Browsing by Author "Leonard, Elizabeth"

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    Development of a health system framework to guide the analysis of innovation adoption in low and middle income countries
    (South African Institute for Industrial Engineering, 2018) Leonard, Elizabeth; De Kock, Imke; Bam, Wouter
    Healthcare systems face numerous challenges that put strain on the system. This is despite the countless resources that are expended on creating innovative healthcare solutions (ranging from innovative healthcare technologies, organisational innovations to pharmaceutical innovations). The literature on innovation and healthcare has shown that the adoption of innovations in practice within the healthcare system is hindered and limited. There is a need to explore and evaluate the role of the innovation system in South Africa insofar as it impacts the adoption of innovations into the national healthcare system. As a starting point, for assessing innovation adoption into health systems, it is necessary to be able to thoroughly describe a health system. In this paper a consolidated health system framework is developed. The purpose of this framework is to be utilised when developing a healthcare innovation adoption framework, i.e. as an input to the healthcare innovation adoption framework. The methodology used to develop the consolidated health systems framework are the eight phases of Jabareen’s conceptual framework. Jabareen’s framework is a qualitative technique for developing conceptual frameworks. The advantages of using this conceptual framework methodology include its capability to be modified, its flexibility and the focus being placed on understanding, rather than on predictions. The results of this research paper are a consolidated health systems framework which was created by considering existing health system frameworks. The consolidated health systems framework thoroughly describes all aspects of a health system by combining elements from six existing health system frameworks. The elements of the existing frameworks were categorised, integrated and synthesised, as per Jabareen’s methodology, to create a complete view of a health system; which includes health processes, building blocks, intermediate objectives and goals. This paper contributes to the field of health systems engineering by providing an extensive list of existing health system frameworks and by providing a framework that combines the major aspects of a health system to thoroughly and completely describe health systems.
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    The development of a healthcare innovation adoption readiness assessment tool (HIARAT)
    (Southern African Institute for Industrial Engineering, 2019) Leonard, Elizabeth; De Kock, Imke H.; Bam, Wouter
    ENGLISH ABSTRACT: A disconnect exists between innovations and the adoption of such innovations, specifically within healthcare facilities. This disconnect results in various healthcare challenges — ones that could be addressed by successfully adopting and integrating an innovation into organisational processes — not being addressed. To address the challenge of innovation adoption within healthcare, it is proposed that a tool be developed to identify areas that should be addressed to improve the chances of the successful adoption and integration of innovations into existing systems in a publichealthcare facility. By assessing a facility’s readiness for innovationadoption, it is possible to identify the barriers to the successful adoption of innovations. Knowing what such challenges or barriers to innovation adoption are will allow role players to address these challenges or barriers. The purpose of this paper is to develop the healthcare innovation adoption readiness assessment tool (HIARAT), which measures the maturity of a healthcare facility’s innovationadoption process. The HIARAT was validated through a face validation workshop, and through a case study at a South African public healthcare facility.
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    Evaluating the successful and sustainable implementation of evidence-based innovations in health systems in low- and middle-income countries: a maturity model approach
    (Stellenbosch : Stellenbosch University, 2023-03) Leonard, Elizabeth; de Kock, Imke. H.; Bam, Wouter. G.; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.
    ENGLISH ABSTRACT: The unsuccessful and unsustainable implementation of evidence-based health innovations frequently occurs, leading to missed opportunities that could have improved various aspects of a health system. Understanding the facilitators and barriers to the implementation of innovations is especially important in the low- and middle-income country (LMIC) context, where unsuccessful implementation practices impede the progress and improvement of health systems. While high-income countries and LMICs experience many of the same implementation facilitators and barriers, LMICs must deal with additional health system complexities that impact implementation. Improving the success and sustainability of innovation implementation has become one of the most apparent promoters of LMIC health system improvements. However, existing approaches aimed at facilitating the innovation implementation process either do not consider a holistic health innovation landscape and thus overlook key concepts; or have not specifically been developed for the LMIC context and thus do not adequately capture the contextual specificities of LMICs. To address this gap, a novel solution is developed in this study – the LMIC Health Innovation Implementation Maturity Model (HII-MM). The research strategy followed in this study is based on the design science strategy. Design science can be divided into three overarching phases: Exploratory, Formative and Evaluative Phases. During the Exploratory Phase, the specific problem and resulting objectives are investigated through three sets of literature reviews: conceptual, systematic, and comparative literature reviews. During the Formative Phase, the solution to the identified problem is developed, namely the HII-MM. Lastly, during the Evaluative Phase, the developed solution is iteratively refined through theoretical and structural verification strategies, and the HII-MM's efficacy in solving the identified problem is validated. The HII-MM is a maturity assessment tool that facilitates the assessment of LMIC health innovation landscapes. It defines the system's current implementation maturity, identifies gaps hindering an innovation's successful and sustainable implementation, and provides potential maturation paths that can inform improvement initiatives. The HII-MM is made up of three dimensions: (i) implementation domains, which describe the concepts that act as either facilitators or barriers when implementing an evidence-based innovation within an LMIC health system, (ii) health system levels, which portray the health system that is being assessed, and (iii) maturity levels, which are statements that enable the understanding of the system's capability to implement an innovation. To verify the HII-MM subject matter expert (SME) interviews and a case study on a mHealth audiology device was leveraged. Then, to validate the HII-MM, additional SME interviews were conducted with expert representation from 25 unique LMICs and two case studies were carried out. The first case study is on the maternal health innovation MomConnect and the second is on the contact tracing innovation COVID Alert. These validated the transferability, flexibility, usefulness, and usability of the HII-MM. This study contributes to the growing literature that aims to inform health system stakeholders in LMICs on successfully and sustainably implementing evidence-based health innovations. The study promotes greater access to evidence-based health innovations to encourage health equity and improve the performance of LMIC health systems.