City Research Online

Abstract

Issue
In broad terms, current thinking and literature on the spread of innovations in healthcare presents it as the study of two unconnected processes – diffusion across adopting organizations, and implementation within adopting organizations. Evidence from the healthcare environment and beyond, however, shows the significance and systemic nature of post-adoption challenges in sustainably implementing innovations at scale. There is often only partial diffusion of innovative practices, initial adoption that is followed by abandonment, incomplete or tokenistic implementation, and localized innovation modifications that do not feed back to inform global innovation designs.

Critical Theoretical Analysis
Such important barriers to realizing the benefits of innovation question the validity of treating diffusion and implementation as unconnected spheres of activity. We argue that theorizing the spread of innovations should be re-focused towards what we call embedding innovation; the question of how innovations are successfully implemented at scale. This involves making the experience of implementation a central concern for the system-level spread of innovations rather than a localized concern of adopting organizations.

Insight/Advance
To contribute to this shift in theoretical focus, we outline three mechanisms which connect the experience of implementing innovations locally to their diffusion globally within a healthcare system; learning, adapting and institutionalizing. These mechanisms support the distribution of the embedding work for innovation across time and space.

Practical Implications
Applying this focus enables us to identify the self-limiting tensions within existing top-down and bottom-up approaches to spreading innovation. Further, we outline new approaches to spreading innovation which better exploit these embedding mechanisms.

Publication Type:	Article
Additional Information:	This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc
Subjects:	H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments:	Bayes Business School > Management
SWORD Depositor:	Symplectic Administrator

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