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- W836131623 abstract "Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation." @default.
- W836131623 created "2016-06-24" @default.
- W836131623 creator A5042034521 @default.
- W836131623 creator A5052902218 @default.
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- W836131623 date "2015-06-26" @default.
- W836131623 modified "2023-10-01" @default.
- W836131623 title "Implementing Role-Changing Versus Time-Changing Innovations in Health Care" @default.
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- W836131623 doi "https://doi.org/10.1177/1077558715592315" @default.
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