2014
DOI: 10.1186/s13012-014-0121-0
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Multi-level factors influence the implementation and use of complex innovations in cancer care: a multiple case study of synoptic reporting

Abstract: BackgroundThe implementation of innovations (i.e., new tools and practices) in healthcare organizations remains a significant challenge. The objective of this study was to examine the key interpersonal, organizational, and system level factors that influenced the implementation and use of synoptic reporting tools in three specific areas of cancer care.MethodsUsing case study methodology, we studied three cases in Nova Scotia, Canada, wherein synoptic reporting tools were implemented within clinical departments… Show more

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Cited by 49 publications
(59 citation statements)
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References 52 publications
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“…Second, organizations could include middle managers as more active participants in decision‐making processes rather than organizational actors who merely provide information (“facts and figures”) to help others make decisions. Such involvement may help ensure that implementation decisions better reflect on‐the‐ground needs and realities, that innovations are better aligned with the local setting from the outset, and increase middle managers' own support and buy‐in for implementation in circumstances where this is lacking (Urquhart, Porter, Sargeant, Jackson, & Grunfeld, ).…”
Section: Discussionmentioning
confidence: 99%
“…Second, organizations could include middle managers as more active participants in decision‐making processes rather than organizational actors who merely provide information (“facts and figures”) to help others make decisions. Such involvement may help ensure that implementation decisions better reflect on‐the‐ground needs and realities, that innovations are better aligned with the local setting from the outset, and increase middle managers' own support and buy‐in for implementation in circumstances where this is lacking (Urquhart, Porter, Sargeant, Jackson, & Grunfeld, ).…”
Section: Discussionmentioning
confidence: 99%
“…109,110 As we have argued, MTS care coordination operates at multiple levels and a science of team-based care for complex cancer patients will require multi-level interventions and multi-level evaluations. 111113 …”
Section: Implications For Researchmentioning
confidence: 99%
“…At the organizational level, several articles have [25][26][27][28][29]36,37 Other studies that have used frameworks like the Barriers Scale and Middle Manager's role in innovation implementation have also found support for individual components of the Innovation Implementation Framework, like "presence of a champion" and "support from management." [30][31][32][33][34] At the clinician level, applications of frameworks like Disruptive Innovation theory, Deskilling and Adaptation, and Sense-Making theory, among others, have helped to demonstrate the crucial role of "innovation-values fit" for enabling behavior change and innovation implementation among frontline clinicians.…”
Section: Key Insights From Retrospective Articles On Innovation Implementioning
confidence: 99%