Innovation coupled with the concept of boundary spanning is the solution to the complexity of health systems problems. What do I mean by this? Traditional thoughts of innovation, while well understood and respected in its inherent creativity, is limited to the brilliance of individual minds confined to their respective silos. By breaking boundaries and engaging potentially non-traditional partners, our ability to innovate grows exponentially.
Delving a bit deeper leads to the notion of transdisciplinary thinking, as presented by our guest speaker, David Cowan, MSHS, Senior Research Scientist at the Georgia Tech SimTigrate Design Lab. This takes boundary spanning slightly further to go beyond simply eliciting the expertise of other disciplines, but also seeks to cross-educate on a philosophical level - the challenge of changing the way people think.
So, what is the practicality of this relative to completion of a DNP scholarly project?
This dialogue resonates well with my project focus on shared decision making, as I believe one of the largest barriers has been inertia. Other medical specialties have made steady process since the landmark IOM report Crossing the Quality Chasm, that kick-started the focus on patient-centered care. So, why the slow pace with (elective) plastic surgery? Private plastic surgery practices operate in a unique healthcare market that is vastly different than the hospital, insurance based counterparts. With today’s value-driven reimbursement, incentives, whether additive or punitive, are more prevalent for specialties that report on quality metrics. While patient reported outcomes are vital to a successful elective plastic surgery practice, efforts are more commonly seen in areas of marketing and patient acquisition than with data-driven improvement, or efforts for which the benefits are realized more downstream. Being innovative in the approach to engagement may facilitate greater adoption of shared decision making, as well as other improvement efforts. For example, to encourage development and use of high quality decision aids, Pope (2017) proposes the idea of offering the incentive of a reduced malpractice insurance premiums for clinicians that demonstrate use in their practice has been proposed as a possible incentive.
Common themes from all presenters included (1) need to connect to be able to innovate, (2) discovery of shared interests and establishing common grounds for effective meetings.
DNP Essentials: Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking; Essential V: Health Care Policy for Advocacy in Health Care; Essential VI: Interprofessional Collaboration for Improving Patient and Population Health Outcomes
Pope, T. M. (2017). Certified patient decision aids: solving persistent problems with informed consent law. The Journal of Law, Medicine & Ethics, 45(1), 12–40. https://doi.org/10.1177/1073110517703097