From health service quality to health system quality. A network innovation adoption and diffusion

Growing demand for health care due to the ageing of the population, rising costs, constrained resources, and evidence variations in clinical practice have increased interest in improving the attention on quality for health services. Quality in this context is mainly based on two dimensions: access and effectiveness. But, due to the challenging environment, to the objectives of the health services and to the structure of the NHS, this is no more sufficient. Attention to issues such as service innovation, attributes and conditions for its adoption and diffusion, patient’s centered care via technological supports, lead to a new scenario of health care services based on the sharing of competencies of different actors belonging to a net system. Those are the elements on which the present work focuses. In this context the main aim of this work is to investigate the link between quality in health services and adoption and diffusion of innovation thanks to a network approach. Quality in health services is reached through the network. The network allows a particular process of services innovation adoption and diffusion that produces not only technical but also relational quality. In this way the quality of a specific innovative service generates benefits also for the health system considered as a whole. In the conceptual framework previously described, this work goes more in depth in the features of the several actors that are involved in the generation of new services and upstream in analyzing which are the conditions for an improved quality of health services thanks to the adoption and diffusion of innovations. In particular the attention is focused on the resources provided by the different actors belonging to the network and on the characteristics of each organization involved in the creation of the innovative services. After a literature review this work investigates the case of an Italian innovative health service provided by a rehabilitative structure, Villa Beretta, a detached ward of the Valduce Hospital. The paper emphasizes how the development of the innovative services presented are based on the interrelationships of several actors specialized in different core activities. More and more the hospitals have to face complex needs. For this reason the hospitals need to attract several actors that provide specific resources. In this way the focus is centered on how those actors cooperate in order to grant value not only to their health performances but also to the entire system.