1. whether it can be tried on a small scale before a decision needs to be made to implement it fully.

Three of the five—relative advantage, compatibility, and complexity—have received more attention than the other two in health care dissemination research (Greenhalgh et al., 2004a). Across a wide range of studies, the evidence of their impact can best be characterized as inconsistent (for reviews, see Damanpour and Schneider, 2006; Greenhalgh et al., 2004b; Rye and Kimberly, 2007).

The development of most evidence-based practices and programs frequently focuses on the technical knowledge that people need to learn. But the social component of knowledge, without which the technical knowledge remains inert, typically receives relatively little or sometimes no systematic attention or elaboration (Glisson et al., 2008; Ramanujam and Rousseau, 2006). Accordingly, when practices and programs are offered for replication or wider use, the adapters often scramble to figure out how to convert the technical abstractions of the intervention into reliable, concrete action (Olds et al., 2003; Racine, 2004). The vagueness and complexity of the social components also may make it more prone to error during implementation, which in turn may interfere with the intended application of the intervention’s technical requirements.

An Example of Guidelines for Adopting Innovations

One useful model that illustrates how innovative practices can be introduced and sustained in complex organizations involves guidelines prepared by the Agency for Healthcare Research and Quality (AHRQ). Will It Work Here? A Decisionmaker’s Guide to Adopting Innovations strives to assist health care providers and community planners in determining whether or not a given innovation will address their needs and is feasible (Brach et al., 2008). The guide provides generic, but pragmatic, advice on the issues and steps that potential adopters should consider. The guide is organized around four core questions, features active links to websites that contain in-depth information on related topics, and provides a hyperlinked index of public domain implementation tools and an appendix of four case studies.

The first core question potential adopters need to consider is “Does the innovation fit?” Related key questions include: Does it work? Where else has it been tried? What—and how good—is the evidence that it works? Does it address fundamental problems and achieve organizational goals? Is it compatible with the organization’s mission, vision, values, and culture? Can it be successfully adapted to improve compatibility with the organization?

Each of these key questions is examined in more detail with links to



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