Diffusion of Innovations in Health Service Organisations A Systematic Literature Review

, by Greenhalgh, Trisha; Robert, Glenn; Bate, Paul; Macfarlane, Fraser; Kyriakidou, Olivia; Donaldson, Liam

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ISBN: 9780727918697 | 0727918699
Cover: Hardcover
Copyright: 3/12/2007

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This is a systematic review on how innovations in health service practice and organisation can be disseminated and implemented. This is an academic text, originally commissioned by the Department of Health from University College London and University of Surrey, using a variety of research methods. The results of the review are discussed in detail in separate chapters covering particular innovations and the relevant contexts. The book is intended as a resource for health care researchers and academics.

Acknowledgements

viii

Foreword

How to read this book

Summary overview

(19)

Introduction

(12)

What is diffusion of innovations theory?

(2)

Why did the UK Department of Health want to research the diffusion of innovations?

(3)

Scope of this research

(1)

Definitions

(5)

Structure of this book

(1)

Method

(16)

Outline of method

(2)

Planning phase

(1)

Search phase

(2)

Mapping phase

(1)

Appraisal phase

(2)

Synthesis phase

(2)

Meta-narrative review: philosophical origins and links with other approaches to the synthesis of complex evidence

(6)

The research traditions

(35)

The origins of diffusion of innovations research

(2)

Rural sociology

(2)

Medical sociology

(2)

Communication studies

(1)

Marketing and economics

(2)

Limitations of early diffusion research

(2)

Development studies

(2)

Health promotion

(2)

Evidence-based medicine and guideline implementation

(2)

Structural determinants of organisational innovativeness

(2)

Studies of organisational process, context and culture

(2)

Interorganisational studies: networks and influence

(1)

Knowledge-based approaches to diffusion in organisations

(7)

Narrative organisational studies

(2)

Complexity and general systems theory

(1)

Conclusion

(3)

Innovations

(17)

Background literature on attributes of innovations

(4)

The Tornatzky and Klein meta-analysis of innovation attributes

(3)

Empirical studies of innovation attributes

(4)

Limitations of conventional attribution constructs for studying adoption in organisational settings

(3)

Attributes of innovations in the organisational context

(3)

Adopters and adoption

100

(14)

Characteristics of adopters: background literature

100

(3)

Adoption as a process: background literature

103

(3)

Assimilation of innovations in organisations

106

(8)

Diffusion and dissemination

114

(20)

Communication and influence through interpersonal networks

114

(4)

Opinion leaders

118

(8)

Champions and advocates

126

(3)

Boundary spanners

129

(1)

Change agents

130

(1)

The process of spread

130

(4)

The inner context

134

(23)

The inner context: background literature

134

(1)

Organisational determinants of innovativeness: meta-analyses

135

(5)

Organisational determinants of innovativeness: overview of primary studies in the service sector

140

(1)

Empirical studies on organisational size

141

(5)

Empirical studies on structural complexity

146

(2)

Empirical studies on leadership and locus of decision-making

148

(2)

Empirical studies on organisational climate and receptive context

150

(4)

Empirical studies on supporting knowledge utilisation and manipulation

154

(3)

The outer context

157

(18)

Interorganisational influence through informal social networks

157

(6)

Interorganisational influence through intentional spread strategies

163

(7)

Empirical studies of environmental impact on organisational innovativeness

170

(2)

Empirical studies of impact of politics and policymaking on organisational innovativeness

172

(3)

Implementation and institutionalisation

175

(24)

Overview of the implementation literature

176

(2)

Measuring institutionalisation and related concepts

178

(2)

Implementation and institutionalisation: systematic reviews and other high-quality overviews

180

(6)

Empirical studies of interventions aimed at strengthening predisposition and capacity of the user system

186

(4)

Empirical studies of interventions aimed at strengthening the resource system and change agency

190

(1)

Empirical studies of linkage activities to support implementation

191

(4)

Empirical studies that have investigated `whole-systems' approaches to implementation

195

(4)

Case studies

199

(20)

Developing and applying a unifying conceptual model

199

(3)

Case study 1: integrated care pathways ('the steady success story')

202

(2)

Case study 2: GP fundholding ('the clash')

204

(2)

Case study 3: telemedicine ('the maverick initiative')

206

(2)

Case study 4: the electronic health record ('the big roll-out')

208

(2)

Conclusion

210

(9)

Discussion

219

(13)

Overview and commentary on main findings

219

(1)

A framework for applying the model in a service context

220

(5)

Recommendations for further research

225

(6)

Conclusion

231

(1)

Appendix 1: Data extraction form

232

(2)

Appendix 2: Critical appraisal checklists

234

(11)

Box A.1 Quality checklist for experimental (randomised and non-randomised controlled trial) designs

234

(1)

Box A.2 Quality checklist for quasi-experimental (interrupted time series) designs

235

(1)

Box A.3 Quality checklist for attribution studies

236

(1)

Box A.4 Quality checklist for questionnaire surveys

237

(1)

Box A.5 Quality checklist for qualitative studies

238

(1)

Box A.6 Quality checklist for mixed-methodology case studies and other in-depth complex designs

239

(1)

Box A.7 Quality checklist for comparison of `real-world' implementation studies

240

(2)

Box A.8 Quality checklist for action research designs

242

(3)

Appendix 3: Descriptive statistics on included studies

245

(10)

Table A.1 Main sources and yield of papers, books and book chapters

247

(1)

Table A.2 Breakdown of studies included in the book

248

(1)

Table A.3 Yield from hand search of journals

249

(3)

Table A.4 Yield from search of electronic databases

252

(2)

Table A.5 Yield from electronic citation tracking

254

(1)

Appendix 4: Tables of included studies

255

(38)

Table A.6 Narrative overviews used as key sources in this review

255

(2)

Table A.7 Empirical studies of attributes of health care innovations in the organisational setting

257

(3)

Table A.8 Empirical studies that focused on the process of adoption in health care organisations

260

(2)

Table A.9 Network analyses of interpersonal influence in health care organisations

262

(1)

Table A.10 Empirical studies of opinion leadership in health care organisations

263

(2)

Table A.11 Controlled trials of opinion leaders as an intervention in health care organisations

265

(2)

Table A.12 Empirical studies of impact of champions in health care organisations and selected other examples

267

(2)

Table A.13 Meta-analyses that addressed the impact of the organisational context on adoption of innovations

269

(2)

Table A.14 Empirical studies of `inner' context determinants of innovation in health care organisations and selected other examples

271

(3)

Table A.15 Empirical studies from health care that looked at the organisational context for innovation from a knowledge utilisation perspective

274

(2)

Table A.16 Empirical studies of informal inter-organisational influence amongst health care organisations and selected other examples

276

(2)

Table A.17 Empirical studies on health care quality improvement collaboratives

278

(2)

Table A.18 Empirical studies of impact of environmental factors on innovation in health care organisations and selected other examples

280

(3)

Table A.19 Empirical studies of impact of political and policymaking forces on organisational innovation

283

(2)

Table A.20 Systematic reviews relevant to the question of dissemination, implementation and sustainability of innovations in service delivery and organisation

285

(2)

Table A.21 Surveys of perceptions about capacity or of association between capacity and implementation in health care organisations

287

(2)

Table A.22 Empirical studies of interventions to enhance user system capacity in health care organisations

289

(2)

Table A.23 `Whole-systems' approaches to implementation and sustainability of innovations in health care organisations and selected other examples

291

(2)

Glossary

293

(3)

References

296

(17)

Index

313

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Diffusion of Innovations in Health Service Organisations A Systematic Literature Review

Summary

Author Biography

Table of Contents

Supplemental Materials