Top-Down ja Bottom-Up: Huomioita systeemisten innovaatioiden johtamisesta julkisessa terveydenhuollossa

Lauri Kokkinen, Sirkku Kivisaari, Eveliina Saari, Juhani Lehto

Research output: Contribution to journalArticleScientific


The article is based on literature review and it discusses the management of system innovations in public health care. System innovation is defined as a new model of operations in the context of health care system. Management of system innovations begins with the identification and interpretation of a need, threat or a possibility and leads to trying something new. The article argues that there are two kinds of processes concerned with the management of system innovations: namely top-down processes and bottom-up processes. First, the utilization and spreading of system innovations can be managed from outside the service-provision organizations. Second, the development and utilization of system innovations requires taking leadership inside the health care system and service-provision organizations
Original languageFinnish
Pages (from-to)374-385
JournalKunnallistieteellinen aikakauskirja
Issue number4
Publication statusPublished - 2011
MoE publication typeB1 Article in a scientific magazine


  • System innovation
  • health care
  • management

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