We apply the theoretical frameworks of knowledge transfer and organizational learning, and findings from studies of clinical practice guideline (CPG) implementation in health care, to develop a contingency model of innovation adoption in long-term care (LTC) facilities. Our focus is on a particular type of innovation, CPGs designed to improve the quality of LTC. Our interest in this area is founded on the premise that the ability of LTC organizations to adopt and sustain the use of innovations like CPGs is contingent on the initial capacity these institutions have to learn about them, and on the presence of factors that contribute to capacity building at each stage of innovation adoption. Based on our review of relevant theory, we develop a set of fifteen testable propositions that relate factors operating at the guideline, individual, organizational, and environmental levels in LTC institutions to stages of guideline adoption/transfer. Our model offers insights into the complexities of adopting and sustaining innovations in LTC facilities particularly, in health care organizations specifically, and in service organizations generally.
Whitney Berta, PhD, is Assistant Professor, Health Services Organization and Management, Department of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada. E-mail: firstname.lastname@example.org.
Gary F. Teare PhD, is Director, Quality Measurement and Analysis, Health Quality Council, Saskatoon, Saskatchewan; is Research Scientist, Toronto Rehabilitation Institute; is Assistant Professor, Health Policy, Management and Evaluation, University of Toronto; is Adjunct Scientist, Institute for Clinical Evaluative Sciences, Ontario, Canada.
Erin Gilbart, PhD, Health Results Team, Ontario Ministry of Health and Long-Term Care, Canada.
Liane Soberman Ginsburg, PhD, is Assistant Professor, School of Health Policy and Management, York University, Ontario, Canada.
Louise Lemieux-Charles, PhD, is Associate Professor, Health Services Organization and Management; is Chair, Department of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.
Dave Davis, MD, is Assistant Professor, Department of Health Policy, Management and Evaluation; is Professor, Department of Family and Community Medicine; is Associate Dean, Continuing Education, Medicine, University of Toronto, Ontario, Canada.
Susan Rappolt, PhD, is Assistant Professor, Department of Occupational Therapy, University of Toronto; is Research Scientist, Toronto Rehabilitation Institute, Ontario, Canada.