Peer Pressure

‘Peers’ can refer to any outside entity with which the organization feels some degree of affinity or competition at some level within their organization (e.g., competitors in the market, other hospitals in a network). The pressure to implement can be particularly strong for late-adopting organizations [1].

There is strong direct evidence that the pressure to adopt an intervention, independent of their perception of whether their patients need it or in response to a perceived problem, influences organizational adoption and implementation, particularly in highly cosmopolitan organizations [2]. In highly competitive markets, organizations may more likely to implement new interventions [3]. If competitors or colleagues in other organizations or in other parts of the same organization are all using an innovation, people may feel compelled to do so as well. This is referred to as “mimetic pressure” or “inter-organizational norm-setting” [2]. This pressure directly influences adoption decisions but can also trickle down to implementation as well, if individual stakeholders are attuned to practices of outside entities or individuals.