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Health System-Level Factors Influence the Implementation of Complex Innovations in Cancer Care
Robin Urquhart1, Lois Jackson2, Joan Sargeant3
1Assistant Professor, Department of Surgery, Dalhousie University, Halifax, NS.
Background:
The movement of new knowledge and tools into healthcare settings continues to be a slow, complex and poorly understood process. In this paper, we present the system-level factors important to the implementation of synoptic reporting tools in two initiatives (or cases) in Nova Scotia, Canada.
Methods:
This study used case study methodology. Data were collected through interviews with key informants, document analysis, non-participant observation and tool use/examination. Analysis involved production of case histories, analysis of each case and a cross-case analysis.
Results:
The healthcare system's delivery and support structure, information technology infrastructure, policy environment and history of collaboration and inter-organizational relationships influenced tool implementation in the two cases.
Conclusions:
The findings provide an in-depth, nuanced understanding of how healthcare system components can influence the implementation of a new tool in clinical practice.
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