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

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