Berta Whitney, Teare Gary F, Gilbart Erin, Ginsburg Liane Soberman, Lemieux-Charles Louise, Davis Dave, Rappolt Susan
Health Services Organization and Management, Department of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.
Health Care Manage Rev. 2005 Oct-Dec;30(4):282-92. doi: 10.1097/00004010-200510000-00002.
We apply the theoretical frameworks of knowledge transfer and organizational learning, and findings from studies of clinical practice guideline (CPG) implementation in health care, to develop a contingency model of innovation adoption in long-term care (LTC) facilities. Our focus is on a particular type of innovation, CPGs designed to improve the quality of LTC. Our interest in this area is founded on the premise that the ability of LTC organizations to adopt and sustain the use of innovations like CPGs is contingent on the initial capacity these institutions have to learn about them, and on the presence of factors that contribute to capacity building at each stage of innovation adoption. Based on our review of relevant theory, we develop a set of fifteen testable propositions that relate factors operating at the guideline, individual, organizational, and environmental levels in LTC institutions to stages of guideline adoption/transfer. Our model offers insights into the complexities of adopting and sustaining innovations in LTC facilities particularly, in health care organizations specifically, and in service organizations generally.
我们应用知识转移和组织学习的理论框架，以及医疗保健领域临床实践指南（CPG）实施研究的结果，来构建长期护理（LTC）机构创新采用的权变模型。我们关注的是一种特定类型的创新，即旨在提高长期护理质量的临床实践指南。我们对这一领域的兴趣基于这样一个前提，即长期护理组织采用和持续使用诸如临床实践指南等创新的能力，取决于这些机构了解这些创新的初始能力，以及在创新采用的每个阶段有助于能力建设的因素的存在。基于我们对相关理论的综述，我们提出了一组十五个可检验的命题，这些命题将长期护理机构中在指南、个人、组织和环境层面起作用的因素与指南采用/转移的阶段联系起来。我们的模型为长期护理机构，特别是医疗保健组织，以及一般服务组织采用和持续创新的复杂性提供了见解。
