The Development of the Innovation Readiness Inventory: An Assessment Tool to Assess Innovation Readiness of Nursing Organizations.

Nursing organizations are expected to make contributions to innovation in Healthcare. However, they are often not innovation ready. How do nursing organizations know how Innovation Ready they are? What should nursing organizations do to become more Innovation Ready? In literature, there exists no consolidated resource to help nursing organizations to answer these questions. Therefore, this research aimed to support nurse-led innovation by developing an Innovation Readiness Inventory to be used as an assessment tool to qualitatively assess the innovation readiness of nursing organizations and support decision-making on actions to be implemented towards innovation readiness. The researchers performed a literature review to provide the theoretical basis for the assessment tool. Thereafter, the researchers engaged innovation experts and end-users in the form of nurse directors and managers, and frontline nurses. The researchers conducted semi-structured interviews, surveys, and design workshops and performed directed qualitative content analysis where relevant. Throughout, emphasis was placed on the scientific rigor of the research methodology with the intent to ensure the "trustworthiness" of the outcomes. To this end, the researchers implemented published best practices, when relevant and appropriate. As contribution to the discussion around nurse-led innovation, this research delivers the innovation readiness inventory that focusses the discussion on nursing organizations and the nurses within, and discusses challenges and opportunities related to the use thereof.

Shifting the distribution curve for healthcare resource use through topical oxygen therapy for wound healing.

The clinical and economic burden associated with hard-to-heal wounds is high and evidence suggests that it continues to increase. Healthcare resources consumed during the provision of wound care can be saved by implementing strategies and actions aimed at promoting wound healing. When these are successful, the frequency distribution curve for time to healing and for the consumption of healthcare resources should 'move to the left' and the extent to which it is 'skewed to the right' would be reduced, resulting in a reduction in the population mean for time to wound healing, and correspondingly, healthcare resources. Not only would this release healthcare resources in the short term, but, if these changes are maintained, would render savings sustainable, thereby contributing to lowering the overall burden of wounds and wound care. In this article, we present evidence that suggests that the adoption of adjunct topical haemoglobin spray can effect these desired changes in the wound healing curve and, due to the nature of the technology, it can be easily and sustainably implemented within relevant whole populations requiring wound care. The ease of adoption and impact is further illustrated by a patient case study.

Using the MEAT VBP Framework to analyse and understand the value of surgical gloves: an explanatory case study.

BACKGROUND: Value-based healthcare is being extensively piloted, scaled and implemented by healthcare providers and systems around the world. However, the ability of the healthcare supply chain function to strategically contribute to the improvement of value has been held back by a lack of practical tools for turning value-based procurement from concept into action. Two recently developed conceptual models - the American CQO Movement and the European MEAT VBP Framework - have been developed to support the implementation of value-based procurement in healthcare. We demonstrate how the latter of these models can be adapted and applied pragmatically to generate insights into the value of a specific medical device, technology or consumable. METHODS: We undertook an explanatory, qualitative, single-case study focused on a specific consumable - surgical gloves - that provide a critical example of a type of medical device usually procured in high volumes but at risk of commoditisation due to a widespread lack of understanding of their value. Since the global Covid-19 pandemic prevented fieldwork, structured interviews were conducted via Zoom and corroborated by a literature review. RESULTS: We identified ten cost criteria and eight outcome criteria with which the value of surgical gloves can be analysed and understood. For each of these criteria we propose definitions and value impact metrics that decision-makers can use during a procurement exercise to describe, quantify and compare glove value. CONCLUSION: The MEAT VBP Framework provides a highly practical and adaptable means of imposing both structure and rigour on a value analysis process and of qualitatively describing the potential value impact of surgical gloves for patients, professionals, providers and health systems.

Cost-effectiveness of adjunct haemoglobin spray in the treatment of hard-to-heal wounds in a UK NHS primary care setting.

OBJECTIVE: To evaluate the cost-effectiveness of topical haemoglobin spray as adjunct therapy in the treatment of hard-to-heal wounds within a UK National Health Service (NHS) community setting. METHOD: In a previously published comparative clinical evaluation, 50 consecutive patients treated with topical haemoglobin spray, as adjunct to standard care and followed up over 26 weeks, were compared with 50 consecutive retrospective controls from the same clinic treated with the same standard care protocol in the year prior to the introduction of adjunct topical haemoglobin spray. A de novo cost-effectiveness and break-even analysis were performed, using data from the previously published clinical evaluation, for all patients (intent-to-treat) and for patients with complete follow-up using a micro-costing approach and considering only wound care dressing costs. RESULTS: At 26 weeks, the total cost of dressings for all patients in the intervention group was £6953 with 874 cumulative weeks healed, compared with £9547 with 278 cumulative weeks healed for all patients in the control group. The incremental cost-effectiveness ratio (ICER), the incremental cost per additional week healed with adjunct topical haemoglobin spray, is therefore negative (dominant). Total treatment costs per week were lower from week six onwards, with break-even estimated to be at week 10.2. When considering only patients with complete follow-up, the results were similarly dominant, with a mean 10.9 more weeks healed, a mean dressing cost saving per patient of £81.83 by week 26 (-37%). Cost savings were realised from week five, and a break-even was estimated to occur at week 8.0. CONCLUSION: Topical haemoglobin spray has the potential to restore the healing process, reduce healing times and reduce dressing costs in a NHS community setting, within a few weeks of adoption.

Cost-effectiveness analysis of a sealing hemostat patch (HEMOPATCH) vs standard of care in cardiac surgery.

BACKGROUND: A recent randomized controlled trial showed that patients undergoing ascending aorta surgery treated with HEMOPATCH to control bleeding had a significantly better hemostasis success rate than with dry or wet gauze compression or similar standard of care (SOC). OBJECTIVE: To compare the cost-effectiveness using two different agents for hemostasis (HEMOPATCH vs dry or wet gauze compression or similar SOC) in cardiac surgery from the European hospital perspective. METHODS: A literature-based cost-effectiveness model estimating average cost per successful hemostasis event was developed based on the hemostasis efficacy difference (HEMOPATCH = 97.6%, SOC = 65.8%, p < .001). Additional clinically significant end-points studied in the trial (blood transfusions and surgical revisions) were also analyzed. It was assumed that each surgery utilized two units of HEMOPATCH (dimensions of 4.5 × 9 cm) and two units of SOC. Product acquisition costs for HEMOPATCH and SOC were included along with outcome-related costs derived from the literature and inflation-adjusted to 2017 EUR and GBP. Results are presented for an average hospital with an annual case load of 574 cardiac surgeries. One-way and probabilistic sensitivity analyses were performed. RESULTS: Considering only product acquisition cost, HEMOPATCH had an incremental cost-effectiveness ratio (ICER) of €1,659, €1,519, €1,623, and £1,725 per hemostasis success when compared to SOC for Italy, Spain, France, and the UK, respectively. However, when considering the cost and potential difference in the frequency of transfusions and revisions compared to SOC, the use of HEMOPATCH was associated with an annual reduction of six revisions and 60 transfusions, improving the ICER to €1,440, €1,222, €1,461, and £1,592, respectively. Sensitivity analysis demonstrated model robustness. CONCLUSIONS: This analysis supports the use of HEMOPATCH over SOC in cardiac surgery in European hospitals to improve hemostasis success rates and potential cost offsets from reduced transfusions, complications, and surgical revisions.