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The degree of tangible fit between meaning and values attached to the intervention by involved individuals, how those align with individuals’ own norms, values, and perceived risks and needs, and how the intervention fits with existing workflows and systems.
The degree of tangible fit between meaning and values attached to the intervention by involved individuals, how those align with individuals' own norms, values, and perceived risks and needs, and how the intervention fits with existing workflows and systems. The more individuals perceive alignment between the meaning they attach to the intervention and meaning communicated by upper management, the more effective implementation is likely to be. For example, providers may perceive an intervention as a threat to their autonomy, while leadership is motivated by the promise of better patient outcomes.
Rationale for inclusion
The degree of tangible fit between meaning and values attached to the intervention by involved individuals, how those align with individuals’ own norms, values, and perceived risks and needs, and how the intervention fits with existing workflows and systems. Greenhalgh et al describe compatibility, meaning, and innovation-system fit. All of three of these terms have a common root definition of aligning with stakeholders’ values and norms and then vary in the degree to which they incorporate: goals, skill mix, strategies, and perceived needs. We consolidate these together under our definition of compatibility. Greenhalgh et al cites strong indirect and moderate direct support for this somewhat elusive construct. For individuals, the perception of the degree of alignment between the meaning they attach to the intervention and meaning communicated by upper management has a strong influence on whether they will embrace the intervention. For example, an intervention that leadership believes will improve performance may be perceived as a threat to autonomy in treatment decisions by physicians. Meaning in this context can be negotiated and reframed through discussions across organizational networks. Compatibility is between the intervention and supporting technologies and ways of working is also important. The degree of compatibility has a positive association with implementation. Changes seen as threatening or incompatible with current conditions will be resisted. Helfrich and colleagues found that perceived fit with organizational and professional mission, core competencies, and experience was an important predictor of successful implementation. A balanced distribution of the risks and benefits throughout the organization increases the likelihood of acceptance.
Qualitative codebook guidelines
Include statements that demonstrate the level of compatibility the innovation has with organizational values and work processes. Include statements that the innovation did not need to be adapted.
- “We already had a weight loss clinic so when MOVE! was mandated, we were glad to finally have a way of getting others on board.”
- “The physicians don’t like the new system because they feel like it takes away their autonomy in the way they treat patients.”
Exclude or double code statements regarding the priority of the innovation based on compatibility with organizational values to Relative Priority, e.g., if an innovation is not prioritized because it is not compatible with organizational values.
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004, 82:581-629.
- ↑ 2.0 2.1 2.2 Klein KJ, Sorra JS: The Challenge of Innovation Implementation. The Academy of Management Review 1996, 21:1055-1080.
- ↑ Auber BA, Hamel G: Adoption of smart cards in the medical sector: the Canadian experience. Soc Sci Med 2001, 53:879-894.
- ↑ Gustafson DH, Sainfort F, Eichler M, Adams L, Bisognano M, Steudel H: Developing and testing a model to predict outcomes of organizational change. Health Serv Res 2003, 38:751-776.
- ↑ Helfrich CD, Weiner BJ, McKinney MM, Minasian L: Determinants of implementation effectiveness: adapting a framework for complex innovations. Med Care Res Rev 2007, 64:279-303.
- ↑ Meyer AD, Goes JB: Organisational Assimilation of Innovations: A Multi-Level Contextual Analysis. Acad Manage J 1988, 31:897-923.