Understanding whole systems change in health care: insights into system level diffusion from nursing service delivery innovations - a multiple case study

被引：10

作者：

Berta, Whitney ^{[1
]}

Virani, Tazim ^{[2
]}

Bajnok, Irmajean ^{[3
]}

Edwards, Nancy ^{[4
]}

Rowan, Margo ^{[5
]}

机构：

[1] Univ Toronto, Toronto, ON M5S 1A1, Canada

[2] TVA Consulting, Markham, ON, Canada

[3] Registered Nurses Assoc Ontario, Toronto, ON, Canada

[4] Univ Ottawa, Ottawa, ON K1N 6N5, Canada

[5] Univ Ottawa, Rowan Res & Evaluat, Ottawa, ON K1N 6N5, Canada

来源：

EVIDENCE & POLICY | 2014年 / 10卷 / 03期

关键词：

innovation diffusion; whole systems change; evidence-informed practice change; COMPLEX INTERVENTIONS; KNOWLEDGE; ORGANIZATIONS; THINKING; SCIENCE;

D O I：

10.1332/174426413X662798

中图分类号：

C [社会科学总论];

学科分类号：

03 ; 0303 ;

摘要：

Our study responds to calls for theory-driven approaches to studying innovation diffusion processes in health care. While most research on diffusion in health care is situated at the service delivery level, we study innovations and associated processes that have diffused to the system level, and refer to work on complex adaptive systems and whole systems change to guide our work. System-level diffusion not only involves the spread of innovations across sector boundaries in a system, it may alter interactions and care delivery within multiple system components, change the nature of the interdependencies between components, and ultimately lead to whole systems change.

引用

页码：313 / 336

页数：24

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