Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

A theoretical framework to support research of health service innovation

Amanda Fox A B , Glenn Gardner A and Sonya Osborne A
+ Author Affiliations
- Author Affiliations

A Queensland University of Technology, School of Nursing, Victoria Park Road, Kelvin Grove, Qld 4059, Australia. Email: ge.gardner@qut.edu.au; s.osborne@qut.edu.au

B Corresponding author. Email: a.fox@qut.edu.au

Australian Health Review 39(1) 70-75 https://doi.org/10.1071/AH14031
Submitted: 4 February 2014  Accepted: 23 September 2014   Published: 17 December 2014

Abstract

Objective Health service managers and policy makers are increasingly concerned about the sustainability of innovations implemented in health care settings. The increasing demand on health services requires that innovations are both effective and sustainable; however, research in this field is limited, with multiple disciplines, approaches and paradigms influencing the field. These variations prevent a cohesive approach, and therefore the accumulation of research findings, in the development of a body of knowledge. The purpose of this paper is to provide a thorough examination of the research findings and provide an appropriate theoretical framework to examine sustainability of health service innovation.

Methods This paper presents an integrative review of the literature available in relation to sustainability of health service innovation and provides the development of a theoretical framework based on integration and synthesis of the literature.

Results A theoretical framework serves to guide research, determine variables, influence data analysis and is central to the quest for ongoing knowledge development. This research outlines the sustainability of innovation framework; a theoretical framework suitable for examining the sustainability of health service innovation.

Conclusion If left unaddressed, health services research will continue in an ad hoc manner, preventing full utilisation of outcomes, recommendations and knowledge for effective provision of health services. The sustainability of innovation theoretical framework provides an operational basis upon which reliable future research can be conducted.

What is known about the topic? Providers of health services are rapidly implementing innovations in an effort to provide effective health care. Little research has been conducted to evaluate the sustainability of these health service innovations.

What does this paper add? This paper aims presents an integration and synthesis of the current body of knowledge to provide a theoretical framework to evaluate the sustainability of health service innovation.

What are the implications for the practitioner? An improved body of knowledge surrounding the sustainability of health service innovations generated from research will consequently result in more appropriate use of resources and improved provision of health services.

Additional keywords: healthcare, sustainability, delivery models.


References

[1]  Black N. Health services research: saviour or chimera? Lancet 1997; 349 1834–6.
Health services research: saviour or chimera?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2svhsVGgtA%3D%3D&md5=41f2378123592b3e56e03713be959c82CAS | 9269229PubMed |

[2]  Stirman SW, Kimberley J, Cook N, Calloway A, Castro F, Charns M. The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future use. Implement Sci 2012; 7 17
The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future use.Crossref | GoogleScholarGoogle Scholar |

[3]  Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004; 82 581–629.
Diffusion of innovations in service organizations: systematic review and recommendations.Crossref | GoogleScholarGoogle Scholar | 15595944PubMed |

[4]  Tham R, Humphreys J, Kinsman L, Buykx P, Sasid A, Tuohey K, Riley K. Evaluating the impact of sustainable comprehensive primary health care on rural health. Aust J Rural Health 2010; 18 166–72.
Evaluating the impact of sustainable comprehensive primary health care on rural health.Crossref | GoogleScholarGoogle Scholar | 20690913PubMed |

[5]  Taylor J, Blue I, Misan G. Approach to sustainable primary health care service delivery for rural and remote South Australia. Aust J Rural Health 2001; 9 304–10.
Approach to sustainable primary health care service delivery for rural and remote South Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD383lvVaksw%3D%3D&md5=87a0e8235b0eceee2a9904f86a993984CAS | 11998266PubMed |

[6]  Gruen R, Weeramanthri T, Bailie R. Outreach and improved access to specialist services for Indigenous people in remote Australia: the requirements for sustainability. J Epidemiol Community Health. 2002; 56 517–21.
Outreach and improved access to specialist services for Indigenous people in remote Australia: the requirements for sustainability.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38zjslKguw%3D%3D&md5=a3e38b437242dfac37ee65291f452601CAS | 12080159PubMed |

[7]  Swayne A, Eley D. Synergy and sustainability in rural procedural medicine: views from the coalface. Aust J Rural Health 2010; 18 38–42.
Synergy and sustainability in rural procedural medicine: views from the coalface.Crossref | GoogleScholarGoogle Scholar | 20136813PubMed |

[8]  Fuller J, Harvey P, Misan G. Is client-centred care planning for chronic disease sustainable? Experience from rural South Australia. Health Soc Care Community 2004; 12 318–26.
Is client-centred care planning for chronic disease sustainable? Experience from rural South Australia.Crossref | GoogleScholarGoogle Scholar | 15272887PubMed |

[9]  Buykx R, Humphreys J, Tham R, Kinsman L, Wakerman J, Asaid A, Tuohey K. How do small rural primary health care services sustain themselves in a constantly changing health system environment? BMC Health Serv Res 2012; 12 81–7.
How do small rural primary health care services sustain themselves in a constantly changing health system environment?Crossref | GoogleScholarGoogle Scholar |

[10]  Scheirer MA, Dearing JW. An agenda for research on sustainability of public health programs. Am J Public Health 2011; 101 2059–67.
An agenda for research on sustainability of public health programs.Crossref | GoogleScholarGoogle Scholar | 21940916PubMed |

[11]  Shediac-Rizkallah MC, Bone LR. Planning for the sustainability of community-based health programs: conceptual frameworks and future directions for research, practice and policy. Health Educ Res 1998; 13 87–108.
Planning for the sustainability of community-based health programs: conceptual frameworks and future directions for research, practice and policy.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3jvVKitA%3D%3D&md5=1fcad622186cd4fd2baa0d56ccd91fccCAS | 10178339PubMed |

[12]  Willis K, Small R, Brown S. Using documents to investigate links between implementation and sustainability in a complex community intervention: the PRISM study. Soc Sci Med 2012; 75 1222–9.
Using documents to investigate links between implementation and sustainability in a complex community intervention: the PRISM study.Crossref | GoogleScholarGoogle Scholar | 22749443PubMed |

[13]  Nordqvist C, Timpka T, Lindqvist K. What promotes sustainability in safe community programmes? BMC Health Serv Res 2009; 9 4–12.
What promotes sustainability in safe community programmes?Crossref | GoogleScholarGoogle Scholar | 19133121PubMed |

[14]  Pluye P, Potvin L, Denis J, Pelletier J, Mannoni C. Program sustainability begins with the first events. Eval Program Plann 2005; 28 123–37.
Program sustainability begins with the first events.Crossref | GoogleScholarGoogle Scholar |

[15]  Pluye P, Potvin L, Denis J, Pelletier J. Program sustainability: focus on organisational routines. Health Promot Int 2004; 19 489–500.
Program sustainability: focus on organisational routines.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2crovVaguw%3D%3D&md5=ccd957abd1be26c638e26c1a159c6b19CAS | 15520036PubMed |

[16]  Evashwick C, Ory M. Organizational characteristics of successful innovative health care programs sustained over time. Fam Community Health 2003; 26 177–93.
Organizational characteristics of successful innovative health care programs sustained over time.Crossref | GoogleScholarGoogle Scholar | 12829940PubMed |

[17]  Barnett L, Van Beurden E, Eakin E, Beard J, Dietrich U, Newman B. Program sustainability of a community-based intervention to prevent falls among older Australians. Health Promot Int 2004; 19 281–8.
Program sustainability of a community-based intervention to prevent falls among older Australians.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2cvgt1CqsA%3D%3D&md5=b1bc0ca75022a343e8a551f79691c278CAS | 15306612PubMed |

[18]  Olsen I. Sustainability of health care: a framework for analysis. Health Policy Plan 1998; 13 287–95.
Sustainability of health care: a framework for analysis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M7gs1ygtA%3D%3D&md5=ad34d5155f3a0affa9a349c05c5bd742CAS | 10187598PubMed |

[19]  Gruen R, Elliott J, Nolan M, Lawton P, Parkhill A, McLaren C, Navis J. Sustainability science: an integrated approach for health-programme planning. Lancet 2008; 372 1579–89.
Sustainability science: an integrated approach for health-programme planning.Crossref | GoogleScholarGoogle Scholar | 18984192PubMed |

[20]  Homa K. Evaluating the sustainability of a quality improvement initiative. Doctor of Philosophy Thesis, Dartmouth College, New Hampshire; 2006.

[21]  Sibthorpe B, Glascow N, Wells R. Emergent themes in the sustainability of primary health care innovation. Med J Aust 2005; 183 77–80.

[22]  Raffel K, Yee Lee M, Dougherty C, Green G. Making it work: administrator views on sustaining evidence-based mental health interventions. Adm Soc Work 2013; 37 494–510.
Making it work: administrator views on sustaining evidence-based mental health interventions.Crossref | GoogleScholarGoogle Scholar |

[23]  Sarriot E, Winch PJ, Ryan LJ, Bowie J, Kouletio M, Swedberg E, LeBan K, Edison J, Welch R, Pacqué MC. A methodological approach and framework for sustain assessment in NGO-implemented primary health care programs. Int J Health Plann Manage 2004; 19 23–41.
A methodological approach and framework for sustain assessment in NGO-implemented primary health care programs.Crossref | GoogleScholarGoogle Scholar | 15061288PubMed |

[24]  Sarriot E, Winch PJ, Ryan LJ, Edison J, Bowie J, Swedberg E, Welch R. Qualitative research to make practical sense of sustainability in primary health care projects implemented by non-governmental organisations. Int J Health Plann Manage 2004; 19 3–22.
Qualitative research to make practical sense of sustainability in primary health care projects implemented by non-governmental organisations.Crossref | GoogleScholarGoogle Scholar | 15061287PubMed |

[25]  Blanchet K, Girois S. Selection of sustainability indicators for health services in challenging environments: Balancing scientific approach with political engagement. Eval Program Plan 2013; 38 28–32.

[26]  May C, Finch T. Implementing, embedding and integrating practices: an outline of normalization process theory. Sociology 2009; 43 535–54.
Implementing, embedding and integrating practices: an outline of normalization process theory.Crossref | GoogleScholarGoogle Scholar |

[27]  May C. A rational model for assessing and evaluating complex interventions in health care. BMC Health Serv Res 2006; 6 86–94.
A rational model for assessing and evaluating complex interventions in health care.Crossref | GoogleScholarGoogle Scholar | 16827928PubMed |

[28]  Forster D, Newton M, McLachlan H, Willis K. Exploring implementation and sustainability of models of care: can theory help? BMC Public Health 2011; 11 S8
Exploring implementation and sustainability of models of care: can theory help?Crossref | GoogleScholarGoogle Scholar | 22168585PubMed |

[29]  Chambers D, Glasgow R, Strange K. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci 2013; 8 117
The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change.Crossref | GoogleScholarGoogle Scholar | 24088228PubMed |

[30]  Considine J, Fielding K. Sustainable workforce reform: case study of Victorian nurse practitioner roles. Aust Health Rev 2010; 34 297–303.
Sustainable workforce reform: case study of Victorian nurse practitioner roles.Crossref | GoogleScholarGoogle Scholar | 20797361PubMed |

[31]  Hanson H, Salmoni A, Volpe R. Defining program sustainability: differing views of stakeholders. Can Public Health Assoc 2009; 100 304–9.

[32]  Ringsted C, Hodges B, Scherpbier A. ‘The research compass’: an introduction to research in medical education: AMEE Guide No. 56. Med Teach 2011; 33 695–709.
| 21854147PubMed |

[33]  Bowling A. Research methods in health investigating health & health services, 3rd edn. New York: Open University Press; 2009.

[34]  Rogers E. A prospective and retrospective look at the diffusion model. J Health Commun 2004; 9 13–9.
A prospective and retrospective look at the diffusion model.Crossref | GoogleScholarGoogle Scholar | 14960401PubMed |