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PubMed2000

Diffusion of foraging innovations in the guppy.

The way in which novel learned behaviour patterns spread through animal populations remains poorly understood, despite extensive field research and the recognition that such processes play an important role in the behavioural development, social interactions and evolution of many animal species. We conducted a series of controlled diffusions of foraging information in replicate experimental populations of the guppy, Poecilia reticulata. We presented novel foraging tasks over 15 trials to mixed-sex groups, made up of food-deprived and nonfood-deprived adults (experiment 1) or small, young fish and old, large adults (experiment 2). In these diffusions, knowledge of a route to a feeder could spread through the group by subjects learning from others, discovering the route for themselves, or, most likely, by some combination of these social and asocial learning processes. We found a striking sex difference, with novel foraging information spreading at a significantly faster rate through subgroups of females than of males. Females both discovered the goal and learned the route more quickly than males. Food-deprived individuals were faster at completing the tasks over the 15 trials than nonfood-deprived guppies, and there was a significant interaction between sex and size, with a sex difference in adults but not young individuals. There was also an interaction between sex and hunger level, with food deprivation having a stronger effect on male than female performance. We suggest that information may diffuse in a similar nonrandom or 'directed' manner through many natural populations of animals. Copyright 2000 The Association for the Study of Animal Behaviour.

Journal Article↗
PubMed2006

The diffusion of a medical innovation: where teleradiology is and where it is going.

Teleradiology is one of the more successful applications of telemedicine as measured by a bibliometric analysis of teleradiology research publications. The organizational diffusion of innovation framework is helpful in understanding the diffusion of teleradiology. Teleradiology had become part of the practices of two-thirds of radiologists who responded to the American College of Radiology survey in 1999. It is clear that teleradiology has become routinized even though quantitative data are hard to find. Telecardiology may be the next successfully diffused form of telemedicine. The potential cloud on the horizon for telediagnostics is political pressure to avoid outsourcing to foreign countries, particularly those to which US information technology jobs have already been transferred. How the outsourcing issue is resolved will have a significant effect on teleradiology specifically, and, perhaps, telemedicine generally.

Diffusion of Innovation↗
PubMed2006

Knowledge barriers to PACS adoption and implementation in hospitals.

PURPOSE: Drawing on the classical theory of diffusion of innovations advanced by Rogers [E.M. Rogers, Diffusion of Innovations, 4th ed., Free Press, New York, NY, 1995] and on the theory of barriers to innovation [P. Attewell, Technology diffusion and organizational learning: the case of business computing. Organ. Sci. 3 (1992) 1-19; H. Tanriverdi, C.S. Iacono, Knowledge barriers to diffusion of telemedicine. Proceedings of the 20th International Conference on Information Systems, Charlotte, NC, 1999, pp. 39-50; S. Nambisan, Y.-M. Wang, Roadblocks to web technology adoption? Commun. ACM, 42 (1) (1999) 98-101], this study seeks a better understanding of challenges faced in PACS implementations in hospitals and of the strategies required to ensure their success. METHODS: To attain this objective, we describe and analyze the process used to adopt and implement PACS at two Canadian hospitals. RESULTS: Our findings clearly demonstrate the importance of treating any PACS deployment not simply as a rollout of new technology but as a project that will transform the organization. Proponents of these projects must not lose sight of the fact that, even if technological complexity represents a significant issue, it must not garner all the project team's attention. This situation is even more dangerous, inasmuch as the greatest risk to the implementation often lies elsewhere. It would also appear to be crucial to anticipate and address organizational and behavioral challenges from the very first phase of the innovation process, in order to ensure that all participants will be committed to the project. CONCLUSIONS: In order to maximize the likelihood of PACS success, it appears crucial to adopt a proactive implementation strategy, one that takes into consideration all the technical, economic, organizational, and human factors, and does so from the first phase of the innovation process.

Attitude of Health Personnel↗
PubMed1990

Continuous cyclophosphamide, doxorubicin, vincristine, and prednisolone. A new, innovative protocol for diffuse aggressive lymphomas.

One hundred eight patients with aggressive non-Hodgkin's lymphoma (high and intermediate grade) were treated with a new protocol: continuous cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP). They were evaluated for long-term survival and pretreatment characteristics predictive of response and survival. Continuous CHOP protocol consists of initial 8 weeks of intensive chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone, followed by local/cranial radiotherapy and maintenance therapy. Complete remission (CR) was achieved in 84 of 108 (78%) patients; seven (6%) had a moderate response and 17 (16%) had a poor response. A statistically significant difference in CR rate was found only in patients with different stages. Seventeen of 84 (20%) complete responders have had a relapse of the disease. The median survival has not been reached. Results show an actuarial disease-free survival (DFS) of 77% for the 84 patients who had a complete response. The overall survival for all patients was 53% at 5 years of follow-up. The difference in DFS at the end of 5 years between different stages, main histologic subgroups, and age groups was not statistically significant. The toxicity observed was acceptable. Thus continuous CHOP appears to be an effective protocol for the treatment of intermediate-grade and high-grade lymphomas.

Adolescent↗
PubMed2006

Barriers and facilitators to replicating an evidence-based palliative care model.

Recognition of the difficulties involved in replicating evidence- based interventions is well documented in the literature within the medical field. Promising research findings are often not translated into practice, and if they are, there is a significant time gap between study conclusion and practice adoption. The purpose of this article is to describe the barriers and facilitators encountered by two managed care organizations while replicating an evidence-based end of life in-home palliative care model. Using Diffusion of Innovation Theory as a theoretical framework, results from focus groups and interviews with the project's clinical, administrative and research teams are presented and recommendations made for improving translational efforts. The process of replicating the end of life in-home palliative care model clearly illustrated the key elements required for successfully diffusing innovation. These key elements include marketing and communication, leadership, organizational support and training and mentorship. This qualitative process study provides clear, real world perspectives of the myriad of challenges encountered in replicating an evidence-based project.

Diffusion of Innovation↗
PubMed2003

Disseminating innovations in health care.

Health care is rich in evidence-based innovations, yet even when such innovations are implemented successfully in one location, they often disseminate slowly-if at all. Diffusion of innovations is a major challenge in all industries including health care. This article examines the theory and research on the dissemination of innovations and suggests applications of that theory to health care. It explores in detail 3 clusters of influence on the rate of diffusion of innovations within an organization: the perceptions of the innovation, the characteristics of the individuals who may adopt the change, and contextual and managerial factors within the organization. This theory makes plausible at least 7 recommendations for health care executives who want to accelerate the rate of diffusion of innovations within their organizations: find sound innovations, find and support "innovators," invest in "early adopters," make early adopter activity observable, trust and enable reinvention, create slack for change, and lead by example.

Diffusion of Innovation↗
PubMed2005

Clinical nurse educators as agents for change: increasing research utilization.

The purpose of this study was to examine the determinants of research utilization among clinical nurse educators. The primary goal for clinical nurse educators is the facilitation of professional development of practicing nurses. Responsibilities include promoting best practice by mentoring others, acting as an information source, and assisting in the development of policies and procedures based on available research evidence. Using Rogers' (Diffusion of Innovations, 4th edn., The Free Press, New York) diffusion of innovations theory as a theoretical foundation, we conducted a secondary analysis to test a predictive model of research utilization using linear regression. Results show that educators report significantly higher research use than staff nurses and managers. Predictors of research utilization include attitude toward research, awareness of information based on research, and involvement in research activities. Localite communication predicted conceptual research use and mass media predicted symbolic use, lending support to the idea that overall, instrumental, conceptual, and symbolic research utilization are conceptually different from one another. Our findings show that the research utilization behaviors of clinical nurse educators position them to facilitate evidence-based nursing practice in organizations. We discuss the theoretical, conceptual, and nursing role implications of our findings for nursing practice, education, and research. Suggestions for future research includes studying actual use of research findings of clinical nurse educators and designing intervention studies that assesses the effectiveness of clinical nurse educators as facilitators of research utilization in organizations.

Adult↗
PubMed2004

From innovation to social norm: bounded normative influence.

CORRECTION: Every innovation begins as a deviation from existing social norms. Given the strong effect of social norms and pressure, how can any innovation ever diffuse to the point where it becomes a new social norm? The seeming paradox of how a minority can influence the majority has not been explained well by prevailing social science theory. Computer simulations of the diffusion of a new behavior within the social network of a Bangladesh village led to the discovery of a new principle of social change that resolves this paradox. The results revealed the important but overlooked role played by boundaries that emerge within a social network and how such local boundaries affect the creation of a new social norm. A minority position can become the social norm by means of the process of bounded normative influence. As long as a minority maintains its majority status within its own, locally bounded portion of the network, then it can survive, recruit converts in the near surround, and establish its behavior as the norm for the network as a whole. The process is accelerated when the minority subgroup is centrally located in the network and communicates more frequently and persuasively than the majority.

Bangladesh↗
PubMed1991

The effect of underlying philosophy upon utilization of a program for impaired medical students.

In recent years, an increasing number of medical schools have implemented educational programs for their impaired, or potentially impaired, students. The present research analyzed one such program viewing it as an organizational innovation and employing a theoretical model from the organizational literature. A survey sample of 170 medical students representing all four classes and recently graduated interns was utilized. Subjects were queried as to anticipated program use, degree of exposure to the program, accuracy of knowledge of the program, and perceived program advocacy. Via ANOVA analysis (regression approach) it was found that the general advocacy stance of the medical school toward the innovation (general diffusion emphasis) was not an influential factor upon potential use of the program by medical students. However, its concentration upon the actual procedures to be employed (specific diffusion emphasis) was a much better predictor. The implications for such a finding on the structure of future kindred educational programs was discussed.

Diffusion of Innovation↗
PubMed1998

Establishing evidence-based practice: issues and implications in critical care nursing.

Evidence-based practice is the application of the best available empirical evidence, including recent research findings to clinical practice in order to aid clinical decision-making. The implementation of these findings is vital for optimizing patient outcomes, improving clinical practice, providing cost-effective high quality care and enhancing the credibility of nurses. The use of research findings to improve practice has been discussed and promoted for the last 20 years. The author argues that Rogers' theoretical model of the Diffusion of Innovations may prove useful in understanding the problem of the slow diffusion of the application of research evidence in clinical nursing practice. Many authors have discussed potential barriers to using research in clinical practice in order to facilitate utilization of findings. However, recent studies all document that a gap between research findings and their implementation in clinical practice still exists. This appears to hold true across a variety of practice settings, including nurses working in critical care. The diffusion of innovations in current critical care nursing practice at each stage of Rogers' theory will be examined, with recommendations given to facilitate the establishment of evidence-based practice (EBP).

Critical Care↗
PubMed2003

Implementing a new health management information system in Uganda.

This paper reports on research investigating the health management information system (HMIS) implementation process in Uganda, utilizing the diffusion of innovation and dynamic equilibrium organizational change models. Neither perspective guided the HMIS development process. Instead, technological issues, rather than wider organizational issues, dominated the planned change. The need to consider the organizational context when changing information systems arises because the process is more complex than some practitioners have realized, when attempting to understand the causes of information management problems and developing HMIS in low-income countries. In particular, information system developers had not acknowledged that they were promoting an informational approach to management when they promoted a change from a centralized reporting system to a HMIS supporting use of information at the level of collection. Strategies to facilitate this approach were not advocated. Organizational theory can contribute to the diffusion of innovation framework. It has yielded an integration of Rogers's diffusion of innovation framework and Leavitt's concept of organizational forces in equilibrium. The diffusion framework describes the process, but the organizational model has given the context and reason for aspects of the process. The diffusion model does not predict what needs to change within the organization when a particular innovation is introduced, or how much. The addition of the organizational model has helped. These frameworks can facilitate the introduction of future information management innovations and allow practitioners to perceive their introduction as a staged process needing to be managed. Implications for practice are identified.

Diffusion of Innovation↗
PubMedDate not supplied

A diffusion survey of coronary precautions.

A national survey of a stratified random sample (n = 240) of accredited hospitals with critical care units (CCU) was conducted in order to describe the current practice of restrictions imposed upon myocardial infarction (MI) patients. A cross-sectional correlational survey with a two-stage mailing was used. The first-stage mailing, at the institutional level, was sent to the head nurses of the CCU's. The second-stage mailing was to two randomly selected nurses plus the head nurse from each responding CCU (n = 600). Nurses were requested to give (a) importance and frequency ratings of selected coronary care nursing practices; (b) information about the use of discontinuance of two specific restrictions: ice water and rectal temperature measurement. Follow-ups by mail and/or telephone yielded response rates of about 87 percent for each stage of mailing. The conceptual framework "Diffusion of Innovations" was used to assess the diffusion of the results of studies published in clinical journals. Despite findings that cast doubt on the practices of restricting ice water and rectal temperature measurement, coronary precautions are commonly practiced. Hours spent reading and the number of journals read correlate (p less than .001) with greater levels of awareness in nurses that such restrictions are in question. Levels of awareness are not related to the importance and frequency ratings for those restrictions. Differences among nurses do not explain differences in ratings. If research is to be used, nurse researchers and managers need to actively intervene in care. Passive diffusion of research results is inadequate, unsure, and slow.

Body Temperature↗