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Table 9 Belonging tensions associated with healthcare innovation

From: What can healthcare systems learn from looking at tensions in innovation processes? A systematic literature review

Authors

Type of innovation

Stage of innovation process

Type of tension

(dilemma or paradox)

Conflicting elements

Rapport et al. (2010)

Endoscopy service delivery and organization

Implementing projects

Economic interest

vs.

Medical convictions

(Dilemma)

A: Economic interest: Decision making based on availability of resources (passage of time, ability of staff members) (p. 926)

B: Medical convictions: Demanding decisions based on medical evidence, patient need, or the immediacy of the problem (p. 926)

Mansfield et al. (2018)

Pilot project implementation in general

Implementing projects

Individual

vs.

Collective

(Dilemma)

A: Individual: (Physicians, Clinicians) Valuing autonomy and independence, having control and routines (p. 8)

B: Collective: Sharing data, improving local care coordination, and working interdisciplinary (p. 8)

Atun et al. (2007)

Family-medicine-centred PHC reform

Implementing projects

Professional boundaries

vs.

Interprofessional relations

(Dilemma)

A: Professional boundaries: Traditional roles in PHC demarcate professional boundaries, thereby assuring a sense of authority, security, and quality of service (p. 34)

B: Interprofessional relations: Expanding knowledge and skills through interprofessional relations, thereby stimulating confidence, performance, work efficiency and more control over professional duties (p. 34)

Lehn et al. (2018)

Readmission prevention program

Implementing projects

Interdisciplinary work

vs.

Professional autonomy

(Dilemma)

A: Interdisciplinary work: Requirement for interdisciplinary cooperation in the initial screening stage (p. 8)

B: Professional autonomy: Control and dependency on other professional groups leads to frustration and decreased motivation (p. 9)

Sharp et al. (2020)

Smart phone application for use by rheumatoid arthritis patients

Implementing projects

Illness experience

vs.

Objectivation practices

(Dilemma)

A: Illness experience: Quantification gives way to an oversimplification of illness experience (p. 8)

B: Objectivation practices: Relying on scoring systems and objective evidence to access treatment (p. 8)