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Value-based healthcare translated: a complementary view of implementation.

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Summary

Management innovations (MIs) are complex to implement. Translation theory offers a new perspective, suggesting MIs should be adapted to organizational contexts rather than strictly followed, leading to successful implementation.

Keywords:
AmbiguityCFIRContextualizationHealth care managementImplementationInsider researchManagement innovationTranslationValue-based health care

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Area of Science:

  • Healthcare Management
  • Implementation Science
  • Organizational Psychology

Background:

  • Management innovations (MIs) present unique implementation challenges compared to medical interventions.
  • Translation theory posits that innovations are adapted to specific contexts, differing from traditional implementation views.
  • Understanding the application of translation theory to the Consolidated Framework of Implementation Research (CFIR) is crucial for managing MIs.

Purpose of the Study:

  • To explore how translation theory can enhance the CFIR for implementing management innovations (MIs).
  • To analyze the two-year implementation of Value-Based Health Care (VBHC) in a psychiatric department using a translation theory lens.
  • To provide insights into the complex process of putting MIs into practice within healthcare settings.

Main Methods:

  • A longitudinal qualitative case study was conducted over two years.
  • An insider researcher collected data through field notes, documents, and meeting recordings.
  • Data were analyzed jointly by an insider and an outsider researcher to ensure rigor and mitigate bias.

Main Results:

  • The Consolidated Framework for Implementation Research (CFIR) did not fully explain the implementation process.
  • Intervention characteristics of the management innovation were modified during implementation.
  • The implementation process deviated from initial plans, yet stakeholders perceived the project as successful.

Conclusions:

  • Translation theory suggests adapting MIs to organizational needs is more effective than strict adherence.
  • The importance of the strength of evidence for MIs may be less critical than for medical innovations.
  • Viewing implementation as a dynamic, adaptable process is more beneficial for MIs than rigid planning and execution.