title: Technology adoption and implementation in organisations: comparative case studies of 12 English NHS Trusts.
abstract: OBJECTIVE
  To understand organisational technology adoption (initiation, adoption decision, implementation) by looking at the different types of innovation knowledge used during this process.
  
  
  METHODS
  Qualitative, multisite, comparative case study design.
  
  
  METHODS
  One primary care and 11 acute care organisations (trusts) across all health regions in England in the context of infection prevention and control.   PARTICIPANTS AND DATA ANALYSIS:  121 semistructured individual and group interviews with 109 informants, involving clinical and non-clinical staff from all organisational levels and various professional groups. Documentary evidence and field notes were also used. 38 technology adoption processes were analysed using an integrated approach combining inductive and deductive reasoning.
  
  
  RESULTS
  Those involved in the process variably accessed three types of innovation knowledge: 'awareness' (information that an innovation exists), 'principles' (information about an innovation's functioning principles) and 'how-to' (information required to use an innovation properly at individual and organisational levels). Centralised (national, government-led) and local sources were used to obtain this knowledge. Localised professional networks were preferred sources for all three types of knowledge. Professional backgrounds influenced an asymmetric attention to different types of innovation knowledge. When less attention was given to 'how-to' compared with 'principles' knowledge at the early stages of the process, this contributed to 12 cases of incomplete implementation or discontinuance after initial adoption.
  
  
  CONCLUSIONS
  Potential adopters and change agents often overlooked or undervalued 'how-to' knowledge. Balancing 'principles' and 'how-to' knowledge early in the innovation process enhanced successful technology adoption and implementation by considering efficacy as well as strategic, structural and cultural fit with the organisation's context. This learning is critical given the policy emphasis for health organisations to be innovation-ready.
authors.affiliation: Department of Infectious Diseases, National Centre for Infection Prevention and Management, Faculty of Medicine, Imperial College London, London, UK.
authors.forename: Yiannis
authors.initials: Y
authors.lastname: Kyratsis
authors.forename: Raheelah
authors.initials: R
authors.lastname: Ahmad
authors.forename: Alison
authors.initials: A
authors.lastname: Holmes