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From pilot project to system solution: innovation, spread and scale for health system leaders
  1. James Shaw1,2,
  2. Joshua Tepper3,4,
  3. Danielle Martin1,3
  1. 1 Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Ontario, Canada
  2. 2 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  3. 3 Department of Family and Community Medicine, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  4. 4 Health Quality Ontario, Toronto, Ontario, Canada
  1. Correspondence to Dr James Shaw, Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, ON M5S 1B2, Canada; jay.shaw{at}wchospital.ca

Abstract

Promoting the scale and spread of effective health innovations requires dedicated action from health system leaders. In order to maximise the effects of leadership strategies to promote the spread and scale of health innovations, conceptual clarity and well-defined strategies are essential. In this commentary, we propose definitions of the concepts of ‘innovation’, ‘spread’ and ‘scale’, and explain how these concepts can be used by health system leaders to generate interest, excitement and commitment for specific innovations from a broad community of stakeholders. We then outline two strategies from the community organising literature that leaders can use to promote spread and scale.

  • clinical leadership
  • health system
  • unwarranted variation
  • health policy
  • healthcare planning

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Footnotes

  • Contributors JS is a scientist at the Institute for Health System Solutions and Virtual Care at Women’s College Hospital in Toronto, and an assistant professor in the Institute for Health Policy, Management and Evaluation at the University of Toronto. JS’s work focuses on implementation science and health policy. JT is the chief executive officer of Health Quality Ontario, the quality-focused agency funded by the Ministry of Health and Long Term Care that oversees quality assessment and improvement efforts for the health system in the province of Ontario, Canada (population: 13.5 million). JT is also an associate professor at the University of Toronto and a practising family physician. DM is the vice president of Medical Affairs and Health System Solutions at Women’s College Hospital, an associate professor at the University of Toronto and a practising family physician. She has led many health system-improvement initiatives and is a frequent commentator on television and in print media on quality improvement and health policy in Canada.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Research ethics approval was not obtained for this manuscript as it was not a research project including human subjects.

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