title: The contingencies of organizational learning in long-term care: factors that affect innovation adoption.
abstract: We apply the theoretical frameworks of knowledge transfer and organizational learning, and findings from studies of clinical practice guideline (CPG) implementation in health care, to develop a contingency model of innovation adoption in long-term care (LTC) facilities. Our focus is on a particular type of innovation, CPGs designed to improve the quality of LTC. Our interest in this area is founded on the premise that the ability of LTC organizations to adopt and sustain the use of innovations like CPGs is contingent on the initial capacity these institutions have to learn about them, and on the presence of factors that contribute to capacity building at each stage of innovation adoption. Based on our review of relevant theory, we develop a set of fifteen testable propositions that relate factors operating at the guideline, individual, organizational, and environmental levels in LTC institutions to stages of guideline adoption/transfer. Our model offers insights into the complexities of adopting and sustaining innovations in LTC facilities particularly, in health care organizations specifically, and in service organizations generally.
authors.affiliation: Health Services Organization and Management, Department of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada. whit.berta@utoronto.ca
authors.forename: Whitney
authors.initials: W
authors.lastname: Berta
authors.forename: Gary F
authors.initials: GF
authors.lastname: Teare
authors.forename: Erin
authors.initials: E
authors.lastname: Gilbart
authors.forename: Liane Soberman
authors.initials: LS
authors.lastname: Ginsburg
authors.forename: Louise
authors.initials: L
authors.lastname: Lemieux-Charles
authors.forename: Dave
authors.initials: D
authors.lastname: Davis
authors.forename: Susan
authors.initials: S
authors.lastname: Rappolt
mesh_terms: D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007858:Learning; D009735:Nursing Homes; D009864:Ontario; D015279:Organizational Culture; D009936:Organizational Innovation; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011787:Quality of Health Care