Explaining Diffusion Patterns for Complex Health Care Innovations

Denis, Jean‐Louis; Hébert, Yann; Langley, Ann; Lozeau, Daniel; Trottier, Louise-Hélène

doi:10.1097/00004010-200207000-00007

Cited by 327 publications

(329 citation statements)

References 9 publications

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“…For example, call centre staff typically have an arrangement with the families of their clients as to who will be called, under what circumstances and what actions will be taken when an alarm is triggered. Interviews with people involved in the development of ALT devices and provision of services in the UK (for a full account see Sugarhood et al 2014) illustrated that for the technology to 'work' effectively, this network of professional and lay carers (the technology's 'soft periphery' (Denis et al 2002)) must be adaptable to the needs of the client, though we found that this did not always occur in practice.…”

Section: Assisted Living Technologies and Servicesmentioning

confidence: 83%

Telecare Call Centre Work and Ageing in Place

Procter

Wherton

Greenhalgh

et al. 2016

Comput Supported Coop Work

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Abstract. We report findings from a study of call centre staff working to deliver a telecare service designed to enable older people to 'age in place'. We show the steps they routinely take to produce a care system on behalf of their clients and their families that is both workable within the constraints of available resources and fit-for-purpose. In doing so, we have seen how call centre staff share with one another their experiences and solutions to problems, carry out liaison work with networks of lay carers, and generally act as the 'glue' providing the all-important link between otherwise fragmented services. We conclude with some thoughts on the significant technical and organizational challenges if the 'ageing in place' vision is to be realized in a practical, secure, dependable and cost-effective way.

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Section: Assisted Living Technologies and Servicesmentioning

confidence: 83%

Telecare Call Centre Work and Ageing in Place

Procter

Wherton

Greenhalgh

et al. 2016

Comput Supported Coop Work

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show abstract

“…Perhaps evidence is not enough to convince us-as many sociologists have pointed out. Rogers' diffusion of innovations theory explains that innovations that depart from centuries-old traditions can be slow to take hold, and require innovators to spread them [49,50]. In Kuhn's theory of paradigm shifts, old models that no longer adequately account for anomalies are slowly replaced with new [51].…”

Section: Eliciting Values and Preferencesmentioning

confidence: 99%

Is Shared Decision Making a Utopian Dream or an Achievable Goal?

Blair

2015

Patient

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The idea of shared decision making (SDM) between patient and physician grew out of a generalized challenge to traditional social hierarchies that occurred in the middle of the last century. Governments have espoused SDM, thousands of articles about it have been published, and evidence has shown that it improves some of the healthcare processes as well as patient outcomes. Yet it has not been widely adopted. From their cross-disciplinary perspective (practical theology and clinical medicine), the authors locate this reluctance in the unfolding of scientific paradigm shifts, summarize the perceived risks and benefits of SDM and the evidence for each, and suggest practical, achievable approaches for clinicians. Finally, they explore some important emerging territories for SDM. Key Points for Decision MakersShared decision making (SDM) has proved its worth and is achievable … but debates continue.Several validated models are available right now for use in clinical practice.People can and are being successfully trained in SDM.SDM is needed to address emerging value-laden clinical decisions such as those about caring for the elderly and about genetic testing.

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“…Previous studies have shown this to be an important factor in the uptake of innovation in health services (see for example: Denis et al, 2002), and in this CAMHS team the purposeful presentation of this girl's critical juncture helped the larger, planned, effort of promoting system change by connecting with practitioners' beliefs. In terms of actors and their goals (Capoccia and Kelemen, 2007), the elevation of the girl's case into the meso-level was a purposeful act on the part of those concerned to introduce uncertainty in the service of organisational development.…”

Section: Aim Design and Methodsmentioning

confidence: 92%

Critical junctures in health and social care: Service user experiences, work and system connections

Hannigan

Evans

2013

Soc Theory Health

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This paper makes an original contribution through the revitalisation, refinement and exemplification of the idea of the 'critical juncture'. In the health and illness context a critical juncture is a temporally bounded sequence of events and interactions which alters, significantly and in a lasting way, both the experience of the person most directly affected and the caring work which is done. It is a punctuating moment initiating or embedded within a longer trajectory and is characterised by uncertainty. As contingencies come to the fore individual actions have a higher-than-usual chance of affecting future, enduring, arrangements. These ideas we illustrate with detailed qualitative data relating to one individual's journey through an interconnected system of mental health care. We then draw on observations made in a second study, concerned with the improvement of mental health services, to show how micro-level critical junctures can be purposefully used to introduce instability at the meso-level in the pursuit of larger organisational change. In addition to demonstrating why scholars and practitioners should pay closer attention to understanding and responding to critical junctures we are, therefore, also able to demonstrate how their emergence and impact can be examined vertically, as well as horizontally.

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Explaining Diffusion Patterns for Complex Health Care Innovations

Cited by 327 publications

References 9 publications

Telecare Call Centre Work and Ageing in Place

Telecare Call Centre Work and Ageing in Place

Is Shared Decision Making a Utopian Dream or an Achievable Goal?

Critical junctures in health and social care: Service user experiences, work and system connections

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