was involved in concept design, secured funding and reviewed the manuscript.

  • Funding This project was supported by the Spark Programme of the National Doctors Training and Planning (NDTP) within the Health Service Executive, Ireland (grant/award number: N/A).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.