Patient-centered innovation in health care organizations: a conceptual framework and case study application

Health Care Manage Rev. 2013 Apr-Jun;38(2):166-75. doi: 10.1097/HMR.0b013e31825e718a.


Background: Patient-centered innovation is spreading at the federal and state levels. A conceptual framework can help frame real-world examples and extract systematic learning from an array of innovative applications currently underway. The statutory, economic, and political environment in Washington State offers a special contextual laboratory for observing the interplay of these factors.

Purpose: We propose a framework for understanding the process of initiating patient-centered innovations-particularly innovations addressing patient-centered goals of improved access, continuity, communication and coordination, cultural competency, and family- and person-focused care over time. The framework to a case study of a provider organization in Washington State actively engaged in such innovations was applied in this article.

Methods: We conducted a selective review of peer-reviewed evidence and theory regarding determinants of organizational change. On the basis of the literature review and the particular examples of patient-centric innovation, we developed a conceptual framework. Semistructured key informant interviews were conducted to illustrate the framework with concrete examples of patient-centered innovation.

Findings: The primary determinants of initiating patient-centered innovation are (a) effective leadership, with the necessary technical and professional expertise and creative skills; (b) strong internal and external motivation to change; (c) clear and internally consistent organizational mission; (d) aligned organizational strategy; (e) robust organizational capability; and (f) continuous feedback and organizational learning. The internal hierarchy of actors is important in shaping patient-centered innovation. External financial incentives and government regulations also significantly shape innovation.

Practice implications: Patient-centered care innovation is a complex process. A general framework that could help managers and executives organize their thoughts around innovation within their organization is presented.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Attitude of Health Personnel
  • Efficiency, Organizational
  • Humans
  • Leadership
  • Models, Organizational
  • Organizational Case Studies
  • Organizational Culture
  • Organizational Innovation*
  • Organizational Objectives
  • Patient-Centered Care / standards*
  • Professional Competence
  • Quality Assurance, Health Care / standards*
  • Staff Development
  • Washington