Contested innovation: the diffusion of interprofessionalism across a health system

Area of Science:

• Healthcare Management
• Health Services Research
• Innovation Theory

Background:

• Interprofessionalism (IP) is a growing healthcare movement addressing workforce shortages, quality, and safety.
• Stakeholder dynamics involve 'push' (e.g., government) and 'pull' (e.g., health systems) forces influencing IP adoption.
• Innovation theory suggests unequal forces facilitate or resist IP implementation.

Purpose of the Study:

• To test a hypothesis on unequal stakeholder forces (push/pull) influencing interprofessionalism (IP).
• To identify key drivers and resistors of IP based on innovation theory.

Main Methods:

• A model of IP forces was tested in a defined health jurisdiction.
• Data collected via 99 individual and 372 group interviews, plus document analysis.

Main Results:

• Healthcare systems and services exerted the strongest pull for IP.
• Individual champions in power positions were the most significant push factor.
• Government support for health workforce reform was a weak push factor.

Conclusions:

• Hypothesis supported: strongest pull from providers, strongest push from government/higher education.
• Model requires extension to include contextual factors like large-scale reforms impacting IP.
• Understanding stakeholder dynamics is crucial for successful interprofessionalism implementation.