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The Process of Adopting Innovations in Organizations: Three Cases of Hospital Innovations
The Process of Adopting Innovations in Organizations: Three Cases of Hospital Innovations
Pages 133-158
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From page 133... ...
Fortunately, some succeed, as exemplified in this book in the three case studies on the adoption of hospital innovations: the evolution of new technologies and administrative Barren s~f~m`~nt~ ~ to ~ ^ ~ ~ v ~ ~ ~ —^ V _ C4 4 ~ CL ~ ~ ~ 1 1 1 I_ 1 1 ~ v In the ambulatory care unit of Pennsylvania Hospital described by Robert Cathcart; the introduction of a new technology jECMOextracorporeal membrane oxygenation in a neonatal intensive care unit of Columbia Presbyterian Hospital described by John Driscoll; and experimentation and implementation of alternative working schedules for nurses in Rochester Methodist Hospital of the Mayo Clinic described by Thomas Choi, Helen Jameson, and Milo Brekke. The three cases represent highly selective examples of successful Innovation adoption.
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From page 134... ...
answers to these questions are not possible from these cases alone, because generalizations from three cases are difficult to substantiate, particularly when they include no instances of failure. To address these questions we will expand our sample by leaning on other published studies as well as research currently under way by the Minnesota Innovation Research Program, which since 1983 has been tracking a wide variety of technological, product, and process innovations as they develop from concept to reality in their natural field settings isee Van de yen, Angle, and Poole, 1989~.
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From page 135... ...
In other words, the process by which organizations adopt innovations makes a difference on subsequent performance. As Figure 1 shows, Rogers's basic model focuses on and elaborates five substages in the process of innovation diffusion and adoption.
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Although extensive empirical support for this adoption process model has been establisher] for individual adopters (such as farmers adopting best practices promoted by the Extension Service of the U.S.
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In particular we will focus on six specific process complexities that are evident in the three cases of hospital innovation adoption in this volume and which are not adequately explained by the basic model in Figure 1.
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5. In the three successful cases, reinvention of the innovation developed elsewhere was facilitated by modifying the innovations to fit the local organizational situation, having top management extensively involved and committed to the innovation, and using various techniques to maintain task completion and momentum throughout the adoption process.
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From page 139... ...
Where these occasions were exploited, people modified and adapted their independent courses of action into interdependent collective actions to undertake concerted efforts to initiate an innovation. Although the basic model in Figure 1 posits that an innovation adoption decision is a relatively straightforward result of knowIedge and persuasion, these observations emphasize that chance plays a significant rode in affecting the Recision anc]
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From page 140... ...
Each of the hospitals housing the innovations is a highly respected, Tong-establishecI, and a very successful institution located at the hub of its industry and community networks. During their respective periods of innovation adoption, the hospitals were reported to have moderately Tow personnel turnover rates, Tong-run strategic time horizons that connected diverse organizational activities to core institutional missions {providing quality care to meet changing patient neecisl, and a high degree of commitment of top management and medical staffs to their respective innovations; in addition, the hospitals were reported to be making significant investments both in new technologies ant!
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From page 141... ...
In the three hospital cases, these shocks included the introduction of the Diagnotic Related Group payment reimbursement system, increasing competitiveness of the hospital industry, infant deaths in the neonatal intensive care unit, as well as results of an employee survey.
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From page 142... ...
or not accepted as important enough to motivate innovative action. With regarc]
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Finally, other organizational activities may appear unrelated to the innovation but often compete for scarce resources and thwart the innovation adoption process [e.g., the introduction of new computerized reporting procedures during the nursing schedule experiment)
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From page 144... ...
For example, in the ECMO case, one way of decreasing complexity of the innovation was to focus on adopting it in the neonatal intensive care unit before efforts were macle to introduce it for regional use with other hospitals in the metropolitan area. In our studies of innovation, we observed organizational adopters to exhibit an impatient quest to leapfrog into a large program or technology without evaluating the merits of the core innovation ;Van de yen, Venkataraman, Polley, and Garuc3, 19891.
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From page 145... ...
in-process criteria of innovation success often shifted over time as the initial euphoria with an innovation waned and new, more exciting alternatives became apparent to organizational participants. Thus, although extensive errors were detected in the Minnesota innovation studies, very few were corrected, and they snowballed!
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From page 146... ...
As a consequence, there is a blurring between "success" and "failure" as results are interpreted in relation to differing personal perspectives and frames of reference {Dornblaser et al., 19891. Perhaps the root problem for why little learning is observed as setbacks arise exists in the basic adoption process moclel itself, which many organizations have come to use to guide their action.
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From page 147... ...
In the organizations where innovations are "home grown," Schroecler et al. t1986J found that implementation and adoption activities often occur throughout the development period, by linking and integrating the new with the old, as opposed to substituting, transforming, or replacing the existing organizational arrangements with the new innovation.
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From page 148... ...
Although this approach provides one way to clear with proliferating complexity f others will be suggested belowl, this may often not be a wise strategy to clear with organizational political life. Linguist and Mauriel 1989 compared two common alternative strategies for adopting and implementing innovations: a breadth strategy in which the innovation is implemented across all organizational units simultaneously, and a depth strategy in which the innovation is implemented and debugger]
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From page 149... ...
Although it might be argued that these scientific methods enhanced the validity of findings from the experiment, they hac3 the tracle-off effects of creating animosity among the staff because experimental procedures permitted no choice or participation in their design or in the work schedules to which nurses were ranclomly assigned. Furthermore, as is common to any depth innovation adoption strategy, nurses in each experimental scheduTe were isolated from those working on other schedules.
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These structures! junctures in the adoption process establish key deadlines to perform planned intermecliate tasks, force things to come together, and facilitate unplanned intersections of key ideas, people, transactions, and outcomes.
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From page 151... ...
Contingencies in the Innovation Adoption Process We may never find one best way to innovate. As the three cases of hospital innovation adoption in this volume suggest, a sophisticated manager of innovation will try instead to identify those contingent factors that influence what works and what floes not.
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From page 152... ...
Innovation Stage and Temporal Duration Transitions from innovation invention to development to adoption activities often entail shifts from radical to incremental and from divergent to convergent thinking. As innovations approach the culminating institutionalization step, they become more highly structured and stabilized in their patterns and less differentiated from other organizational arrangements ;Zaltman et al., 1973; Linguist ant]
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From page 153... ...
found were critical to successful adoption of innovations in large organizations. CONCLUSION This chapter has attempted to explain why the three hospital cases presented in this book were successful in adopting their innovations and what can be learned from these cases to understand organizational innovation adoption.
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From page 154... ...
3. Once adoption activities begin, the process floes not unfold in a simple linear sequence of stages and substages; insteacl, it proliferates into complex bundles of innovation ideas and divergent paths of activities by organizational units.
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From page 155... ...
Professor William McKelvey at the University of California, Los Angeles, tells a story of the 1976 Winter Olympics, where Franz Klammer won the men's downhill skiing competition. When interviewed after the event ant!
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Chapter 18 in Research on the Management of Innovation: The Minnesota Studies, A
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From page 157... ...
1981. Organizational innovation: The influence of individual, organizational, and contextual factors on hospital adoption of technology and administrative innovations.
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From page 158... ...
1986. Managing innovation and change processes: Findings from the Minnesota innovation research program.
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