Innovation and the Creative Process
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Innovation and the Creative Process

Towards Innovation with Care

Edited by Lars Fuglsang

This book explores new frameworks and methods of understanding and analysing innovation. These are set against a backdrop of ‘innovation with care’, which is seen as a phenomenon that takes place among many actors with different perspectives, ideas and cultures that must be carefully woven together in order to achieve the benefits of innovation.
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Chapter 4: Innovation with Care in Health Care: Translation as an Alternative Metaphor of Innovation and Change

John Damm Scheuer


John Damm Scheuer INTRODUCTION An innovation may be defined as an idea, practice or object that is perceived as new by an individual or other unit of adoption (Rogers, 1983: 11). Innovation in the public sector1 may be divided into different types of innovations: a new or improved service, a process innovation, an administrative innovation, system innovation, conceptual innovation and radical change of rationality (Koch and Hauknes, 2005). The focus of this chapter is the introduction of a process innovation in the form of a new idea and object aimed at organizing clinical pathways for patients in health care organizations. The idea/object is that of a “clinical pathway” which may be defined as “a standardized, prewritten, one- or two-page document showing the interventions of all disciplines along a time schedule. In effect, it is a grid, with time as one axis and staff actions as the other” (Zander, 1995: 9). It was developed by the nurse Karen Zander and her team of nurses at the New England Medical Center Hospitals in Boston (Zander, 1995) (Garbin, 1995) (Hofmann, 1993). According to Karen Zander the idea of clinical pathways soon spread internationally because they were not conceptual, visually appealing, easy to write and effective in reviewing and decreasing the length of stay of patients (Zander, 1995: 11). Following Vrangbæk (1999) the concept of New Public Management is related to a number of different tools of governance which, based on economic and theoretical ideas about rationality...

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