When the user is not the chooser: learning from stakeholder involvement in technology adoption decisions in infection control.
BACKGROUND
Health systems need efficient and effective innovation decisions to provide maximum benefit to patients, particularly in a climate of financial constraints. Although evidence-based innovations exist for helping to address healthcare-associated infections, the uptake and implementation of these is highly variable and in some cases very slow.


OBJECTIVE
To investigate innovation adoption decisions and implementation processes from an organizational perspective, focusing on the implications of stakeholder involvement during the innovation process.


METHODS
Thirty-eight technology adoption decisions and implementation processes were examined through 121 qualitative interviews in 12 National Health Service healthcare organizations across England.


RESULTS
Stakeholder involvement varied across organizations with decisions highly exclusive to the infection prevention and control (IPC) team, to highly inclusive of wider organizational members. The context, including organizational culture, previous experience, and logistical factors influenced the level of stakeholder engagement. The timing of stakeholder involvement in the process impacted on: (i) the range of innovations considered; (ii) the technologies selected, and (iii) the success of technology implementation. Cases of non-adoption, discontinued adoption, and of successful implementation are presented to share learning. The potential benefits of stakeholder involvement for 'successful' innovation adoption are presented including a goal-oriented framework for involvement.


CONCLUSIONS
Key stakeholder involvement can lead to innovation adoption and implementation compatible with structural and cultural contexts, particularly when involvement crosses the phases of initiation, decision-making and implementation. Involving members of the wider healthcare organization can raise the profile of IPC and reinforce efforts to make IPC everybody's business.
National Centre for Infection Prevention and Management, Faculty of Medicine, Imperial College London, UK. raheelah.ahmad@imperial.ac.uk
R
R
Ahmad
Y
Y
Kyratsis
A
A
Holmes
D001291:Attitude of Health Personnel; D003659:Decision Making, Organizational; D003695:Delivery of Health Care / Q000379:methods; D004059:Diffusion of Innovation; D004739:England; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000295:instrumentation / Q000379:methods; D007407:Interviews as Topic; D009313:National Health Programs; D009936:Organizational Innovation; D036301:Qualitative Research; D013672:Technology