| Implementing complex innovations: Factors influencing middle manager support. | |
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MedLine Citation:
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PMID: 21691212 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: Middle manager resistance is often described as a major challenge for upper-level administrators seeking to implement complex innovations such as evidence-based protocols or new skills training. However, factors influencing middle manager support for innovation implementation are currently understudied in the U.S. health care literature. PURPOSE:: This article examined the factors that influence middle managers' support for and participation in the implementation of work-based learning, a complex innovation adopted by health care organizations to improve the jobs, educational pathways, skills, and/or credentials of their frontline workers. METHODS:: We conducted semistructured interviews and focus groups with 92 middle managers in 17 health care organizations. Questions focused on understanding middle managers' support for work-based learning as a complex innovation, facilitators and barriers to the implementation process, and the systems changes needed to support the implementation of this innovation. FINDINGS:: Factors that emerged as influential to middle manager support were similar to those found in broader models of innovation implementation within the health care literature. However, our findings extend previous research by developing an understanding about how middle managers perceived these constructs and by identifying specific strategies for how to influence middle manager support for the innovation implementation process. These findings were generally consistent across different types of health care organizations. PRACTICE IMPLICATIONS:: Study findings suggest that middle manager support was highest when managers felt the innovation fit their workplace needs and priorities and when they had more discretion and control over how it was implemented. Leaders seeking to implement innovations should consider the interplay between middle managers' control and discretion, their narrow focus on the performance of their own departments or units, and the dedication of staff and other resources for empowering their managers to implement these complex innovations. |
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Authors:
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Emmeline Chuang; Kendra Jason; Jennifer Craft Morgan |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-17 |
Journal Detail:
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Title: Health care management review Volume: - ISSN: 1550-5030 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7611530 Medline TA: Health Care Manage Rev Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Emmeline Chuang, PhD, is Postdoctoral Research Scholar, Department of Mental Health Law and Policy, Department of Child and Family Studies, University of South Florida, Tampa. E-mail: echuang@usf.edu. Kendra Jason, MS, is Doctoral Candidate, Department of Sociology, North Carolina State University, Raleigh. E-mail: kjason@email.unc.edu. Jennifer Craft Morgan, PhD, is Associate Director for Research, Institute on Aging, University of North Carolina at Chapel Hill. E-mail: craft@email.unc.edu. |
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