Action plan for disseminating effective health innovations

Description

Based on a study of the spread of innovation in the health sector, the author prepared this position paper for the Ministry of Health in New Zealand. The report targets changes both at the organizational and systems levels to foster environments supportive of change and innovation.

Several different areas of research within the organization and management literature inform this method. These theories examine different perspectives of how organizations adopt and implement innovations.

1. Structural determinants of an organization's capacity for innovation, such as size, slack resources, specialization, functional differentiation and decentralized decisionmaking.
2. Organizational processes and culture, such as prevailing workplace norms, leadership style, social relations and attitudes toward risk taking.
3. Interorganizational relations, where the influence of other organizations persuades an organization's capacity to develop and adopt innovations. Focusing on interorganizational communication, collaboration and norms, the literature looks at networks amongst individuals across organizations as vehicles for innovation spread based on 'social network theory.'
4. Knowledge-based approaches to innovation in organzations, which looks at the organization's absorptive capacity for new information. Absorptive capacity includes the organization's existing knowledge base, values and goals oriented toward learning, technological infrastructure, leadership and knowledge sharing.
5. Narrative organizational studies, where an innovative organization supports sharing and capturing new ways of performance. Within this literature, innovation is supported through 'communities of practice' where stories of innovation are shared.
6. Complexity studies where the diffusion of innovations is viewed as a highly fluid and flexible process. This literature looks at how the innovation is adapted to the organization, and how the organization changes to accomodate the innovation.

Steps for Using Method/Tool

The plan identifies three main steps to spread proven health innovations.

A) Innovation and innovation spread

Innovation development and spread is highly dependent on social interaction, rather than technical and structural issues alone.

Innovation

• Innovations have two critical aspects: novelty (a new configuration of resources, behaviours, strategies) and problem orientation (improving how current programs achieve their desired results).
• A barrier to spread innovations is their challenge to the status quo.
• Innovation can be thought of as a continuum that includes the initial idea to subsequent best practice (an innovation with a local track record of success), to research-based evidence (best practice with proven generalizable value).

Innovation spread:

There are three key components of innovation spread:

1. Developing Innovations. Organizations that produce innovation are characterized by: dedicating time and resources for reflection and exploration of new ideas; senior leadership valuing and committing to innovation; tolerating and sharing stories of success and failure in experimentation; reflective time for addressing implementation issues; and the facilitation of networking and sharing amongst innovators, evaluators and implementers.
2. Disseminating Innovations. Effective dissemination of innovations is characterized by: attending to potential adopters' needs and their resources; tailoring different strategies to different audiences; using persuasive channels of communication; developing compelling messages; and using relevant evaluation findings in messages.
3. Adopting Innovations. Organizations most likely to have the capacity to adopt innovations have: decentralized decision-making; specialized professional expertise working in a team environment; slack resources for new projects; and mature structures.

B) Production, dissemination and adoptation

• Innovations often emerge in the health sector, but the evaluation infrastructure to establish their worth is missing.
• The timing is excellent to create an applied research and evaluation infrastructure.
• Evaluation is needed to determine if an innovation is worthwhile to pursue; solid evaluation findings can assist in disseminating innovations.
• There is emerging network support in health target areas that has the potential to address the need of regional or national venues for innovation dissemination.
• There are economic, historical and cultural factors impeding inter-organizational collaboration and innovation adoption.
• Leadership for innovation development and adoption is lacking.
• Few opportunities exist for exchange and interaction across and between different segments of health care organizations, ministries and universities.
• There is a lack of reflective time to foster a culture of innovation.

C) An action plan

The developer suggests a number of actions to address gaps in innovation spread including:

• Developing a strategy and infrastructure for applied research and evaluation of innovations, with a focus on health targets provided by the Ministry of Health.
• Encouraging and supporting regional and national networks and exchanges to foster social and relational capital amongst health care organizations, ministries and universities.
• Fostering the development of evidence-informed decision-making and innovation within senior leadership within health care organizations and government.
• Organizing reflective opportunities to foster innovation at all levels.
• Supporting knowledge brokers to foster innovation spread.
• Providing training in the use of innovation and research adoption as a change management tool.
• Establishing an external clearinghouse with innovations relevant to health priorities.