Peer Pressure

Mimetic or competitive pressure to implement an intervention; typically because most or other key peer or competing organizations have already implemented or are in a bid for a competitive edge.

‘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.

Inclusion Criteria

Include statements about perceived pressure or motivation from other entities or organizations in the local geographic area or system to implement the innovation.

  • “I went to a conference and heard [a prominent physican] speak about [the innovation] so I came back and pushed to get it implemented here.” This statement may be double-coded with Evidence Strength & Quality
  • “All the other clinics in our area are doing this so I want to be sure we’re doing it here too.”
  • “Our facility is so far behind the other facilities in the system.”

Exclusion Criteria

Currently no criteria are listed; as we become aware of criteria, we will post them here. Please contact us with updates.

Check out SIRC’s Instrument Review project and published systematic review protocol, which has cataloged over 400 implementation-related measures. 

Note: As we become aware of measures, we will post them here. Please contact us with updates.

  1. Walston SL, Kimberly JR, Burns LR: Institutional and economic influences on the adoption and extensiveness of managerial innovation in hospitals: The case of reengineering. Med Care Res Rev 2001, 58:194-228. discussion 229-133
  2. 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.
  3. Frambach RT, Schillewaert N: Organizational innovation adoption: a multi-level framework of determinants and opportunities for future research. Journal of Business Research 2001, 55:163-176.