Sharing leadership for diffusion of innovation in professionalized settings

Currie, Graeme; Spyridonidis, Dimitrios

doi:10.1177/0018726718796175

Cited by 54 publications

(56 citation statements)

References 74 publications

(154 reference statements)

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“…The complex and pressurised context of primary care is well recognised [ 44 , 45 ], making the implementation of new innovations challenging. Whilst the importance of leadership [ 46 – 48 ], impact of hierarchy [ 48 – 51 ] and a positive culture receptive to change [ 51 – 53 ] are commonly cited in primary care literature, our study illustrates the importance of facilitation and innovations in primary care that explicitly address the motivators and priorities of general practices and key stakeholders. This appears to be particularly pertinent when considering OA as a condition which is seen as a ‘low priority’ to patients and clinicians [ 54 , 55 ] and, therefore, may require more dedicated facilitation from trusted partners.…”

Section: Discussionmentioning

confidence: 91%

Understanding the uptake of a clinical innovation for osteoarthritis in primary care: a qualitative study of knowledge mobilisation using the i-PARIHS framework

et al. 2020

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Background Osteoarthritis is a leading cause of pain and disability worldwide. Despite research supporting best practice, evidence-based guidelines are often not followed. Little is known about the implementation of non-surgical models of care in routine primary care practice. From a knowledge mobilisation perspective, the aim of this study was to understand the uptake of a clinical innovation for osteoarthritis and explore the journey from a clinical trial to implementation. Methods This study used two methods: secondary analysis of focus groups undertaken with general practice staff from the Managing OSteoArthritis in ConsultationS research trial, which investigated the effectiveness of an enhanced osteoarthritis consultation, and interviews with stakeholders from an implementation project which started post-trial following demand from general practices. Data from three focus groups with 21 multi-disciplinary clinical professionals (5–8 participants per group), and 13 interviews with clinical and non-clinical stakeholders, were thematically analysed utilising the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, in a theoretically informative approach. Public contributors were involved in topic guide design and interpretation of results. Results In operationalising implementation of an innovation for osteoarthritis following a trial, the importance of a whole practice approach, including the opportunity for reflection and planning, were identified. The end of a clinical trial provided opportune timing for facilitating implementation planning. In the context of osteoarthritis in primary care, facilitation by an inter-disciplinary knowledge brokering service, nested within an academic institution, was instrumental in supporting ongoing implementation by providing facilitation, infrastructure and resource to support the workload burden. ‘Instinctive facilitation’ may involve individuals who do not adopt formal brokering roles or fully recognise their role in mobilising knowledge for implementation. Public contributors and lay communities were not only recipients of healthcare innovations but also potential powerful facilitators of implementation. Conclusion This theoretically informed knowledge mobilisation study into the uptake of a clinical innovation for osteoarthritis in primary care has enabled further characterisation of the facilitation and recipient constructs of i-PARIHS by describing optimum timing for facilitation and roles and characteristics of facilitators.

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Section: Discussionmentioning

confidence: 91%

Understanding the uptake of a clinical innovation for osteoarthritis in primary care: a qualitative study of knowledge mobilisation using the i-PARIHS framework

et al. 2020

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“… 24 Leaders—clinical, managerial, and perhaps most importantly hybrid leaders who bridge both these roles—have a crucial part in creating the preconditions in which staff will feel confident to innovate and improve (for example, by setting a climate of risk taking and collaborative learning rather than one of playing safe and covering one’s back). 3 12 An example of how social science has informed a study of spread and scale-up is shown in box 4 .…”

Section: Social Science: Spread and Scale-up As Social Actionmentioning

confidence: 99%

“…Through a keyword and snowball search, we identified recent systematic reviews, narrative reviews, realist reviews, and theoretical syntheses on spread or scale-up (see supplementary file). Each had a different focus, such as improvement science in high income 4 5 6 and low and middle income countries, 3 7 8 innovation in primary care 9 or public health, 10 complex interventions, 11 leadership for innovation, 12 the social practice of innovation, 13 and technology adoption. 14 15 …”

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confidence: 99%

Spreading and scaling up innovation and improvement

Greenhalgh

Papoutsi

2019

BMJ

210

242

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“…Their role as knowledge brokers in formal translational health research structures facilitates this. Following which, as well as enhancing their capabilities, there also needs to be incentives and opportunities for clinicians to participate in translational research 18…”

Section: Acap For Translational Health Researchmentioning

confidence: 99%

“…Particularly crucial is the exploitation dimension of ACAP since healthcare organisations and systems are renowned for their failure to scale up evidence-based innovation. Those leading translational health research initiatives need to fully examine what’s working, from whose perspective, what might we adapt as we scale up, and how we might glean resource for any potential scale up 18…”

Section: Acap For Translational Health Researchmentioning

confidence: 99%

From what we know to what we do: enhancing absorptive capacity in translational health research

Currie

Kiefer

Spyridonidis

2019

leader

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BackgroundGlobally, evidence about what works is slow to translate into frontline healthcare delivery. As a response, government policy has focused on translational health initiatives, such as the National Institute for Health Research funded Applied Research Collaborations in England. Concepts from organisation science prove useful to support such translational initiatives. We critique the application of two organisation science concepts linked to the broad domain of what is commonly termed ‘knowledge mobilisation’ in healthcare settings, specifically ‘knowledge brokers’ and ‘absorptive capacity’, to provide lessons for leaders of translational initiatives.ResultsThe presence of knowledge brokers to ‘move from what we know to what we do’ in healthcare delivery appears necessary but insufficient to have a system level effect. To embed knowledge brokers in the wider healthcare system so they draw on various sources of evidence to discharge their role with greatest effect, we encourage leaders of translational health research initiatives to take account of the concept of absorptive capacity (ACAP) from the organisation science literature. Leaders should focus on enhancing ACAP though development of ‘co-ordination capabilities’. Such co-ordination capability should aim not just to acquire different types of evidence, but to ensure that all types of evidence are used to develop, implement and scale up healthcare delivery that best benefits patients. Specific co-ordination capabilities that support translation of evidence are: clinician involvement in research and its implementation; patient and public involvement in research and its implementation; business intelligence structures and processes at organisational and system level.ConclusionAttention to the dimensions and antecedents of ACAP, alongside the implementation of the knowledge brokering solution, in translational health research initiatives, is likely to better ensure the latter’s success.

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Sharing leadership for diffusion of innovation in professionalized settings

Abstract: This had been posted ahead of publication. Currie, Graeme and Spyridonidis, Dimitrios (2018) Sharing leadership for diffusion of innovation in professionalized settings. Human Relations.

Cited by 54 publications

References 74 publications

Understanding the uptake of a clinical innovation for osteoarthritis in primary care: a qualitative study of knowledge mobilisation using the i-PARIHS framework

Understanding the uptake of a clinical innovation for osteoarthritis in primary care: a qualitative study of knowledge mobilisation using the i-PARIHS framework

Spreading and scaling up innovation and improvement

From what we know to what we do: enhancing absorptive capacity in translational health research

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