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PubMed2004

Doctors on-line: using diffusion of innovations theory to understand internet use.

BACKGROUND AND OBJECTIVES: Family physicians must be aware of the latest and best evidence for a broad range of clinical and public health topics. The Internet is an important source of this information, but not all family physicians use the Internet. This study used "diffusion of innovations" theory to identify strategies for increasing Internet use by family physicians. METHODS: We conducted a mail survey of 58 family physicians in a midsized Northeastern metropolitan area in the United States to assess Internet use and identify sources from which physicians obtain medical information. We then used diffusion of innovations theory to describe the process by which physicians learn and develop skills at using the Internet. RESULTS: Internet use begins when physicians are not constrained by a heavy patient volume and are able to learn about and observe the benefits of Internet use. When they experience its usefulness, their Internet browsing and searching develop and become more effortless and less time-consuming. CONCLUSIONS: The innovation attributes of diffusion of innovations theory act as predictors of Internet use among family physicians. Internet use by family physicians might be increased by providing them time to learn about how to use it and to experience its benefits. Integration of continuing medical education courses created for the purpose of developing and enhancing Internet usage skills into their schedule may be a workable solution. Demographic factors such as gender and training recency have no influence on Internet use by family physicians.

Adult↗
PubMed2002

Modeling diffusion of innovations in a social network.

A simple model of diffusion of innovations in a social network with upgrading costs is introduced. Agents are characterized by a single real variable, their technological level. According to local information, agents decide whether to upgrade their level or not, balancing their possible benefit with the upgrading cost. A critical point where technological avalanches display a power-law behavior is also found. This critical point is characterized by a macroscopic observable that turns out to optimize technological growth in the stationary state. Analytical results supporting our findings are found for the globally coupled case.

Journal Article↗
PubMed1978

Management stretegy for the diffusion of innovation: unit dose drug distribution.

The concepts of the change agent and opinion leader are explored as means to aid the pharmacists in affecting the diffusion of an innovation such as unit dose. A four-part model which describes one possible management strategy for the diffusion of innovation into the organization is presented. The effect of changes in the environment of hospital pharmacy, which may result in the recognition of performance gaps and thus stimulate the introduction of innovation, is discussed. Aspects of diffusion of an innovation--supplying the appropriate information, the knowledge function; creating a positive attitude toward the implementation of the innovation, the persuasion function; the adoption or rejection of the innovation, the decision function--are explained. The successful diffusion of an innovation requires a conscious management strategy, such as the four-component model discussed in this paper.

Decision Making↗
PubMed2004

Diffusion of innovations in service organizations: systematic review and recommendations.

This article summarizes an extensive literature review addressing the question, How can we spread and sustain innovations in health service delivery and organization? It considers both content (defining and measuring the diffusion of innovation in organizations) and process (reviewing the literature in a systematic and reproducible way). This article discusses (1) a parsimonious and evidence-based model for considering the diffusion of innovations in health service organizations, (2) clear knowledge gaps where further research should be focused, and (3) a robust and transferable methodology for systematically reviewing health service policy and management. Both the model and the method should be tested more widely in a range of contexts.

Diffusion of Innovation↗
PubMed1983

Diffusion of innovations in burn care: selected findings.

Large sums of money are spent to support biomedical research, but relatively little effort is directed toward getting results to the clinical setting. Understanding the process underlying the diffusion of innovations would promote more efficient conversion of new knowledge into practice. This study examines the diffusion of innovations in burn care that were discussed at the United States National Institutes of Health 1978 Consensus Development Conference on Supportive Therapy in Burn Care. The study traces the awareness and use of innovations in burn care, the source and timing of new information to physicians and the ways in which characteristics of both innovations and physicians are related to the diffusion process. The principal basis for the study is a survey in five New England States of physicians who treat burn patients. The data suggested that between 56 and 97 per cent of physicians were aware of eight major advances. Physicians were more aware of high than low consensus treatments and the adoption rate and adoption level were higher for high consensus treatments. The three most important sources of information about the advances were staff conferences, journals and medical school.

Awareness↗
PubMed2001

A diffusion of innovations model of physician order entry.

OBJECTIVE: To interpret the results of a cross-site study of physician order entry (POE) in hospitals using a diffusion of innovations theory framework. METHODS: Qualitative study using observation, focus groups, and interviews. Data were analyzed by an interdisciplinary team of researchers using a grounded approach to identify themes. Themes were then interpreted using classical Diffusion of Innovations (DOI) theory as described by Rogers [1]. RESULTS: Four high level themes were identified: organizational issues; clinical and professional issues; technology implementation issues; and issues related to the organization of information and knowledge. Further analysis using the DOI framework indicated that POE is an especially complex information technology innovation when one considers communication, time, and social system issues in addition to attributes of the innovation itself. CONCLUSION: Implementation strategies for POE should be designed to account for its complex nature. The ideal would be a system that is both customizable and integrated with other parts of the information system, is implemented with maximum involvement of users and high levels of support, and is surrounded by an atmosphere of trust and collaboration.

Diffusion of Innovation↗
PubMedDate not supplied

Evidence-based practice: how nurse leaders can facilitate innovation.

Evidence-based nursing practice (EBNP) is the wave of the future. Increasingly, EBNP is being identified as a key to quality and excellence in nursing services. Incorporating evidence into practice is necessary to deliver scientifically sound patient care. In addition, understanding the importance of evidence is crucial for meeting the excellence requirements of Magnet designation. Despite the growing popularity of EBNP and its documented significant benefits, the literature demonstrates that only 15% of the nursing workforce consistently practices within an EBNP framework. If EBNP adoption is to increase in the profession, it will require the active efforts of nurse leaders to pursue an aggressive innovation diffusion strategy. The purpose of this article is to discuss the nurse leader's role in facilitating EBNP in nursing using a theoretical framework grounded in innovation diffusion theory. The article develops 4 areas of focus. First, the components of innovation diffusion theory are discussed. Second, a pertinent empirical review of the EBNP adoption literature is presented. Third, strategies for applying innovation diffusion theory to facilitate EBNP adoption are proposed. Lastly, the article ends with a leadership call to action.

Attitude of Health Personnel↗
PubMed2002

Introducing domestic violence assessment in a postpartum clinical setting.

OBJECTIVES: Attempts to introduce assessment for exposure to domestic violence in health care settings have met with limited success, in spite of widespread knowledge of the prevalence of spousal abuse and its implications for women's health. We assessed the utility of Rogers' model of institutional change for the implementation of a universal screening program for domestic violence in postpartum clinical settings. METHODS: We adapted Rogers' innovation-diffusion model to develop and implement a protocol for domestic violence assessment among 300 nurses working in two hospitals that together provide obstetrical care to the City of Vancouver, British Columbia, Canada. Our education sessions introduced new knowledge and addressed attitudes and beliefs. They were followed by "hands-on" demonstration and supervision of assessments. Our "Let's Talk" visual aids program added visibility to our initiative and provided cues as to how to undertake screening and response. Screening rates were monitored along with a process evaluation based on anecdotal reporting by nursing staff. RESULTS: Following the initiation of educational sessions and supervision of assessment, the screening rate was 42%. Within 6 months, the screening rate had climbed to 60% and was sustained at that level. Major barriers to screening include difficulty in finding the opportunity to screen in privacy and overcoming language barriers. CONCLUSIONS: Application of Rogers' principles of diffusion of innovation in the implementation of a universal program for a domestic violence in two obstetrical care settings resulted in a screening rate of 60% which has been sustained for the first 18 months of the program.

British Columbia↗
PubMed2006

Diffusion of innovations and network segmentation: the part played by people in promoting health.

OBJECTIVE: The objective of this study was to describe how diffusion of innovations theory can integrate mass media, interpersonal communication, and social network analysis. These principles can be used to implement and tailor data-based health promotion activities. GOAL: The goal of this study was to develop a model for using and incorporating interpersonal communication into health promotion programs designed to encourage behaviors that reduce the spread of sexually transmitted diseases (STDs)/HIV. STUDY DESIGN: The authors conducted a review of selected studies that exemplify how diffusion of innovations theory has applied interpersonal communication to promote STD/HIV preventive health behaviors. RESULTS: Few studies have incorporated interpersonal communication as an intervention strategy to encourage STD/HIV preventive behavior. Interventions that have used interpersonal communication have observed successes in health promotion and increases in safer sex behaviors. CONCLUSIONS: This study shows that social network analysis can be used to design more appropriate and perhaps more effective health promotion programs.

Communication↗
PubMed1990

Use of diffusion of innovation model for agency consultation.

Change is an ongoing phenomena in organizational life. The consultant role is often that of assisting organizations in the formulation and management of institutional change. The use of the Diffusion of Innovation Model by the nurse consultant as a tool for change management can make the difference between well accepted change and programs that are doomed to failure. This article presents Rogers' Diffusion of Innovation model, identifies the stages in the innovation process for organizations, demonstrates how the model can be applied to organizational change and proposes its use by nursing consultants.

Communication↗
PubMedDate not supplied

Diffusion of preventive innovations.

The present paper draws on the diffusion of innovations model to derive a series of strategies for speeding up the spread and implementation of new ideas in preventing addiction. Preventive innovations usually require an action at one point in time in order to avoid an unwanted future condition. Hence, preventive innovations diffuse rather slowly, in part due to delayed rewards from adoption. Here we suggest five strategies, based on diffusion theory, for speeding up the diffusion of preventive innovations.

Diffusion of Innovation↗
PubMed2002

Patient oriented activities in Dutch community pharmacy: diffusion of innovations.

OBJECTIVES: To explore the implementation of patient oriented activities, the perception of an innovation aimed at implementation of patient education and the preconditions for implementation of this innovation among Dutch pharmacists. METHOD: A survey, based on Roger's theory of diffusion of innovations, was carried out among a random sample (n = 300) of Dutch managing pharmacists. MAIN OUTCOME MEASURES: Reported activities regarding patient education, medication surveillance and drug therapy meetings, as well as perception of the innovation and its perceived compatibility with pharmacy practice. RESULTS: The response rate was 49.3%. Hundred (84.7%) respondents reported to provide extra written and verbal information with first prescription medication. Medication surveillance (100% check by computer, and check of the lists by the pharmacist) was reported by 43 (36.4%), and complete participation in drug therapy meetings was reported by 57 (48.3%) respondents. Observability (or results to others) of the new strategy was perceived as important by 90 (77.6%), compatibility (perceived consistency with existing values, past experiences and needs of potential adopters) by 87 (76.4%) and trialability (degree to which an innovation may be experimented with) by 81 (69.8%) respondents. Relative advantages (perception of the innovation as being better) and complexity (relatively difficult to understand and use) of the innovation were perceived as important by less respondents. The preconditions that were met by most pharmacists were 'financial resources' (n = 70; 59.8%), 'enough workspace' (n = 61; 53.1%) and 'enough time' (n = 58; 50%). Fifty-eight (49.2%) respondents intend to adopt the innovation, but this intention would be higher when more time and money and technicians are available, as well as less situations that are experienced as barriers (rush hours, lack of support, illness of employees). CONCLUSION: Based on the definitions used, we conclude that the implementation of medication surveillance and drug therapy meetings is relatively low compared to patient education. The development of an implementation tool is justified, but should deal with the experienced preconditions, barriers and needs of pharmacists. Combined, comprehensive pharmacy interventions promise to be a good way to change pharmacy practice.

Adult↗
PubMed2002

Explaining diffusion patterns for complex health care innovations.

Why are some less solidly supported health care innovations widely adopted while others with apparently stronger scientific support remain underused? Drawing on four case studies, the authors argue that the way in which the distribution of benefits and risks map onto the interests, values, and power distribution of the adopting system is critical to understanding how innovations diffuse.

Cholecystectomy, Laparoscopic↗
PubMed1990

Baccalaureate entry into practice: an example of political innovation and diffusion.

Activity within several states over the past two decades to require a baccalaureate nursing degree as the minimum educational preparation for licensure as a registered professional nurse is reviewed as an example of policy innovation and diffusion. Sufficient ratio of baccalaureate degree to associate degree programs and political party turnover in the governor's office have frequently accompanied private and public policy action on BS entry.

Diffusion of Innovation↗