Elaborating on theory with middle managers’ experience implementing healthcare innovations in practice

Implementation Science

Nancy M. Albert¹  Mark McClelland¹  Shoou-Yih D. Lee²  Meredith A. Kirk²  Lisa D. DiMartino²  Sarah A. Birken² 

[1] Office of Nursing Research and Innovation, Cleveland Clinic, 9500 Euclid Ave., Cleveland 44195, OH, USA;Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1103E McGavran-Greenberg, 135 Dauer Drive, Chapel Hill 27599-7411, NC, USA

关键词: Innovation implementation;    Healthcare;    Job roles;    Nurse managers;    Middle managers;   

Others  :  1235433
DOI  :  10.1186/s13012-015-0362-6

 received in 2015-08-31, accepted in 2015-12-21,  发布年份 2016

【 摘 要 】

Background

The theory of middle managers’ role in implementing healthcare innovations hypothesized that middle managers influence implementation effectiveness by fulfilling the following four roles: diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. The theory also suggested several activities in which middle managers might engage to fulfill the four roles. The extent to which the theory aligns with middle managers’ experience in practice is unclear. We surveyed middle managers (n = 63) who attended a nursing innovation summit to (1) assess alignment between the theory and middle managers’ experience in practice and (2) elaborate on the theory with examples from middle managers’ experience overseeing innovation implementation in practice.

Findings

Middle managers rated all of the theory’s hypothesized four roles as “extremely important” but ranked diffusing and synthesizing information as the most important and selling innovation implementation as the least important. They reported engaging in several activities that were consistent with the theory’s hypothesized roles and activities such as diffusing information via meetings and training. They also reported engaging in activities not described in the theory such as appraising employee performance.

Conclusions

Middle managers’ experience aligned well with the theory and expanded definitions of the roles and activities that it hypothesized. Future studies should assess the relationship between hypothesized roles and the effectiveness with which innovations are implemented in practice. If evidence supports the theory, the theory should be leveraged to promote the fulfillment of hypothesized roles among middle managers, doing so may promote innovation implementation.

【 授权许可】

   
2015 Birken et al.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Birken SA, Lee SY, Weiner BJ. Uncovering middle managers’ role in healthcare innovation implementation. Implement Sci. 2012; 7:28. BioMed Central Full Text
• [2]Birken SA, Lee SY, Weiner BJ, Chin MH, Chiu M, Schaefer CT. From strategy to action: how top managers’ support increases middle managers’ commitment to innovation implementation in health care organizations. Health Care Manage Rev. 2014; 40:159-68.
• [3]Birken SA, Lee SY, Weiner BJ, Chin MH, Schaefer CT. Improving the effectiveness of health care innovation implementation: middle managers as change agents. Med Care Res Rev. 2013; 70:29-45.
• [4]King N. Qualitative methods and analysis in organizational research. Sage, London, England; 1998.
• [5]Hawk M, Ricci E, Huber G, Myers M. Opportunities for social workers in the patient centered medical home. Soc Work Public Health. 2015;30(2):175–84. doi: 10.1080/19371918.2014.969862. Epub 2014 Dec 12.