Three physicians write in NEJM Catalyst about whether healthcare organizations should  decide between small, incremental improvements or care redesign. Among their remarks:

“The shift from volume- to value-based payment may constrain revenue, forcing organizations to consider dramatic changes to care delivery. Doing this may require increasing their capacity for innovation relative to incremental improvement. Innovation and improvement are sometimes used interchangeably, but the distinction between them matters.

“Quality improvement methods are usually applied to refine existing care delivery processes. The way forward is relatively clear, and the returns are predictable and quick. Innovation, however, involves creating new products, services, or processes. The way forward is filled with uncertainty. Will the new approach work? When will it show results? Given the choice, most organizations are more comfortable with the predictability of quality improvement, labeling it innovation in some cases, but shunning the risk-taking that characterizes true innovation work.

“But incremental improvement in the absence of some degree of innovation is likely to produce limited gains.

They conclude:

“To thrive in a value-based care environment, organizations will have to be able to do the same things more efficiently and take advantage of the opportunities of digital health, patient empowerment, and integration across sectors to redesign much higher-value care. Organizations will need to decide how much money, time, or political capital they should expend to build structures and cultures that support both the goals of improvement and of innovation.”

To read their essay, please hit this link.