Innovation in healthcare: how does credible evidence influence professionals?
Corresponding Author
Louise Fitzgerald PhD BA(Econ)Hons DipPM
Department of Human Resource Development, Leicester Business School, De Montfort University, Leicester, UK,
Correspondence Louise Fitzgerald Professor of Human Resource Development Department of Human Resource Development Leicester Business School De Montfort University The Gateway Leicester LE1 9BH UK E-mail: [email protected]Search for more papers by this authorEwan Ferlie BA Hons MSc PhD
The Management School, Imperial College, London and
Search for more papers by this authorChristine Hawkins MA
Centre for Creativity, Strategy and Change, Warwick Business School, University of Warwick, Warwick, UK
Search for more papers by this authorCorresponding Author
Louise Fitzgerald PhD BA(Econ)Hons DipPM
Department of Human Resource Development, Leicester Business School, De Montfort University, Leicester, UK,
Correspondence Louise Fitzgerald Professor of Human Resource Development Department of Human Resource Development Leicester Business School De Montfort University The Gateway Leicester LE1 9BH UK E-mail: [email protected]Search for more papers by this authorEwan Ferlie BA Hons MSc PhD
The Management School, Imperial College, London and
Search for more papers by this authorChristine Hawkins MA
Centre for Creativity, Strategy and Change, Warwick Business School, University of Warwick, Warwick, UK
Search for more papers by this authorAbstract
The objectives of the present paper are to describe selected findings from a research project on the diffusion and adoption of innovations in primary-care settings. The project design was a comparative case study design exploring four innovations in different settings. The findings are used to explore the influence of evidence on clinical behaviour, particularly how clinical professionals judge credible evidence and take decisions. The article goes on to explore other influences on behaviour and the role of context in shaping processes and behaviour. Finally, the concluding section draws out the relevance of these data for the current changes being implemented in primary care, and raises questions about the implementation of clinical governance and quality improvements.
References
- Anglia and Oxford Regional Health Authority (1994) Getting Research into Practice and Purchasing (GRIPP), Four Counties Approach; Resource Pack. Anglia and Oxford Regional Health Authority, Oxford.
-
Brock D.,
Powell M. &
Hinings C.R. (1999) Restructuring the Professional Organisation. Routledge, London.
10.4324/9780203018446 Google Scholar
- Callon M., Laredo P., Rabehariosoa V., Gonadr T. & Leray T. (1992) The management and evaluation of technological programs and the dynamics of techno-economic networks: the case of the AFME. Research Policy 21 215–236.
- Cmnd 3807 (1997) The New NHS: Modern, Dependable. The Stationery Office, London.
- Cochrane A. (1972) Effectiveness and Efficiency: Random Reflections on Health Services. Nuffield Provincial Hospitals Trust, London.
- Coleman J., Katz E. & Menzel H. (1966) Medical Innovation: A Diffusion Study. Bobs Merill, New York, NY.
- Department of Health (1998) A First Class Service: Quality in the New NHS. The Stationery Office, London.
- Department of Health (2000) The NHS Plan – A Plan for Investment, a Plan for Reform. The Stationery Office, London.
- Dopson S., Miller R., Dawson S. & Sutherland K. (1999) Influences on clinical practice. Quality in Health Care 8, 108–118.
- Eisenhardt K. (1989) Building theories from case research. Academy of Management Review 14, 532–550.
- Fairhurst K. & Huby G. (1998) From trial data to practical knowledge: a qualitative study of how general practitioners have accessed and used evidence about statin drugs in their management of hypercholesterolaemia. British Medical Journal 317, 1130–1134.
- Ferlie E., Fitzgerald L. & Wood M. (2000) Getting evidence into clinical practice? An organisational behaviour perspective. Journal of Health Services Research and Policy 5, 96–102.
- Ferlie E., Fitzgerald L., Wood M. & Hawkins C. (2001) The non-spread of innovations: the mediating role of professionals. Paper presented at the Academy of Management, Washington, DC, 5–8 August 2001.
-
Ferlie E. &
Pettigrew A.M. (1996) Managing through networks: some issues and implications for the NHS.
British Journal of Management
7, 81–99.
10.1111/j.1467-8551.1996.tb00149.x Google Scholar
- Fitzgerald L. (1999) Case studies as a research tool. Quality in Health Care 8, 75.
- Fitzgerald L., Ferlie E., Wood M. & Hawkins C. (1999a) Evidence into practice? An exploratory analysis of the interpretation of evidence. In: A. Marks & S. Dopson (Eds) Organisational Behaviour in Health Care, pp. 189–206 . Macmillan, London.
- Fitzgerald L., Ferlie E., Wood M. & Hawkins C. (2002) Interlocking interactions: the diffusion of innovations in health care. Human Relations 55, 1–21.
- Fitzgerald L., Hawkins C. & Ferlie E. (1998) Understanding change in primary care practice. Paper presented at the Royal College of General Practitioners’ Research Symposium, Regents College, London, 21 May 1998.
- Fitzgerald L., Hawkins C. & Ferlie E. (1999b) Understanding Change in Primary Health Care Practice: Behavioural, Organisational and Scientific Processes. Final report to W. Midlands R&D Directorate. [WWW document.] URL http://www.doh.gov.uk/research/wmro
- Fitzgerald L., Hawkins C. & Ferlie E. (1999c) Interpretation of evidence from primary care research. Paper presented at the 2nd Annual Conference of the Federation of Primary Care Research Networks, London, 7 October 1999.
- Glaser B. & Strauss A. (1967) The Discovery of Grounded Theory. Aldine, Chicago, IL.
- Handy C. (1986) Understanding Organisations. Penguin, Harmondsworth.
- Huxham C. & Vangen S. (2000) Leadership in the shaping and implementation of collaborative agendas: how things happen in a (not-quite) joined up world. Academy of Management Journal 43, 1159–1176.
- Kimberly J.R. (1981) Managerial innovation. In: P. Nystrom & W. Starbuck (Eds) Handbook of Organisational Design, Vol. 1, pp. 84–104 . Oxford University Press, Oxford.
- Kimberly J.R. & Evanisko M.J. (1981) Organisational innovation: the influence of individual, organisational and contextual factors on hospital adoption of technological and administrative innovations. Academy of Management Journal 24, 689–713.
- Langley A. (1999) Strategies for theorizing from process data. Academy of Management Review 24, 691–710.
- Latour B. (1987) Science in Action. Harvard University Press, Cambridge, MA.
- Lea M., O'Shea K. & Fung P. (1995) Constructing the networked organization: content and context in the development of electronic communications. Organization Science 6, 462–478.
- Lee T.W. (1999) Using Qualitative Methods in Organizational Research. Sage, Thousand Oaks, CA.
- Locock L., Dopson S., Chambers D. & Gabbay J. (2001) Understanding opinion leaders’ roles. Social Science and Medicine 53, 745–757.
- Mintzberg H. (1983) Structure in Fives, Designing Effective Organizations. Prentice Hall, Englewood Cliffs, NJ.
- Pettigrew A. (1990) Longitudinal field research on change: theory and practice. Organization Science 1, 267–292.
-
Pettigrew A. (1997) What is processual analysis?
Scandinavian Journal of Management
13, 337–348.
10.1016/S0956-5221(97)00020-1 Google Scholar
- Pettigrew A.M., Ferlie E. & McKee L. (1992) Shaping Strategic Change; the Case of the NHS. Sage, Thousand Oaks, CA.
- Pettigrew A.M. & Fenton E. (Eds) (2000) The Innovating Organisation. Sage, Thousand Oaks, CA.
- Rich R.F. (1997) Measuring knowledge utilization: processes and outcomes. Knowledge and Policy: the International Journal of Knowledge Transfer and Utilization 10, 11–24.
- Rogers E. (1995) The Diffusion of Innovations, 4th edn. Free Press, New York, NY.
- Thomson O’Brien M.A., Oxman A.D., Haynes R.B., Davis D.A., Freemantle N. & Harvey E.L. (1999) Local Opinion Leaders: effects on professional practice and health care outcomes (Cochrane Review). In: The Cochrane Library, Issue 3. Update Software, Oxford.
- Van de Ven A., Polley D.E., Garud R. & Venkataraman S. (1999) The Innovation Journey. Oxford University Press, Oxford.
- Williamson P. (1992) From dissemination to use: management and organisational barriers to the application of health services research findings. Health Bulletin 50, 78–86.
- Williams F. & Gibson D.V. (1990) Technology Transfer – A Communications Perspective. Sage, Thousand Oaks, CA.
- Wood M., Ferlie E. & Fitzgerald L. (1998) Achieving clinical behaviour change: a case of becoming indeterminate. Social Science and Medicine 47, 1729–1738.
- Yin R.R.K. (1994) Case Study Research: Design and Method, 2nd edn. Sage, Thousand Oaks, CA.