Role of Champions in the Implementation of Patient Safety Practice Change

Soo, Stephanie; Berta, Whitney; Baker, G. Ross

doi:10.12927/hcq.2009.20979

Cited by 123 publications

(120 citation statements)

References 40 publications

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“…Their role in the practicalities of implementation may be less useful, even detrimental to progress. At this point it may be necessary to hand over to other organizational members, with different perceptions, identities 23 and skills more appropriate for managing pragmatic issues of implementation (see Soo et al 2009).…”

Section: Discussionmentioning

confidence: 99%

The role of the organizational champion in achieving health system change

Hendy

Barlow

2012

Social Science & Medicine

134

156

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In healthcare there is a long held wisdom that 'champions' are a key aspect of organizational change. Drawing on organizational management theory, we examine the role of champions in three health and social care organizations in England as they attempt to move services to a remote model of delivery. The delivery of remote care is a significant policy in the UK and elsewhere, but its introduction has been challenging. Over three years ethnographic methods were used to analyse the role of organizational champions in implementing remote care.Cases were local authorities and associated primary care trusts. Participants were champions and organizational members involved in implementation.Our study shows that organizational champions are highly effective in the first phase of adoption, when change is contained within distinct sub-sets of practice. Moving beyond local contexts the effectiveness of the champions varied. Identification centred on the remote-care work. This identification enabled the champions to motivate others and move beyond their normally prescribed roles, contributing to innovation ideas, processes and practices. When required to shift their work organization-wide, and share ideas outside their professional culture, some champions responded with resistance, resulting in a lack of innovation spread.These results caution against allowing change to become positioned within the remit of a few individuals. Whilst this strategy may be initially beneficial, the role of champion may be less useful, even detrimental to progress, in the later stages of implementation, particularly if identification with the new circumstances is not established.

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Section: Discussionmentioning

confidence: 99%

The role of the organizational champion in achieving health system change

Hendy

Barlow

2012

Social Science & Medicine

134

156

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“…Research has demonstrated the importance of champions 13,18,19 and of leadership and management support 12,13,15 to the success or failure of implementation efforts. In the present study, leadership was closely tied to many of the factors identified, including attainment of the necessary resources and funding to implement the innovation and establishment of a supportive implementation climate.…”

Section: Discussionmentioning

confidence: 99%

Factors Related to the Implementation and Use of an Innovation in Cancer Surgery

2011

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ConclusionsAn improved understanding of the multilevel factors influencing the implementation of innovations is critical to planning effective change interventions in health care. Further study is needed to explore differences in the use of the innovation between breast and colorectal cancer surgeons. Findings will inform the study of additional cases of synoptic reporting implementation, enabling cross-case analyses and identification of higher-level themes that may be applied in similar settings or contexts. KEY WORDSImplementation, synoptic reporting, cancer, surgery BACKGROUNDThe operative report records details of a surgical procedure and findings, and thus documents information that is important to subsequent patient care and management. The traditional method of reporting findings from surgery is the narrative report, involving a descriptive free-text account of the procedure, suspected or confirmed findings, and proposed treatment. Although report dictation is an important practice, a survey of academic general surgeons found that only 18% of general surgery programs provide training in this skill 1 . As medicine becomes increasingly multidisciplinary and technology-supported, several issues related to narrative reporting provide an impetus to change reporting mechanisms.First, for patients with cancer, a clear and thorough record of the surgical procedure and findings supports accurate diagnosis and staging, and therefore facilitates improved estimates of prognosis and postoperative treatment planning. The completion of a cancer operation is a unique point in time at which the surgeon has not only specific knowledge of the technical details of the procedure, but also detailed knowledge of important presentation, diagnostic, staging, and presurgical care ABSTRACT ObjectiveNationally, efforts to implement an innovation in cancer surgery-a Web-based synoptic reporting tool-are ongoing in five provinces. The objective of the present study was to identify the key multilevel factors influencing implementation and early use of this innovation for breast and colorectal cancer surgery at two academic hospitals in Halifax, Nova Scotia. MethodsWe used case-study methodology to examine the implementation of surgical synoptic reporting. Methods included semi-structured interviews with key informants (surgeons, implementation team members, and report end users; n = 9), nonparticipant observation, and document analysis. A thematic analysis was conducted separately for each method, followed by explanation-building to integrate the evidence and to identify the key multilevel factors influencing implementation. An audit was performed to determine use. ResultsKey factors influencing implementation were these: In a 6-month period after implementation, 91.2% and 58.0% respectively of eligible breast and colorectal cancer surgeries were reported using the new tool.

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“…oral health (Bassim 2008), nutrition (Gaskill 2009), continence care (Ouslander 2007), delirium (Siddiqi 2008), and infection control (Damschroder 2009)) one model of intervention being increasingly adopted is that of the 'champion'. Outside long-term care, the term 'champion' is often adopted to characterise a number of diverse categories of roles, groups or individuals whose goal is to effect positive change (Shaw 2012;Soo 2009) and often refers to influential and often charismatic individuals with high social and institutional status (Shetty 2013). Because of its positive connotations, it is now used in a wide range of settings (Clarkson 2009;Jenkins 2014;Temoka 2013) leading to a level of conceptual confusion.…”

Section: Description Of the Interventionmentioning

confidence: 99%