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Using organization theory to position middle-level managers as agents of evidence-based practice implementation
Sarah A Birken1, Graeme Currie2
1Department of Implementation Science, Wake Forest School of Medicine, 525@Vine Room 5219, Medical Center Boulevard, Winston-Salem, NC, 27157, USA. sbirken@wakehealth.edu.
Implementation Science : IS
|April 10, 2021
Summary
Middle-level managers (MLMs) significantly influence evidence-based practice (EBP) implementation. Organization theory offers strategies to enhance MLM roles in adapting EBPs within specific contexts for improved healthcare delivery.
Area of Science:
- Organizational theory applied to healthcare management.
- Implementation science and evidence-based practice (EBP) dissemination.
- Healthcare professional roles in organizational change.
Background:
- Middle-level managers (MLMs) are crucial for implementing evidence-based practices (EBPs) in healthcare.
- Existing research often overlooks the organizational dynamics influencing MLM roles in EBP implementation.
- A theoretical framework is needed to understand how MLMs facilitate or hinder EBP adoption.
Discussion:
- Organization theory provides a lens to optimize MLM engagement by integrating understanding of EBPs, context, and implementation strategies.
- Delineating MLM types (generalist vs. hybrid) reveals distinct contributions to EBP implementation.
- MLMs' vertical linking pin role can be strengthened by external environmental interactions, and lateral connections enhance collective impact.
Key Insights:
- MLMs' contextual understanding enables adaptation of EBPs for improved effectiveness and implementation.
- Enhancing MLMs' external interactions and internal networks can optimize their strategic role in EBP adoption.
- Integrating EBPs, context, and implementation strategies is key to leveraging MLM influence.
Outlook:
- Future research should explore specific organizational interventions to support MLMs in EBP implementation.
- Investigating the impact of different MLM roles and network structures on EBP outcomes is warranted.
- Developing practical strategies based on organizational theory can enhance healthcare organizations' capacity for evidence-based practice.
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